July 2008 Health & Wellness:
Protect your skin!

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Study: U.S. Adults Skimp on Sun Care

A new study shows that most U.S. adults don't practice top-notch sun protection. Here are the top areas for improvement:

• Wear a wide-brimmed hat, long-sleeved shirt, and long pants or other clothes reaching the ankles.
• Wear sunscreen with an SPF of at least 15.
• Limit your time in the sun.
• Don't get sunburned.
• Don't use indoor tanning devices.

About two-thirds of U.S. adults only practice two of those sun protection habits, according to the new study, which is based on a 2005 survey completed by more than 28,000 adults.

People younger than 40, whites, Midwesterners, smokers, heavy drinkers, people who say their skin isn't sensitive to the sun, and people with less education were more likely to have bad sun protection habits.

Getting too much sun makes skin cancer more likely. And even if you wear sunscreen, you should also practice other forms of sun protection, such as limiting your time in the sun.

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Not just lip service: Gloss can invite skin cancers makes the sun’s UV rays hit harder -- MSNBC

Right now, 23-year-old Laura Brown has at least six lip glosses on her. They’re in her backpack, her purse, her pocket, her makeup bag — and just in case, she keeps a couple of spares at her desk and in her bathroom.

Brown, who lives in College Station, Texas, assumes she takes very good care of her lips. She spends enough money on them, anyway. (A tube of her go-to brand, Mac, can cost as much as $20.) And she’s always gooping something on her lips. That’s got to be enough of a barrier between her skin and the sun. Right?

But some dermatologists say that slathering on shiny lip glosses can actually increase your risk of developing skin cancer. Of course, wearing any lip product without SPF doesn’t exactly shield the thin skin from sun damage. But the slick, shiny nature of the gloss could be making the sun’s UV rays hit harder, some experts say.

“These lip glosses can make more of the light rays penetrate directly through the skin instead of getting reflected off of the skin’s surface,” says Dr. Christine Brown, a dermatologist at Baylor University Medical Center in Dallas. (You're covered, however, if you wear lip gloss with SPF.)

At worst, say some dermatologists, the resulting sun damage can lead to potentially fatal forms of skin cancer. An estimated 3,500 new cases of skin cancer of the lips are diagnosed each year, and 90 percent of those cancers are squamous cell carcinoma. While that form of cancer isn't usually particularly serious, it can be more aggressive on the lips than on other parts of the skin. If left untreated, it can cause disfigurement, and in very few cases, it can spread to other organs and become deadly.

But the less serious effects may grab a lip gloss junkie’s attention more quickly: All that sun exposure could be slowly building gross, non-cancerous disfigurements on your lips. One such effect is actinic keratosis, a small, scaly patch of skin that can morph into a wart-like bump if left untreated. Sun exposure can also cause small brown spots that look like freckles on the lips. The spots are noncancerous but could cause people to whisper, "Hey, you've got food on your lips."

Sun damage can also cause premature aging, making the already thin skin on your lips even thinner, which can lead to rips and tears. Ultraviolet light zaps skin of much of its elasticity, leaving the skin lax. That lack of elasticity can prevent the upper and lower lips from lining up properly, which can cause pools of saliva to collect at the corners of the mouth.

It's the moisture in lip gloss that's to blame, says Dr. Bruce Robinson, a Manhattan dermatologist. Your lips are equipped with a protective outer layer, but the hydration of a lip gloss "kind of smooshes that down," Robinson says. Once that outer layer is effectively squashed, it's easier for UV rays to penetrate deeper into the skin.

"Instead of having to travel through that thicker layer, it's more condensed," Robinson says. "So the UV rays reach are reaching deeper layers of epidermis and dermis because you don't have this forcefield."

Sun's laser focus on lips
Apart from the extra hydration, the “super shine” and “ultra shine” of the glosses could be damaging as well.

“Take a magnifying glass and put it over your lips,” Robinson says. When you apply lip gloss and go out in the sun, “that’s essentially what you’re doing.”

But no studies have confirmed the lip gloss-skin cancer link, and not all dermatologists agree that it poses a risk.

“The only way I could see it is if you’re thinking you’re protected, and you stay out in the sun longer, that may increase your risk,” says Robin Ashinoff, a dermatologist in Hackensack, N.J.

That's what happened to Sherry Duplar, a fair-skinned, horseback-riding redhead who spends as much time as possible outdoors. She always applied lip balm or gloss, and figured that was enough.

“I didn’t realize, back then, that our lips were so susceptible,” says Duplar, who’s 59 and lives in Mesquite, Texas.

But about 12 years ago, Duplar’s lips were cracked and chapped, and constantly peeling, and nothing she did would heal them. She’d developed actinic cheilitis, a precancerous condition that's sometimes known as "farmer's lip" or "sailor's lip." It often leads to squamous cell carcinoma, a form of skin cancer.

Since then, she’s had three laser treatments, to deconstruct the affected skin cells. The treatments which leave her lips raw, swelled up and oozing, for as many as three weeks. “It was nasty,” Duplar says.

Now she slathers on lip balm boasting 50 SPF before she goes out in the sun, which makes her dermatologist, the lip gloss-bashing Brown, much happier. Brown wishes women would abandon their lip glosses for lip balm with an SPF of at least 30. But for those who balk at tossing all their lip gloss, Robinson offers a compromise: find a lip gloss infused with SPF, which also protects the lips from ultraviolet light.

Saving Young Skin From the Sun’s Perils

Dr. Michael L. Ramsey, a dermatologist at the Geisinger Medical Center in Danville, Pa., coaches his son’s Little League team these summery days when he’s not removing patients’ skin cancers.

“The last thing I want is to someday see one of my baseball players as a patient,” he remarked recently in The Skin Cancer Foundation Journal.

And so, while encouraging the players to do their best on the field, he also pays close attention to their need to protect themselves from the sun’s skin-damaging ultraviolet rays. For he knows all too well that more than 90 percent of all skin cancers are caused by sun exposure; that the risk for a future skin cancer doubles with five or more sunburns; and that while the jury is still out, the risk of future melanoma, the deadliest form of skin cancer, may well be increased by even one blistering sunburn in childhood.

Moreover, while children may find it hard to imagine ever being old (over 50), repeated sun exposure also ages the skin, causing premature wrinkling and a mottled, leathery hide that resembles an elephant’s. It may also be hard to impress children with the possibility of cumulative sun damage to their eyes, like cataracts.

Children — as well as their parents and school authorities — have a lot to learn about protection against sun damage. Arrangements should be made in school, for example, for children to apply sunscreen and wear hats at recess. A child’s skin is especially vulnerable to the damaging effects of ultraviolet radiation. Most children will have had nearly a quarter of their lifetime exposure to this radiation by age 18, and the resulting damage is compounded repeatedly by subsequent exposure.

I’d be the last person to suggest that children spend the glorious months of summer indoors. I want them out playing actively year-round, and the warm months are ideal for such activities as running through sprinklers, swimming, boating, playing ball, riding bicycles and scooters, playing in sandboxes and on playground equipment, and otherwise having a grand old time being children.

But just as children must be protected against the hazards of traffic and predators, so must they also be protected against the downside of that life-giving force, the sun. Yet a study in Florida in 2001 found that only 33 percent of parents used any form of sun protection for their children, and those who did relied solely on sunscreen, which other studies have found is used incorrectly most of the time.

Some parents worry about a possible deficiency of vitamin D in babies kept out of the sun, since this essential nutrient is produced in skin in the presence of sunlight. But it takes only a few minutes of exposure to ultraviolet light two or three times a week during the summer months to make enough vitamin D to last all year. And child health experts, including the American Academy of Pediatrics, suggest that a safer alternative is to take 200 International Units of vitamin D a day, starting at the age of 2 months, through infant formula, fortified cows’ milk or soy milk, or a vitamin. Short of remaining indoors, there are three main approaches to sun protection, regardless of age:

• Wearing clothes that block much of the sun’s radiation.
• Applying a complete sunscreen throughout the day every day.
• Staying out of the midday sun and in the shade as much as possible.

Protective Clothing

Dermatologists consider “covering up” to be the first line of defense against skin-damaging ultraviolet radiation. That means wearing long-sleeved shirts and long pants, a hat that shields the face, ears and back of the neck, and sunglasses. I don’t know about you, but I sure wouldn’t want to have my arms and legs covered in clothing on 90-degree days, especially not when I’m running around playing. Nor would I expect my grandsons to be so attired.

However, for as long as parents can get away with it, clothing is the ideal sunblock. In fact, for infants under 6 months old it is the only sunblock, far more effective than keeping babies in the shade. The skin of very young children is highly susceptible to sunburn and other harmful effects of ultraviolet radiation.

Wise parents will start putting hats on their children as soon as they are born and never stop. That greatly reduces battles about wearing a hat when they’re older. A baseball-style cap is not enough. The hat should have a full wide brim or desert-type flap that shields the face, ears and back of the neck.

Dark-colored clothing (again, not ideal for a hot summer day) is a better sunscreen than something light-colored. A white T-shirt, which some children wear in the water, has an sun protection factor, or S.P.F., of only about two when wet.

Instead of buying your child a costly toy this summer, consider investing in clothing specially designed with a built-in S.P.F. of 30 that offers 97 percent ultraviolet protection. One popular brand, Solumbra, includes neck-to-ankle swim suits for toddlers and swim shirts and leggings for older children, as well as everyday sun-protective clothing for children through size 12. The Web site is www.sunprecautions.com and the phone number is (800) 882-7860.

The fabric in this and other brands is designed to retain sun-protective properties through scores of washings, and the clothes can be handed down to younger children. Alternatively, try washing your children’s clothes with SunGuard, which treats fabric with Tinosorb, offering 96 percent ultraviolet protection that is retained through about 20 washings.

And don’t forget sunglasses with full ultraviolet protection (check the label), which should be worn by babies and children as well as adults. An elastic band can keep them on and not easily lost.

The Sunscreen Necessity

This is a must for everyone starting at age 6 months, and there are now many effective products to choose from, including some that incorporate a light artificial tanning agent. Make sure the product provides full ultraviolet protection, against both UVA and UVB rays. The S.P.F. rating, which should be 15 or higher, refers only to UVB, the burning rays. Products with higher S.P.F. ratings offer minimal added protection.

Whether it is sunny or overcast and whether the child’s skin is light or dark, sunscreen should be applied daily, 20 minutes before the child goes outdoors so the chemicals can interact with skin. And it should be reapplied every two hours, because sun gradually degrades the chemicals. Each application should fully cover the child’s exposed skin, including ears and feet. Add a lip balm with an S.P.F. of 15 or higher.

Look for water-resistant products, though even these should be reapplied after swimming or heavy sweating. And check the expiration date because old sunscreen may lose some effectiveness.

Made in the Shade

While staying in the shade is better than nothing, a lot of ultraviolet radiation is reflected off the ground or nearby objects when you are under an awning or beach umbrella. Infants should be protected by shade as well as clothing.

Even with sunscreen on, it is best to keep children out of the sun from 10 a.m. to 4 p.m. Parents may have to lobby their schools to provide shaded areas for children during recess.

Finally, set a good example by following the above advice yourself. For additional information, see “Sun Protection for Life,” by Mary Mills Barrow and John F. Barrow (New Harbinger Publications, 2005).