Tips & Wisdom
Sun Protection Tips
Exposure to the sun has been associated with melanoma, non-melanoma skin cancers (basal cell and squamous cell carcinoma), and photo-aging (wrinkling, fragile skin, and spotty dyspigmentation (so called “liver spots”). Both melanoma and non-melanoma skin cancers are more common in those with light skin, light hair, and blue eyes, those who sunburn easily, suntan poorly, or freckle with sun exposure.
There is good evidence that the risk of both melanoma and non-melanoma skin cancers is increased with increased UV exposure, although they differ in the way that UV exposure causes them and this influences prevention. Non-melanoma skin cancers are most strongly related to lifelong chronic UV exposure, whereas melanoma correlates best with episodic UV exposure and blistering sunburns.
UVA & UVB
There are two forms of ultraviolet (UV) light to protect against: UVA and UVB. UVA is present throughout the entire day (not just the peak sun hours), and comes through glass and clouds. UVA plays a key role in skin wrinkling, leathering, and skin cancer promotion.
UVB are burning rays present in greatest amounts during midday. UVB rays play a major role in skin cancer promotion and photoaging.
The sun protection factor (SPF) number on the sunscreen lotion is a guide as to how long you can stay in the sun before risking sunburn. Recent studies have shown that most people apply sunscreens too thinly and therefore the SPF is probably less than what it says on the bottle.
“Waterproof” on the sunscreen label indicates that the protection is effective for four 20-minute swims. “Water resistant” is effective for two 20-minute swims. Reapply more frequently if perspiring excessively or toweling off frequently. Whichever form of sunscreen is chosen, it must be applied 20 to 30 minutes before being exposed to the sun. A new component of sunscreens, Parsol or Avobenzone, extends the protection from UVA and is advisable.
Choosing a sunscreen is an important part of your complete sun protection program but remember it is only one part! Sunscreens are typically divided into two broad categories: physical and chemical. Physical sunscreens such as titanium dioxide and zinc oxide actually reflect and scatter ultraviolet light, while chemical sunscreens act as protective filters by absorbing ultraviolet light.
Patients with sensitive skin may benefit from using sunscreens with no dyes or perfumes. Patients with acne or oily skin should use sunscreens that include “hypo-comedogenic or non-comedogenic” on the label. These words mean that this product will be less likely to clog skin pores and contribute to acne.
Types of Sunscreen Vehicles
- Oils: The most effective sunscreen ingredients are oil-based. They spread easily and have good water resistance. However, they are greasy and messy, cost more, and are easy to spread too thinly (which reduces their SPF).
- Emulsions: These are creams or lotions and are the most widely used sunscreen vehicles. They feel good and are easy to spread. The difference between creams and lotions depends on how much oil is used in the emulsion and therefore how viscous the product is.
- Ointments: These are unpopular because they are thick and greasy. Their use is restricted to activities involving prolonged water exposure such as surfing.
- Gels: The water-based gels do not feel greasy or occlusive and are popular with people with oily skin and those who are more physically active. They are difficult to apply uniformly and can be irritating. Alcohol-based gels are more water resistant but can sting, especially around the eyes.
- Sticks: Great for localized areas such as the nose and lips.
- Aerosolized Sunscreens: Usually oil based. Are easy to use but apply unevenly.
Recommendations for proper sun protection
- Apply before going out. It takes about 20 minutes for the active sunscreen ingredients to fully absorb into the skin.
- Apply enough (about one ounce for an adult body). The effectiveness of any sunscreen depends on the amount applied.
- Reapply frequently. Sunscreens become inactivated over time and they also get rubbed, sweated and washed away. Reapply every two hours and after swimming for maximum effect.
- Use a broad-spectrum and high SPF product of at least SPF 15 that contains both UVA and UVB.
- Don’t rely on sunscreen alone. Use sun protection such as hat, sunglasses with UV protection, long-sleeved clothing. Beware of reflectivity from sand, snow, cement and water. Utilize the shade.
- Don’t use sunscreen as an excuse to spend more time in the sun. Limit child’s UV exposure by decreasing time in the sun during peak sun hours (10 a.m. to 3 p.m.). Individualize interventions based on child’s skin color, susceptibility to burns, family history and presence of moles.
- Babies under six month sold should be kept out of direct sunlight and have adequate clothing for physical protection. Most recommend sunscreen for infants over six months. Selected use in younger infants is not harmful but should rarely be necessary because they should not be exposed to direct sunlight.
Rosacea is a chronic skin condition that can lead to facial redness, enlarged blood vessels on the cheeks and nose, red bumps and pimples. In advanced stages, it can lead to thickened skin on the nose.
Rosacea usually affect the face, and is sometimes present on the neck and chest, as well. These symptoms occurs most frequently in people with fair skin, although people of any skin color can have them. Rosacea usually occurs in adults 30 to 60 years old. Although it affects more women than men, the symptoms are often more severe in men.
The first signs and symptoms include frequent flushing and redness of the face and neck. The exact cause of rosacea is not known but many factors can trigger a flare-up. Many people report the following rosacea triggers; sun exposure, hot weather, emotional stress, exercise, alcohol, spicy food, hot food and beverages (especially coffee and tea), hot baths, irritating cosmetics, and certain medicines (especially vasodilators and topical steroids).
As rosacea progresses, small, solid red bumps and pus-filled bumps appear on the face. Thin, red lines caused by enlarged blood vessels may appear on the surface of the skin. These are referred to as "telangiectasias".
Rosacea leads to conditions affecting the eyes in about 20%-30% of those affected. Symptoms may include redness, tearing, stinging and the sensation of a foreign body or grittiness in the eyes. This condition (ocular rosacea) is commonly known as conjunctivitis and should be evaluated by your doctor.
Although rosacea cannot be cured, it can be treated and controlled. The treatment should be tailored to the individual patient. Patients are advised to avoid the rosacea triggers and often benefit from medical treatment.
The red bumps and pustules can be successfully treated with either a topical or oral medicine. Patients usually notice improvement within 3-6 weeks. The enlarged blood vessels are best treated with a laser The flushing or redness on the face is difficult to treat but often responds to laser.Learn More
Hives are itchy, red welts or small bumps that last from 15 minutes to 24 hours. They usually appear suddenly and leave no trace when they disappear (unless they have been scratched). Crops of hives may appear several times a day. They may come and go for days or weeks, sometimes longer.
Hives are common, affecting 10-20% of the population at least once in their lifetime. Hives are certainly annoying, but are otherwise harmless unless they cause throat swelling; this is rare but requires immediate treatment.
What causes hives?
Hives may be caused by something taken internally, most often a medicine such as penicillin or aspirin. Sometimes foods cause hives. Shellfish, nuts, eggs, milk, strawberries and food additives are well-known examples. Hives may appear within minutes or up to several hours after eating.
Hives in children are often caused by infections such as a virus or strep throat, but are rarely the sign of more serious internal disease. Occasionally, physical agents such as pressure or cold can cause hives.
How is it treated?
In treating your or your child's hives, we try to find a cause, but this is not always possible. It may be helpful to keep a record of foods or other ingested items (for example, vitamins, medicines and herbal supplements). However, in 90% of cases we cannot discover the underlying.
Hives are usually controlled with antihistamines, but in order for the antihistamines to prevent the hives from forming, they usually need to be given several times a day, not just when the hives are present. They also help the itching. Some antihistamines cause drowsiness and may only be tolerated at nighttime. Others are non-sedating. Occasionally, antihistamines may make a child hyperactive.
Corticosteroids may need to be prescribed to control the hives and provide symptomatic relief. Hives usually improve within days after medication is begun.Learn More
Jeffrey Sugarman MD is a board-certified Dermatologist and Pediatrician providing care to patients in Santa Rosa, California at Redwood Family Dermatology.
Dr. Sugarman is also an Assistant Clinical Professor in the Departments of Dermatology and Family and Community Medicine at S.C. San Francisco.
Dr. Sugarman has published many articles on topics ranging from cancer research to childhood eczema.
Dr. Sugarman is also an active member of the Sonoma County Medical Association and serves on its editorial board.
Education & Training
Dr. Sugarman then completed a residency in pediatrics at the University of Washington Children’s Regional Medical Center in Seattle, as well as his training in dermatology, which was followed by a fellowship in pediatric dermatology at University of California, San Francisco (UCSF)
Redwood Family Dermatology
In July 2002, Jeffrey Sugarman MD started his practice as a solo physician. He was later joined by Albert Peng MD, Judith Hong, MD, Ligaya Park, DO, Angela Wyble PA-C and Heather Lowe PA-C. The practice also offers the services of an esthetician, Dionne Ferronato. In August 2006 we opened a satellite office in Ukiah which allows us to help the patients from northern and coastal areas without such a long drive.
2725 Mendocino Avenue,
Santa Rosa, California, 95403