Sunscreen - what you need and when you need it

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Benjamin Ringger, MD

There’s no reason for subtlety - you need to protect your skin from the damaging rays of the sun.

Sun protection comes in many different forms, but in the case of sunscreen, consumers should pay special attention to what they put on their skin and how often they do it, according to Dr. Benjamin Ringger, MD of North Idaho Dermatology. It can make a big difference when it comes to avoiding skin damage and cancer.

“Skin can be the most neglected of our organs even though it’s the largest,” Ringger said. “You can do a lot now that will really prevent problems down the road.”

People have many choices of sunscreen based on ingredients, SPF, how it’s applicated to the skin, scent and much more. While Ringger definitely has his preferences, his number one tip is straightforward: Use it.

“People ask me, ‘What’s the best sunscreen to use, and the answer is the one that you like,” Ringger said. “The one you don’t mind putting on, because if you don’t like it, you aren’t going to wear it.”

With that in mind, some sunscreens offer better protection and more preferred ingredients. Some considerations to keep in mind:

Broad spectrum

Sunscreens with the term “Broad Spectrum” on the label mean they block both UVA and UVB rays from the sun. Ultraviolet A rays penetrate deep into the skin and cause long-term skin damage. Ultraviolet B rays are what cause visible sunburns. Ringger said to make sure you’re protecting from both.

“A reason a company might not make it a broad spectrum lotion is that until more recently, it was more difficult to put a UVA lotion on the skin as easily,” Ringger said. “A UVB lotion will protect from sunburn, but if it doesn’t block UVA, you’re still putting yourself more at risk of cancer.”

A lotion that prevents immediate, visible burns may also result in greater sun exposure.

“You’re putting it on really well and feeling good, so that sunscreen enables you to endure more sun than you normally should,” Ringger said.

Ingredients

Ringger said the industry has used some confusing terminology when it comes to sunscreen ingredients. Terms like “natural” and “organic” don’t always mean the same thing when applied to the best sunscreen (the term “inorganic” applies to mineral-based sunscreens, which are currently preferred).

Cutting to the chase - Ringger recommends sunscreens with ingredients of zinc oxide and titanium dioxide. For children, Coeur d’Alene Pediatrics also recommends these barrier creams that coat the skin and often leave a white coating on the skin surface.

“The mineral sunscreens block the widest range of UVA. They reason they are seen as natural sunscreens are because they are not absorbed by your body, whereas the chemical sunscreens are absorbed,” Ringger said.

“The FDA has begun to study the efficacy of the (absorbent chemical products) to see if they result in adverse side effects, but it’s still really early in the process,” he continued.

The zinc oxide and titanium dioxide “barrier creams” have been around a while, though Ringger said companies have begun to develop better formulations that don’t leave you looking completely white.”

Coeur d’Alene Pediatrics listed Blue Lizard, Aveeno Natural/Mineral, Banana Boat Natural and Neutrogena Pure and Free as some brands that include the mineral ingredients.

Application

While traditional lotions are still a big part of the sunscreen market, spray-on sunscreens have grown in popularity because of their convenience and relative ease of application.

“Spray sunscreens can be really effective, and if they aren’t it’s user error in most cases,” Ringger said.

Proper application includes shaking well and physically rubbing the spray into the skin after application. Again, check for preferred ingredients, as only a few spray-application sunscreens are of the mineral-based variety. Coeur d’Alene Pediatrics also warns of certain spray-on and foam sunscreens that are more chemical based and can irritate skin and air passages in some cases.

Water use, SPF and more considerations

Sunscreen isn’t waterproof. Ringger said companies are no longer allowed to claim such a thing. Instead, lotions can say “water-resistant” or “very water-resistant,” and consumers should be aware of the difference.

“Water-resistant is 40 minutes of swimming or sweating before the need for re-application,” Ringger said. “Very water-resistant means 80 minutes of swimming or sweating before needing to reapply.”

SPF (sun protection factor) used to be the big thing in marketing sunscreen to consumers. Nowadays, Ringger said an SPF 15 is good for daily use, while he recommends an SPF 30 for outdoor recreational activity. Coeur d’Alene Pediatrics warns parents to take special notice of the ingredients in higher SPF products, as it typically means more chemicals in the product.

Time of day matters too. The sun is most severe between 10 a.m. and 2 p.m., though Ringger extended that window in the summertime in the Inland Northwest to 4 p.m. Still, regular use of sunscreen and consistent re-application matters.

Put a shirt on!

Clothing - including sun shirts and rash guards - are also excellent ways to protect the body from long-term sun exposure.

“I always tell my patients that clothing is the cheapest and most effective sunscreen there is,” Ringger said. “More and more clothes are even including an SPF rating. Sunscreen can be quite expensive if you are putting it on the way you should.”

He encouraged men to especially consider wearing a shirt more often rather than worrying about getting that tan.

“We’ve got hair on our arms, back and chest, and the more hair you have the harder it gets to apply sunscreen, which means you are less likely to use sunscreen,” Ringger said.

Most sunscreen products also do not recommend use for babies six months of age or younger. Coeur d’Alene Pediatrics notes that barrier sunscreens are safer than sunburns, however, they also recommend thin, light clothing and hats on infants. Try to avoid direct sun exposure by using sun umbrellas, shade trees, etc.

When to see a doctor

“Seek medical attention if you have a sunburn that blisters,” Ringger said. “Sometimes thick, water-filled blisters may need to have some fluid replacement. Other reasons to seek attention are if you feel nauseous or are vomiting, or if you have sunburns over a very large part of your body.”

If you think your skin has been exposed longer than it should have been, Ringger also said a dose of ibuprofen or aspirin can significantly reduce the onset of redness.

Regular skin checks are recommended for people with a family history of melanoma. Also, contact your doctor or seek out a dermatologist if you have a new or changing mole that hasn’t gone away for three months. Look for darkening of existing moles, and marks with changing, irregular edges, he said.

• • •

North Idaho Dermatology is located at 2199 Merrit Creek Loop in Coeur d’Alene. Call (208) 665-7546 or visit www.NIDerm.com for more information. Coeur d’Alene Pediatrics has locations in Coeur d’Alene, Post Falls and Hayden. Visit www.CdaPeds.com for more information.

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