Medical Monday: The Ten Commandments of Sun Protection

Women’s Voices’ skin-care guru is dermatologist and dermatologic surgeon Anetta Reszko, M.D., Ph.D., who is Director of New York Skin Institute; a Clinical Assistant Professor of Dermatology at Weill Cornell Medical College; and an Assistant Professor, Dermatology, at New York–Presbyterian Hospital. She has written many detailed articles for us on skin care, ranging from the diagnosis and treatment of pre-cancerous skin growths to a series on skin care for women over 40. Today she turns her attention to everyday sun protection—a more serious matter than you may think. —Ed.

  1. Wear sunscreen and sun-protective clothing (clothing with UV filters) every day, regardless of the weather or season. Sun exposure occurs all day long. Visible and ultraviolet (UV) light can penetrate even through clouds, on a rainy day, and through the glass windows of our homes and cars.
  1. Limit sun exposure by wearing hats/gloves/sun-protective clothing and avoid direct exposure between the peak hours of 10 a.m. to 3 p.m.
  1. Wear sunscreen every day on exposed areas (i.e., face, neck, V-neck, chest, hands/forearms, and legs)—not only for skin cancer protection, but also as a defense against skin aging (photo-aging). Hallmarks of photo-induced aging are coarse lines and wrinkles, brown spots, and skin discolorations.
  1. Reapply sunscreen every 2 hours when outside.
  1. A word about the Sun Protection Factor (SPF):

SPF is defined as the ratio of the length of time in the sun it takes to become sunburned while wearing sunscreen to the length of time in the sun required to burn without sunscreen.

Sunscreen with SPF of 30 blocks 96.7% of UV radiation, whereas SPF50 blocks 98% of UV radiation.

Dr. Reszko’s Tip: High SPF should not give you a false sense of security. SPF100 will not protect you the entire day. You still need to reapply throughout the day.

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  • Dr. Anetta Reszko June 6, 2015 at 11:11 pm

    Coconut oil is quickly gaining reputation of a natural super food. Health websites and blogs that tout natural alternatives are promoting pure, organic coconut oil as a cure for a number of ailments.
    Known health benefits of coconut oil relate to:
    1. the high content of medium chain triglycerides (MCTs), which are direct precursors of ketone bodies that may have therapeutic effects on brain disorders like epilepsy and potentially Alzheimer’s.
    2. anti-microbial properties. Almost 50% of the fatty acids in coconut oil is the 12-carbon lauric acid. Both lauric acid and its main metabolite monolaurin kill harmful pathogens like bacteria, viruses and fungi.

    Many people use coconut oil for its cosmetic purposes to improve the health and appearance of their skin and hair. Some studies on individuals with dry skin show that coconut oil can improve the moisture and lipid content of the skin.
    Only a single study (*) evaluated the effectiveness of the coconut oil as a sunscreen. Estimated effectiveness is only about “20% resistance to the sun’s ultraviolet rays”. By comparison sun block with SPF of 30 blocks 96.7% of UV radiation. Coconut oil should NOT be used as a substitute for sunscreen.

    The issue of intolerance to various skin care products, including sunscreens, is a common issue that I encounter in my clinical practice.
    I commonly utilize a dual approach to patients with product intolerance:
    1. Diagnose/treat underlying skin condition and restore normal skin barrier. Some skin diseases such as rosacea, sun/actinic damage with numerous pre-cancers, atopic dermatitis, irritant and/or allergic contact dermatitis, seborrheic dermatitis, psoriasis may present as skin sensitivity. Treating these underlying conditions improve structure and function of the skin reducing overall sensitivity.
    2. Choose cosmetics and skin care products that work. In general look for products that are non-comedogenic (do not clog pores) and avoid chemical sun screens. You might also consider sun screen in powdered form. It is always a good idea to test a new product by applying it to the inner forearm for a few days in the row. Please see prior installments of my blog for details.
    In my blog I try to refrain from naming individual brands/products and discuss general principles of skin care. That said, I do realize how difficult it is to find “the right” product. Below is the list of sunscreens that I found most tolerable for patients with sensitive skin.
    EltaMD UV Clear Broad-Spectrum SPF 46
    MDSolarSciences Mineral Tinted Crème SPF 30 Broad Spectrum UVA-UVB
    Skin Soothing Mineral Sunscreen with Olive Polyphenols SPF 40

    Have a happy and healthy sun protected summer!

    Dr. Reszko

    (*) Pharmacogn Rev. 2011 Jul;5(10):164-73. doi: 10.4103/0973-7847.91114.
    Potential of herbs in skin protection from ultraviolet radiation.
    Korać RR1, Khambholja KM.

  • Marcia June 4, 2015 at 3:22 pm

    Every sunscreen I have tried from the cheap to the more expensive, has made me break out in itching and a a rash. Is coconut oil a good substitute?

  • Isabela June 2, 2015 at 11:54 am

    Thank you for your advice Dr. Reszko. I really liked the info about Ultraviolet B and “immune surveillance of the skin.” It’s very interesting.

  • Patricia. Moscatello June 1, 2015 at 7:46 am

    Great article, clear and concise.
    I will pass it on to all my nearest and dearest.