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Wait, You Mean the Sun is Harmful?

Without the light and warmth of the sun, it would not be possible for life to exist on earth. But the sun has a dark side as well. The sun is a nuclear furnace that emits a tremendous amount of electromagnetic radiation. One form of this radiation is invisible, and is known as ultraviolet radiation (UV). These UV rays are dangerous to your skin, eyes, and immune system. UV rays can directly damage DNA that can lead to skin damage and skin cancer, and can also cause the production of harmful substances in the body (free radicals and reactive oxygen species) that can lead to other health disorders.



Harmful Effects of Sun Exposure

UV radiation from the sun cause many medical conditions but also causes many of the unsightly changes in our bodies that are often considered part of the aging process:



-Skin Pigment Abnormalities (freckles, brown sun spots, white spots)

-Leathery Skin

-Thin Skin

-Enlarged and Visible Blood Vessels

-Photodamage and Pre-Cancerous Skin Lesions

-Skin Cancers




So the sun is not great. Should I go to the tanning bed?

Absolutely not. Tanning beds are a great way to get radiation exposure. They use the same UV wavelengths that the sun emits to induce tanning. Rates of melanoma are increasing in all groups, but most in young women in their late teens and twenties. Dermatologists believe this may be due to the high rates of tanning bed use in women in these age groups.



But a tan is healthy, right?

Actually, no. It is true that people with very high levels of melanin have effective protection. This is why it is very rare for dark-skinned people of African descent to develop the typical sun-induced skin cancers. But for the average Caucasian or Hispanic person, the amount of melanin is not enough to effectively prevent skin cancer development.

The melanocytes in the skin do produce more melanin in response to the damage caused by UV light exposure. This results in a tan. Although the increased levels of melanin absorb UV light to prevent damage, the increased levels are just not very protective. A good tan provides only around a 2 to 4 SPF increase, not really enough to effectively protect against the aging and carcinogenic effects of the sun.




Hey, the sun can't be all bad!

It's true. The sun does have some beneficial effects. First, it plays a big part in elevating our mood. People in northern climates with lower levels of sunlight can develop mood disorders and depression that is can actually be treated with visible light (not the harmful UV rays). Also, a large amount of the Vitamin D that we need is created in the skin by the action of sunlight. This is a critical vitamin that plays an important role in the regulation of calcium levels and bone growth. Also, medical science is beginning to discover that Vitamin D also protects against the development of internal cancers. Therefore, it is recommended that patients who practice sun protection and sunscreen use must supplement their diet with foods high in Vitamin D, and dietary supplements that contain Vitamin D.

So the sun can be good for us. We should practice safe moderation, protect ourselves, and prevent against overdosing on the sun.




What about protecting children?

This is very important. Many people get a large percentage of their total lifetime exposure to solar UV light in childhood. All of this sun-induced skin damage is cumulative over a lifetime and manifests in middle age and later as visible signs of aging and skin cancer formation. Studies have suggested that in may only take a small number of bad burns in childhood to pose an increased risk of melanoma.

Parents, protecting your children now will pay a lifetime of dividends as they end up with much less cumulative solar exposure, and they continue sun-protective habits during their adult years. Sun protection in kids should be combined with good nutrition and vitamin supplementation according to pediatrician recommendations to prevent Vitamin D deficiency.



But I have already developed so much sun damage, why start now?

Sun protection is beneficial for everyone. Although sun damage is cumulative, our skin can repair itself somewhat if it is not being constantly bombarded with damaging UV rays.

Although this is not widely known, the sun also lowers the defensive capabilities of the immune system in the skin. Normally, the immune system can detect many skin cancers that are beginning to form, and kill them before they become apparent. With continued exposure to solar UV light, the immune system is prevented from this defensive action, and more skin cancers can develop than would with sun protective measures.




Sun Safety Tips:



- Avoid the Sun When You Can

Sun exposure is inevitable in the course of our daily lives, but we should moderate it.  Care should be taken also on cool and cloudy days.  Just because there is cloud cover, it is no impediment to damaging UV rays that easily penetrate clouds.  If you are going to be out in mid-day sun, look for shade.  Although the sun emits UV rays all the time, the there are factors that greatly increase the amount of damage that can occur:

Season - Levels of UV are much higher in the summer

Time of Day - Peak levels of UV occur between 10 am and 4 pm. Outdoor activities are much safer before and after these times (and more comfortable due to the heat!)

Southern Latitude - You'll get more UV in Corpus Christi than you will in Chicago

High Altitude - You'll get higher levels of UV up in the Rockies than on a beach at sea level


Consider the Effect of Reflective Surfaces

Sunlight reflecting off of water or snow can cause a great deal more exposure than direct sunlight alone.  You may be getting a great deal of UV even when you are in the shade if the rays are directed off of these surfaces.




 -Cover Yourself

Covering up can go a long way toward effective sun protection.  Wide-brimmed hats provide great protection for the face.  Modern day ball-caps provide little to no protection for the lateral cheeks, ears, and neck.  Our ancestors in bonnets, wide cowboy hats, and sombreros were on to something.

Fabric makes a difference in the ability of clothing to protect the skin.  A white T-shirt typically provides little protection (equivalent to a 6 to 8 SPF sunscreen), and it is common to get a sunburn on skin covered by one.  A wet T-shirt drops further to 3 to 4 SPF.  Tighter-woven, and darker fabrics work better.  A good way to test this is to hold the garment up to a light bulb or the sun.  If you can see light through the fabric, like through a white straw hat, it is not doing a great job of sun protection.

There are clothing products with much higher ultraviolet protection factors (UPF).  High UPF hats and swim shirts are a great idea, especially for kids. As sunscreens and sunblocks lose effectiveness with time in the sun, and by washing off, such protective clothing is superior to them for protection.  UPF fabrics of 30 or even 50 are available in a wide variety of products. You can access some of these products online here:

Sunglasses with UV protective lenses are great for protection of the thin, sensitive skin around the eyes, and can help prevent eye complications from UV overdose such as cataracts.




- Use Sunscreen!

Most people use sunscreen when they are going to be hanging around the pool in the summer or spending a day at the beach to prevent sunburns.  But consider that most of the sun exposure that we receive is probably a result of day to day activities, such as driving in the car, or working in the yard on a cool, cloudy day.  By making sunscreen a part of your everyday routine, you won't just be preventing the occasional sunburn, you'll be decreasing the overall cumulative UV exposure that eventually leads to accelerated skin aging, wrinkles, and skin cancers.

It is important to choose a sunscreen that you find comfortable and will wear.  General principles of daily use include choosing an effective sunscreen, applying enough to adequately cover the skin, applying sunscreen to critical areas, and reapplying frequently to maintain effectiveness.  Please see the special section on sunscreens for further discussion on these topics.

Not everyone is going to embrace the idea of everyday sunscreen, and frankly, not everyone needs to.  But some should consider it.  For those patients with extremely fair skin and red or blonde hair, it is essential.  Most women are very concerned about their skin and the effects of aging.  It makes little sense to spend so much time and money on cosmetics, cosmetic dermatology and plastic surgical procedures to fight aging, while continuing to undermine it all by accelerating aging and damage to the skin with sun exposure.

Patients with a personal history or family history of melanoma or a large number of non-melanoma skin cancers should definitely implement everyday sunscreen.  Also, other high-risk patients such as those with lowered immune systems due to medications and disease should as well.

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