We've come a long way from our days of sunbathing in baby oil. When rates of skin cancer started climbing in the 1980s, health experts rolled out awareness campaigns aimed at getting us to quit catching rays and start covering up. It appears many of us have gotten the message.
In a recent survey by the Skin Cancer Foundation, most respondents said they use sunscreen regularly. But the survey also uncovered a puzzling fact: More than 25 percent of respondents also said they suffer at least one sunburn every year. That's worrisome because even isolated burns heighten skin cancer risk.
"Over time, the sun's UV radiation can cause a mutation in the genetic material of skin cells, releasing the brake that keeps cells from dividing uncontrollably," says Allan Halpern, M.D., chief of dermatology at Memorial Sloan-Kettering Cancer Center in New York City and vice president of the Skin Cancer Foundation.
To complicate matters, the sun produces not one but two forms of cancercausing ultraviolet light: UVB, which leaves visible burns, and UVA, which strikes beneath the surface (and is thought to be largely responsible for premature skin aging). Fortunately, most skin cancer cases are preventable.
Read on as top specialists share 10 surprising scenarios that endanger skin—and strategies to outsmart the sun for good.
1. You're outdoors when your shadow is short. A stumpy shadow means the sun is directly overhead, the point at which UVB rays poke straight down through the ozone layer with minimal scattering. As a result, a person's UVB exposure is up to 50 percent higher during this stretch of the day than in early morning or late afternoon, when the oblique angle of the sun sends rays on a longer path through the atmosphere. (UVA radiation isn't absorbed by ozone, so it's a danger at all times of day.) At peak intensity, the sun can scorch even if you're careful about wearing sunscreen. Stay in the shade as much as possible.
2. You can't see the hat on your head. Covering your noggin is a smart impulse, but don't bother with a close-fitting cap. "The hat needs to throw a shadow over your face and neck," says David Leffell, a professor of dermatology and surgery at Yale School of Medicine in New Haven, Connecticut. Choose a hat with a 2- to 4-inch brim that goes all the way around. "Baseball caps and visors aren't adequate because they don't shade the neck and ears, where skin cancers commonly develop," Leffell says. Material matters, too: A tightly woven fabric, such as canvas, will shut out more solar rays than Swiss-cheese straw.
3. Your sunscreen absorbs in seconds. Sorry, but that thin squiggle of lotion isn't going to cut it, Halpern says. To get the level of SPF promised on the label, you need to slick on enough for your skin to stay damp for a minute or two. (When wearing a swimsuit, count on using an amount that fills your palm.) Be sure to hit the spots that many people miss: the tops of your feet, backs of your knees, calves, ears, underarms, and hairline. Sunscreen sprays work just as well as lotions if applied correctly, Halpern adds. Hold the can 3 inches from your skin and spray on generously. Gently rub in, then mist yourself once more to ensure consistent coverage.
4. You throw on a breezy white top. Many people wear white in summer, believing that pale fabrics are best at reflecting rays. You might want to choose a bright red T-shirt instead. It turns out that bleached textiles offer the lowest level of protection because they lack pigments, which absorb a measure of UV light before it can strike skin, explains Dawn Davis, a dermatologist at the Mayo Clinic in Rochester, Minnesota. When sporting gauzy white garments, wear sunscreen underneath. For extra peace of mind, consider treating clothes with a laundry additive such as SunGuard ($2 for a 1-oz. box; sunguardsunprotection.com), which contains an invisible UV absorber that lasts through as many as 20 washes.
5. You apply your first coat of sunscreen outside. Beware: You could burn while the stuff is booting up. Modern chemical formulas—those made with oxybenzone, avobenzone, and similar ingredients—work by absorbing ultraviolet rays. For the products to be effective, they must first bind to proteins in the skin, a process that takes about 20 minutes, Halpern says. So apply your base coat indoors and give it time to take effect. (Sunscreens that contain zinc oxide or titanium dioxide work right away because those ingredients form a physical barrier on skin.) No matter what type of formula you prefer, reapply at least every two hours—more often if you're sweating or swimming.
6. You grab sunscreen from the car. On a bright summer day, you could fry an egg on the dashboard of a parked vehicle (see YouTube for proof). Don't let those triple-digit temperatures cook your sunscreen, too. "The active ingredients break down in heat, and the damage is cumulative," Davis says. "The more frequently and more intensely sunscreen is heated, the less effective it becomes." Take your sunscreen with you when you leave your car, and while outdoors, do what you can to shield it—say, by stashing the tube in a drink cooler.
7. You pop a pain reliever. Once absorbed by the body, common medications can react with ultraviolet light on skin's surface, resulting in serious burns, Leffell says. This rapid reaction, known as photosensitivity, is most often seen with ibuprofen (Motrin, Advil), naproxen (Aleve), certain antibiotics, oral contraceptives, and diuretics. Ask your doctor if your meds are on the list. If so, take special care to safeguard your skin, even if you aren't the type to burn.
8. You settle in near a window. Granted, you won't get a visible burn through sunny panes—UVB rays can't penetrate glass. But unless the window is specially treated, UVA light sails right through. That might explain why one study found a link between long periods of driving and skin cancer on the left side of the face. And although many glass companies now make UVA-blocking windows, it's tough to tell which windows are which. Whenever you're stuck in a sunny spot—at your desk or in the driver's seat—err on the side of caution and cover up.
9. You dab on makeup and dash. The label on your tinted moisturizer says it provides SPF 20 broad-spectrum protection. What it probably doesn't say is how much you have to apply. "SPF ratings for cosmetics are determined using thicker applications than most women use: about a tablespoon for the face and neck," Halpern says. In addition, you'd have to reapply the product every two hours, just as you would regular sunscreen. If you're planning to be outside for more than a few minutes (and you prefer a natural look), treat makeup as sunscreen backup and apply the real deal underneath.
10. You're banking on a beach umbrella. Sure, these colorful canopies have their merits. Typically made of heavy-duty nylon, most brands are great at blocking solar rays from above, says Sandra Read, a dermatologist in Washington, D.C., and a spokesperson for the American Academy of Dermatology. The problem is the lack of protection from below. Sand and water reflect at least 25 percent of ultraviolet radiation, leaving eyes and skin vulnerable to rebound damage. Don't let down your guard when the umbrella goes up; take the same precautions you would in full sunlight.
New labeling requirements from the U.S. Food and Drug Administration took effect July 2012. Here's a look at what the updated rules do:
Define "broad spectrum." Now, only sunscreens that pass a standard test against UVA and UVB rays can tout broadspectrum coverage, a claim some companies had been using on products that offered skimpy protection.
End exaggerations. Sweatproof, waterproof, all-day protection—such terms are misleading because all sunscreen loses effectiveness after a while. Now the claims are prohibited.
Quantify water resistance. It's no longer sufficient for sunscreens to "resist" water for a measly 5 minutes. The new minimum is 40, and manufacturers have to back up their numbers with test results.
Warn against poor protection. If a sunscreen-containing product has an SPF of less than 15 or doesn't provide broadspectrum coverage, the label has to state that the product doesn't lower the risk of skin cancer or premature aging. Put that one back on the shelf!
Dogs and outdoor cats—especially those with short coats and light-color noses—can get sunburned, too, says Jennifer Pendergraft, an assistant professor of veterinary medicine at Colorado State University in Fort Collins. She offers this advice for owners:
Make shade mandatory. Pets love catching rays, but try to discourage this habit. If you have a dog, take walks on tree-lined routes. If the dog stays outside during the day, confine it to a shaded section of the yard. Cat owner? Keep Mr. Whiskers inside from 11 a.m. to 2 p.m., when sun intensity peaks.
Consider sunscreen. For dogs, there's Epi-Pet Sun Protector ($18 for 4 oz.; epi-pet.com). Cats don't have a dedicated product of their own just yet, but some experts\ recommend baby sunscreens. Check with your vet before using one, as some brands can be toxic to animals if licked off.
Watch for symptoms. On cats and dogs, the most common sunburn sites are the nose, rims of the ears, inner thighs, and underbelly. As in humans, key indicators are redness and tenderness. Also, an animal's ears might crack, and in cases of severe sunburn, loss of fur can result.
Soothe discomfort. If your pet does suffer a sunburn, submerge the animal in a tepid bath or hold a cool wet cloth to the affected area. With your vet's OK, try applying witch hazel or aloe vera gel— both substances are nontoxic to pets and cool skin without stinging.