The sun is more intense these days due to a depleting ozone layer, and burning is something to contend with whenever you are outside.
Each year, more than 1 million Americans, of all ages and ethnic origins, get skin cancer. Nine of 10 skin cancers develop on exposed areas, such as the face, ears, forearms, and hands, reports the American Academy of Dermatology (AAD). Skin cancer's most deadly form, melanoma, kills close to one American every hour, or 8,000 people a year.
But these statistics don't mean you have to live like a monk. You can still read out on the deck and take the kids to the beach -- if you first take time to safeguard your skin.
Sunscreen should be applied 15 to 30 minutes before you go out, even for a trip to the grocery store, says Dr. Ercem Atillasoy, a clinical assistant professor at Thomas Jefferson University in Philadelphia. "If you use only one bottle of sunscreen a year, that's not enough," says Dr. Atillasoy. "During summer, you should use several bottles of sunscreen a month."
Slather an ounce -- one-fourth the typical bottle -- on your body. Reserve at least a teaspoonful for your face, neck, and oft-omitted earlobes. For the greatest potency, let the thick coating absorb, instead of rubbing it in. Reapply protection every two hours if you plan to stay outdoors. And if you'll sweat or swim, use a waterproof or slightly less-effective water-resistant block every time you towel off.
The safest way to protect your family is to shun the sun from 10 a.m. to 4 p.m., when a person gets 80 percent of the day's dose of skin-crinkling ultraviolet rays, says Dr. Darrell S. Rigel, president of the AAD. But that's not realistic for most people, so when you are outside, wear protective lip balm; sunglasses; tightly-woven, light-colored clothes; and a sun-blocking hat with at least a four-inch brim.
"For every inch of brim you add, you can lower your incidence of skin cancer by 10 percent," Dr. Rigel says.
If you want to be super safe in the sun, wear a long-sleeved shirt and pants when you go out, and keep them dry. Dampened clothing is 40 percent less effective.
Use a sunscreen or sunblock with an SPF of 15 or higher. The number indicates how many times longer you could remain in the sun without getting sunburned than if you were unprotected. For instance, if ordinarily your skin burns after 10 minutes, then theoretically an SPF 15 would delay the burning for 150 minutes.
That sounds impressive, but don't be fooled by a blazing sun, says Dr. James Leyden, dermatology professor at the University of Pennsylvania School of Medicine in Philadelphia. He recommends using an SPF 30 every day, but upgrading to an SPF 45 when outdoors for more than an hour.
"SPF 15 is not enough," Dr. Leyden says. "It may protect you against redness, but if you biopsy the skin, you can see clear-cut evidence of injury to the cells. This means damage can occur without the skin turning red."
As important as SPF is the range of the sunscreen. Much like a radio, the sun sends out two different frequencies that damage skin: ultraviolet A and ultraviolet B rays. UV-A rays penetrate deeper into the skin and are blamed for aging, spotting, and crinkling. The shorter UV-B rays burn and blister your skin's outer layers. Either length can lead to skin cancer.
That's why you need a "broad spectrum" sunscreen or sunblock that blocks all frequencies, says Dr. Vincent DeLeo, dermatology chairman at St. Luke's-Roosevelt Hospital Center in New York City. Any one of four ingredients -- oxybenzone, titanium dioxide, zinc oxide, or avobenzone (also known as Parsol 1789) -- will provide that power.
Frighteningly, 80 percent of lifelong sun damage occurs before age 18. Remind your kids to use sunscreen and wear a hat and sunglasses until the habit becomes as automatic as getting dressed.
"If you start early, they'll accept it," says Dr. Roger I. Ceilley, assistant clinical professor of dermatology at the University of Iowa. Dr. Ceilley recommends that sunscreen use start at 6 months old.
To help, enlist the aid of babysitters, camp counselors, and your kids themselves. "Make it a game," says Dr. Ella L. Toombs, dermatologist and spokesperson for the American Society for Dermatologic Surgery in Washington, DC. "Challenge your kids to see how much sunscreen they can apply and if they can cover every area of their skin."
Don't feel defeated if you got a lot of sun exposure as a child. Many adults feel that past actions have blown any chances of ever having healthy skin. Actually, it's never too late to change your habits -- and some damage will fade with time. "It's like cigarette smoking," says Dr. Rigel, clinical professor of dermatology at New York University School of Medicine in New York City. "No matter how much you've smoked, it always pays to stop."
If you're bugged by insects, you're best off using a sunscreen that already contains repellent. Insect repellents that are DEET-based weaken the potency of sunscreen by about 30 percent, according to a study by the Walter Reed Army Institute of Research in Washington, DC. The active ingredient in DEET dissolves the active ingredients found in most sunscreen products.
Bug spray isn't the only sun saboteur. Alpha-hydroxy acid skin creams make your skin up to 50 percent more sensitive to sunlight, according to Food and Drug Administration studies.
Certain drugs also make you more vulnerable to the sun, such as antihistamines, diuretics, tranquilizers, antifungals, antibiotics (including tetracyclines, sulfa, and quinolones), nonsteroidal anti-inflammatories, and drugs that lower blood sugar, Dr. Ceilley says. The same applies to bergamot, an ingredient in some fragrances, as well as mangoes, celery, fennel, figs, parsnips, and lime rinds.