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My Complex and Ever-Changing Relationship with the Sun



I have always loved the outdoors and fresh air. Growing up, I spent most of my summer days entirely outside. As a young child this involved daily swim team practice, long days at the neighborhood pool, and countless soccer camps. As the years went by it evolved into lifeguarding, running, and coaching many of those same camps. Blessed with a little built in protection from my Italian heritage, I had a dark golden tan throughout the season. My mom had me apply an SPF 8 sunscreen to avoid sunburns, but that never really seemed to happen.

When I attended college in upstate New York, I spent nearly 6 straight months during the cold winter almost completely out of the sun. I consequently developed my first true sunburn that I can remember on the first beautiful day of spring during my freshman year. I spent the whole day outside without sunscreen while wearing a tank top and enjoying the warm sun. My shoulders paid the price.

When I entered Dermatology residency, I saw the large toll that the sun took on my patient’s skin. The extensive surgeries that result from skin cancers, the discoloration and wrinkles that ultraviolet radiation produced with age, and even the way sunlight ate up the elastin fibers of skin under the microscope. Since then I have worn facial sunscreen every day of my life. I have been diligent to avoid tanning at the beach or on the soccer fields watching my children. I had won the battle.

UNTIL COVID 19

Amidst all the change and chaos, we have had a lot of shifts in our sun exposure at my house. My 3 children flourish with daily physical activity and fresh air. I have been spending more time with them which is wonderful, but a huge chunk of this time has been spent outside for our sanity. I have given up my gym membership and have instead focused on yoga at home and lots of running and walking outdoors. The exercise and fresh air really helped me stay grounded… well for the most part. A few months ago, I looked down at my arms and realized that for the first time in well over a decade they are officially tan.

Below are some of the tips that I like to share with my patients regarding how to find sun protection strategies that work. I personally try to control my exposure when possible, wear sun protective clothing, and use high quality mineral based sunscreens. There will still be slip ups for those who love the outdoors like myself, but the effort is well worth it. Admittingly, my exposure control needs a little work at this time, but I will continue to do my best and adjust to this ever-changing life.

Behavior tips:

1. Plan ahead when possible. Try to schedule long walks, bike rides, and trips with the kids (or grandkids) to the pool early or late in the day. When possible avoid peak sun hours from 10am – 3 pm. This is especially important during the summer.

2. Use sun protective clothing when possible. Add a wide brimmed hat while working in the garden. Rash guards and swim shirts greatly enhance your sun protection efforts at the lake and beach. Throw on a hat if you are going for a morning run.

3. Add a mineral based sunscreen when needed. This is particularly important if you plan on being in peak sun for more than 15 minutes. This should be done daily on the face for individuals at high risk for skin cancer or those concerned about wrinkles.

4. Layer sun protection measures together for vacations and long days outside.

Why I recommend mineral based sunscreens:

1. Mineral based sunscreens made of zinc and titanium protect against both UVA and UVB rays. UVA rays have been linked to melanoma, advanced photoaging (wrinkling), and uneven pigmentation. UVB rays are related to sunburns and nonmelanoma skin cancer (basal and squamous cell carcinoma). Unfortunately, SPF ratings currently only relate to UVB protection in the United States. This means you could be using a sunscreen that has an SPF of 100 with minimal melanoma and wrinkling protection!

2. These ingredients are active until they are physically removed. This makes them last longer than chemical sunscreens that convert to heat in the sun and wear out more quickly (typically every 2 hours). It is still important to re-apply if out in heavy sun exposure, but it also means that there is some degree of sun protection remaining until the products are removed.

3. Less overall chemical exposure. These products use zinc oxide, titanium dioxide, and on occasion iron oxide. This is particularly important for babies and children, and also helps protect our environment.

I hope you find these tips helpful. Feel free to reach out if you need help customizing a plan for yourself or loved ones.

Stay safe and be sun smart!

Elizabeth Prater MD

The amazing photo was taken by Stephen Leonardi on Unsplash