Proper sun protection is not only vital for avoiding premature aging but also crucial to one’s skin health. I had a scary brush with a pre-cancerous mole a couple of years ago and had it removed immediately. I now make it a habit to plan yearly mole exams in advance and have my moles carefully checked for changes and signs that they need to be removed.
The talented plastic surgeon who removed my mole was Dr. Patricia DePoli of DePoli Plastic Surgery and Medical Spa. I had the pleasure of revisiting Dr. DePoli to discuss the importance of using effective SPF protection and hopefully inspire others to schedule yearly mole exams—or at least their first!
30-second summary:
- Sun protection is essential all year round, not just in warmer months, to prevent premature aging and maintain skin health.
- Yearly mole checks help identify potentially problematic lesions early, especially for those with a history of abnormal moles or skin cancer.
- Sun protection should be tailored to different skin types and body areas, with faces requiring higher protection due to constant exposure.
- Sunblock ingredients like Zinc Oxide, Titanium Dioxide, and Melanin are recommended, with SPF 15-30 adequate for daily use in a tinted moisturizer.
- Recommended SPF brands include Cerave, Neutrogena, and Bobbie Brown for over-the-counter products and Elta MD, Tizo, and Neocutis Journee’ for physician-dispensed options.
(Related: This Is The One Place You’re Forgetting To Wear Sunscreen)
For years, there was a widespread misconception that proper sun care was only reserved for the warmer months. Can you share the importance of effective SPF protection throughout the year and what level of protection we should be using in the winter, fall, spring, and summer?
DePoli: Effective ultraviolet light protection is important all year round because we are exposed to ultraviolet light incidentally, not only when we are in direct sunlight.
The radiation that we absorb in our lifetime is cumulative, so it is important to minimize that accumulation while experiencing enough healthy sunlight exposure to be able to utilize vitamin D, which is used by the body to strengthen our bones and experience the healthy hormone stimulation of the nervous system that controls our circadian rhythms and has a protective benefit against Seasonal Affective Disorder (SAD), which is common in geographic areas that have low light seasons.
Please tell me what you think about yearly mole checks and why you think they help prevent skin cancer or find it early.
It has not been scientifically proven that yearly mole exams decrease the mortality risk from skin cancer. It makes sense, though, that having an expert look at a patient’s skin once in a while and helping them with their own self-skin surveillance will give patients information and education that will make their own direct observations of their skin more useful.
Theoretically, identifying potentially problematic lesions that may require treatment at an earlier, more easily treatable stage is a favorable practice.
Patients with a history of dysplastic or abnormal moles, a history of spending a lot of time in the sun, or a personal or family history of skin cancer can benefit from regular skin surveillance visits to a Board Certified Dermatologist in addition to skin checks done by their Primary Care Doctor as part of a physical exam.
Sun protection may not be the same for everyone and in all areas of the body. Can you share the level of coverage we should be wearing on our faces versus the rest of the body? Also, should sun protection vary amongst skin colors (light vs. medium vs. darker complexions)?
Because our faces are usually uncovered and exposed to the environment, the cumulative amount of risk from UVA and UVB exposure is relatively constant. UVA rays are primarily responsible for actinic aging (wrinkles, texture changes), and UVB is primarily responsible for causing sunburn and changes that occur in the DNA of skin cells that are associated with the development of skin cancer.
The anatomy of the skin of the head and neck participates in many functions, including facial expression, which is important to us in social interactions and nonverbal communication, and other specialized functions, such as eating (lips), breathing (nose), seeing (eyelids), and hearing (ears).
The skin covering this area is routinely exposed to ultraviolet light and is a common area of skin cancer occurrence. When skin cancers show up and need to be treated, the head and neck can be hard to fix because they have special functions, complex three-dimensional structures, and little extra tissue. It is, therefore, very important to protect the skin over our lifetimes to keep the skin healthy.
The body is less subject to absorption if it is not exposed. Clothes confer some protection, however, not 100% protection. In general, the tighter the weave of the fabric, the less penetration of ultraviolet light.
Also, the level of hydration of the fabric can affect the penetration of ultraviolet light in non-specialized fabrics.
A jersey t-shirt may convey a Sun Protection Factor (SPF) of 6 when dry, but when wet with perspiration could be reduced to 2.
Knowing this, it is important to be aware of how much exposure the skin is getting and the time of day or season. The summer midday sun is the strongest.
In general, the more melanin in the skin and the darker the complexion, the higher the natural sun protection factor for UVB. Even if your skin is tanned or naturally darker, it can still absorb radiation.
Because of this, it is still important to be aware of how much radiation you are exposed to and how much you absorb over time. All skin types need sunblock to protect the skin during this exposure.
We’ve all heard about using proper sun protection to prevent premature aging. What ingredients and level of sun protection should we be looking for in SPF creams, skincare, and makeup (such as tinted moisturizers)? Also, do you think it’s a good idea to put an SPF cream on top of tinted moisturizers with a lower SPF? Many tinted makeups have an SPF range of 15 or 20.
In general, sunblock products are classified as physical blockers or chemical blockers. Physical blockers like Zinc Oxide, Titanium Dioxide, and Melanin are great choices. Some chemical blockers contain Avobenzone as an active ingredient.
Each sunblock has favorable and unfavorable properties. Allergic reactions and hormone disruption by chemical blockers have all been concerns in the past. In general, FDA-approved sunblocks are safe and are applied to intact skin on the outer layer; there is little penetration or absorption.
The website of the Environmental Working Group (EWG) is an excellent resource to direct consumers to healthy and appropriate choices of sunblock based on the products’ risks and benefit profiles.
There are many variations of products containing key active ingredients as well as other ingredients which are added to stabilize the sunblock. Some contain other nourishing ingredients, such as hyaluronic acid to smooth the skin or redness calming ingredients temporarily. There are also sensitive skin preparations and special products for acne-prone skin.
In general, I recommend a tinted moisturizer for the face for everyday use in climates with four seasons. An SPF of 15 to 30 is adequate. These preparations are usually made to be non-comedogenic and safe enough for use around the eyes.
I usually suggest lightly “setting” this with one of the many loose mineral powders and a Kabuki brush. This sets the lotion, mattes it, and confers a little extra SPF protection.
In direct sunlight or in a more tropical or vacation setting, I usually recommend a tinted sunblock of at least SPF 30 and a more water-resistant or waterproof preparation due to activities and sweating.
It is also important to remember that even when wearing a water-resistant preparation, the product can be removed inadvertently by friction while drying your face with a towel or by an exposed area rubbing against clothing or the inside of a hat.
Sun protection clothing can provide very effective protection, as can wash-in products that confer SPF to favorite clothes for up to 25 washes.
Wearing UVA/UVB eyewear reduces squinting, which can cause etched lines around the eyes, and protects the eyes from ultraviolet light, which can cause macular degeneration and cataract formation.
Can you offer any preferred recommendations for professional-grade cosmetic SPF brands and mass-market brands (such as tinted moisturizers or foundations) that offer both quality coverage and effective protection in one easy step?
Products that I like over the counter include:
Physician-dispensed sunblocks I like include:
Patricia DePoli, M.D., is a Board Certified Plastic and Reconstructive Surgeon who is in Private Practice and the Founder of DePoli Plastic Surgery and Laser Center in Skokie, Illinois. She is an Attending Surgeon affiliated with the Northshore University Hospital System. She is a fellow of the American College of Surgeons. Dr. DePoli’s practice philosophy is customized, science-based, preventative care.