Transcription:

Melanie Cole (Host):  You know you should use it but when you see all the sunscreens on the market, it can be so confusing. Here to clear that up my guest today is Dr. Rex Largen. He’s a dermatologist with Bryan Health. Welcome to the show, Dr. Largen. So, first of all, let’s talk about who needs sunscreen. Are there some people who don’t?

Dr. Rex Largen (Guest):  That’s a good question, Melanie, and the answer is all of us probably need sunscreen, although people with darker skin tones tend to not need it maybe not as much is a good way to look at it.

Melanie:  Okay. So, let’s start with little guys and babies and the sun. Is the sun more damaging to that little sensitive skin than it is to someone my age with little thicker skin?

Dr. Largen:  That’s correct, Melanie. Babies’ skin is thinner and they are more susceptible to sun burning and long-term sun damage if they get burned as a baby or as an infant. It’s important to protect babies from the sun and especially burning.

Melanie:  Are we allowed to use normal sunscreen?  What do you want us to know about our little guys and using sunscreen on them?

Dr. Largen:  What we prefer in babies is to try to use a broad spectrum sunscreen with an SPF of 30 minimally. SPFs greater than 30 are also fine but it’s important to use at least an SPF 30. The key with babies a lot of times, because sunscreens do contain a variety of different ingredients, is to find a sunscreen that is approved for babies or also a sunscreen that does not contain as many chemicals. What we sometimes recommend is a physical type sunscreen with what we call “titanium dioxide” or “zinc oxide”.

Melanie:  So, that’s safe to use on babies and but better we should be keeping them out of the sun altogether?

Dr. Largen:  That’s correct. That’s the point I wanted to make as well. It’s important to keep babies covered up, keep them in the shade and keep them clothed so they aren’t allowed to burn.

Melanie:  Let’s talk about older adults and teenagers. We’re hearing so much, Dr. Largen, about Vitamin D deficiency and yet we want to put on sunscreen. What do you tell your patients about that?

Dr. Largen:  That’s a good question and there have been conflicting studies in the literature but the overwhelming amount of evidence really does support using a sunscreen on a regular basis. I would say the same thing that I did for babies. Use a sunscreen that’s an SPF 30 with a broad spectrum coverage. There are a number of different brands that are excellent out there. As long as those two criteria are fulfilled--SPF 30 and broad spectrum--you really probably can’t go wrong with any particular brand of sunscreen. As far as the Vitamin D goes, yes, sunlight allows our bodies to metabolize Vitamin D or produce Vitamin D but it’s really more important, I think, to provide additional Vitamin D with your diet rather than try to get it through sun exposure.

Melanie:  You’ve mentioned the words broad spectrum and we hear about UVA and UVB. Explain what these mean.

Dr. Largen:  The sun basically emits three wavelengths of ultraviolet light:  UVA which is the longest of the wavelengths, UVB which is a little shorter wavelength and then UVC which is actually the shortest but it’s blocked by our atmosphere by and large. So, most sunscreens when they first came out--the earlier sunscreens--blocked UVB quite well but were negligent in blocking UVA. The newest sunscreens now do a much better job of blocking the entire ultraviolet spectrum to which we are exposed. They do block UVB quite well and they do a much better job now of blocking the UVA spectrum. UVA penetrates deeper into the skin, so it probably contributes more to wrinkling and the aging process. Also, as we’re finding out, it definitely contributes to the formation of skin cancers as does UVB. When you’re looking at the two in a simplistic way, UVB is the wavelength that causes the painful burning. UVA does not do that as much which is deceptive because you can get a lot more UVA without burning, so you have to be careful especially with tanning beds which emit primarily UVA. Long answer to a short question. Sorry.

Melanie:  No. That’s a good answer and it makes it so understandable and sets it out for everybody very easily. Do you have a favorite lotion, sprays, dry spray, and oils? Do you have any that you like better than another?

Dr. Largen:  I like lotions personally because they are less greasy and I think they’re easier to apply than the creams. I also like sprays but there’s some evidence to show that maybe the sprays aren’t as effective and there are some reasons for that. It’s not that they aren’t effective, it’s just that with the application process it appears, we don’t get quite as good coverage with the sprays. I tend to advise my patients to use a lotion or a cream of their choice. There are a multitude on the market and you just have to kind of pick and choose the ones that you like the best or agree with your skin the best.

Melanie:  How often should you keep re-applying it?

Dr. Largen:  Good question. If you’re just out in the yard and it’s not a real hot day and you’re not sweating, maybe once every three or four hours. Certainly, if you’re at the beach and you’re swimming, probably every 90 minutes to two hours you should reapply sunscreen.

Melanie:  Now, our teens, particularly, love that golden tan and how do you convince teens--because they don’t care if they get burned?  Maybe you use vanity?  Do you talk to teens about using sunscreen because they don’t seem to care that much?

Dr. Largen:  You’re absolutely right. I have four children – one who is still a teenager—and, I tell you, it’s a challenge. You just have to try to make the point, convince them, I think appealing to their vanity is a good approach or a good strategy. It’s still tough and, I think the key with teens is just consistency. I think you just have to continually reinforce the importance of sunscreen and it’s still a challenge but you bring up a good point with the vanity.

Melanie:  Do we have to use sunscreen, Dr. Largen, all year round?  People don’t think in the winter time that they really have to.

Dr. Largen:  Correct. The bottom line is and the official recommendations are that you should use sunscreen. Quite frankly, if you use sunscreen on a daily basis even year round, you will go a long way towards preventing a lot of the changes that we see in aging which are wrinkles primarily, dark spots,  that crepe paper skin that occurs even with time. It’s certainly accelerated with sun exposure. If you can wear something on the face like a moisturizer with a sunscreen on a daily basis year-round that really is ideal. The reality of it is, it’s not always easy to do. I try to tell my patients be realistic. If, in the wintertime, you know you’re going to be out for a short period of time, it’s probably okay. Anything over a half hour or longer, you really should apply sunscreen if you’re going to be exposed to the sun even with summer or winter. When it’s snowy, it just magnifies the amount of ultraviolet light that you receive.

Melanie:  Dr. Largen, you’re a dermatologist, people want to know:  if they bought sunscreen last summer is it still good this summer or do these things go bad?  Does it lose its strength?

Dr. Largen:  Sunscreen does lose its strength and most of the sunscreens, if not all, will have expiration dates on the bottom. If it’s expired, I would recommend getting a new bottle. The other thing that will cause sunscreen to go bad more quickly is heat. I like to golf and so, if I have a bottle or two of sunscreen in my golf bag, I will change it after every season whether it’s expired or not because the heat will break down the effectiveness of the sunscreen.

Melanie:  Give us your best advice in the last few minutes here about sunscreen – the importance of it and how it can protect us from skin cancer.

Dr. Largen:  I think to sum things up, if you will, the way I look at it, sunscreen, of course, prevents skin cancer and that’s an important thing. I see skin cancer every day in my office and a lot of people, if they had been wearing sunscreen from day one, they would have done a lot to prevent their skin cancer. That’s obviously a very important to wear sunscreen on a consistent basis. The incidence of skin cancer continues to increase, especially the deadly form of skin cancer, melanoma. Even beyond that, I can tell daily, again, in my office, who wears sunscreen consistently and who doesn’t. You see it in the aging process and the people that ignore sunscreen, they have a lot more freckling. They have a lot more what we call “age spots” or “liver spots”. They have a lot more wrinkles; their skin thins significantly. As you get older that thinning skin, that skin is much more prone to tearing and bruising. Something a lot of people don’t even consider is, chronic sun exposure can cause problems like redness and blood vessels to form that are abnormal, as well as acne. That’s something I don’t think anyone talks about but you can actually get a form of acne that is caused by chronic sun damage. There are just a lot of bad things that occur with chronic sun exposure. The real challenge is when we’re young, when we’re teenagers we just don’t appreciate it because our skin is young and healthy and it can actually handle a few burns without us really seeing any significant changes other than the temporary pain and redness. In the long run you’ll go a long way towards preventing a lot of age-related changes and certainly skin cancer by wearing regular sun screen.

Melanie:  Dr. Largen, tell us about your team at Nebraska Dermatology and why patients should come to Bryan Health for their care.

Dr. Largen:  Well, I’m in solo practice. The name of my practice is Nebraska Dermatology and I’m on staff at Bryan Hospital. We do an annual skin cancer screening every year and we feel we provide very comprehensive skin care here at Nebraska Dermatology, not only with skin cancers but all sorts of related skin type conditions and skin problems. I’m biased, of course, but I feel like I have the best staff in the city of Lincoln. We’re always happy to see new patients here at Nebraska Dermatology.

Melanie:  Thank you so much for being with us. It’s really great and very important information. You’re listening to Bryan Health Radio. For more information you can go to bryanhealth.org. That’s bryanhealth.org. This is Melanie Cole. Thanks so much for listening.