As summer officially begins this week, patients may need reminders about the importance of protecting their skin from sunburn, particularly oft-neglected areas such as the feet. I feel compelled to discuss the myths of tanning and sunscreen as outlined by Sandra Fryhofer, MD, on Medscape’s Medicine Matters.1 Two years ago, I discussed sunscreens more in depth (http://goo.gl/ufVhB  ), but I would like to take this time to go through the most common misconceptions about sun exposure. Chances are, you probably hear these lines from your patients from time to time.
“A base tan will protect me when I go on my vacation.” Actually, according to Dr. Fryhofer’s article, a base tan gives you a sun protection factor (SPF) of 3, which ultimately can lead to a false sense of security and less sunscreen use. More sun exposure equals DNA damage no matter what you did beforehand and certainly increases when not using any protection at all. I have to yell (gently) at my students all the time for this offense.
If patients want to keep track of how much sun exposure they have had on their vacation, they may want to consider purchasing these bracelets (http://www.uvsunsense.com/uvss/  ) that change color to remind them it is time to reapply sunscreen or get indoors.
“I have darker skin. I don’t need sunscreen.” That is definitely not the case. Everyone can benefit from applying sunscreen prior to outdoor activities. Skin cancer is rising in the skin of color populations and the five-year melanoma survival rate is lower for African-Americans (55 percent) in comparison to Caucasians (85 percent).2
“Wearing a T-shirt will protect me from burning.” Sadly, no. Most dermatologists give a dry T-shirt a SPF of 3 while others say it has a SPF of 15. Once you get the shirt wet, it loses its protection factor considerably.
What can patients do to clothing to make it more sun friendly? They can “wash” the clothing in SPF as seen in https://sunguardsunprotection.com/order-now/info_8.html  . If your patients really want to go swimming with that shirt or enter a certain type of contest at the Jersey Shore, they can try Neutrogena’s Wet Skin product (http://www.neutrogena.com/category/sun/wet+skin.do?nType=3  ). Patients would apply this product to damp skin.
Your patients are probably thinking that you are a killjoy. They are thinking that you want them to wear a broad brimmed hat, wear sunglasses to protect against ultraviolet rays, apply sunscreen liberally and often to the body and feet, and basically not have any fun at the beach. For most of my life, I was that kid who was covered head to toe with clothing and sunscreen at the pool due to my childhood agent, who wanted me to have skin the color of porcelain (No skin lines! No burns!) as much as possible for auditions (I was a professional dancer).
Thankfully, this video doesn’t exactly apply to the 16-year-old me because of my uncool summer gear but perhaps it is something you can share with your younger patients to drive the point of sun safety: http://www.youtube.com/watch?v=_4jgUcxMezM  .
1. Fryhofer SA. Myths about sun exposure could kill your patients. Available at http://www.medscape.com/viewarticle/746197  . Published July 21, 2011. Accessed June 21, 2012.
2. Bradford PT. Skin cancer in skin of color. Dermatol Nurs. 2009; 21(4)170-7.
Editor’s note: The correct answer to the skin condition treated in last month’s blog (http://goo.gl/QZ3IQ  ) is dysplastic nevus.