How to Protect your Skin from Sun Damage

Chat led by Dr. Jean-Louis Peyron, Dermatologist at the University Hospital of Montpellier, member of the Executive Committee of the French Society of Photodermatology.



Transcription of sun and protection chat:


Question 1
Internet user: Does children’s skin resist the sun better than adult’s skin?
Dr. Jean-Louis Peyron: Children have thinner, and therefore more fragile, skins than adults. However, children will keep their skin type, that is to say their tendency to burn or tan under the sun, all their life. Children who tend to tan easily will tan easily all their life, and vice versa.

Question 2
Internet user: Do you know of a sun screen that provides maximum protection for babies?
Dr. Jean-Louis Peyron: No sun screen provides better protection than the others. In any case, a baby should not be exposed to sun and thus the question should not arise.

Question 3
Internet user: I have very light, sensitive skin and I have rosacea. Can I still tolerate exposure to the sun? What type of protection should I use?
Dr. Jean-Louis Peyron: You may expose yourself to the sun if you protect yourself very carefully by avoiding exposure in the middle of the day and by using external sun screens with a high protection index (SPF 50+). Certain laboratories provide specific products for skin with rosacea. In general, these contain decongestants in addition to sun protection. And don’t forget that rosacea is aggravated by too much exposure to sun!

Question 4
Internet user: Hello. I would like to know what you think about pre-tanning capsules.
Dr. Jean-Louis Peyron:  Pre-tanning capsules are products containing “anti-radicals” (vitamin C, vitamin E, selenium, carotene, etc.). These products are supposed to protect from the harmful effects of sun on the skin. In the laboratory, they have proven their effectiveness in vitro on cell cultures. In actual use, their effectiveness has not been totally proven. They seem to increase the ability to withstand sunburn (but not over 20%), but they have never demonstrated a preventive effect on solar allergies. However, they are not dangerous to health.

Question 5
Internet user: My son, who is thirty months old, is blond with blue eyes, has a porcelain skin and suffers from eczema.  We’d like to take him to the beach at the end of the afternoon. What do you advise as protection?
Dr. Jean-Louis Peyron: To protect him from the sun, the first step is to avoid exposing him to the sun in the middle of the day, between noon and four o’clock. He should first be protected with clothing, preferably in cotton (eczema is facilitated by contact with wool or synthetic garments); if you also use a sun protection, use one that contains only mineral screens, since these are the ones with less tendency to aggravate eczema.

Question 6
Internet user: My skin tans easily. If I’m out in the sun after four o’clock, should I still apply sun cream?
Dr. Jean-Louis Peyron: You should use sun creams when you are first exposed to the sun, at the beginning of your vacation, for example.  This will protect you from sunburn without keeping you from tanning. Once you are tanned, external sun protection is less important, but don’t forget that even if you tan easily, this will not protect you from the long-term effects of sun (skin aging and skin cancer).

Question 7
Internet user: Is there a cream that will lessen spotting from sun exposure?
Dr. Jean-Louis Peyron:  - If you are taking about freckles, there is no cream that will keep them from appearing in summer; they correspond to a natural skin type and thus you will need to avoid exposure to the sun.
- If you are talking about brown spots from pregnancy, it’s possible to prevent them by using an external sun protection with a strong UVA index as soon as you are outside.
- If you are talking about brown spots on exposed areas after the age of fifty, unfortunately the damage has already been done, and sun protection will only keep you from having a few more.

Question 8
Internet user: As the years pass, I have an increasing number of moles on my skin.  Why is this?
Dr. Jean-Louis Peyron:  There are two types of moles: those that are present at birth, usually few in number and lasting a lifetime, and those that appear around puberty. Their number increases with exposure to the sun. Don’t worry, this does not continue indefinitely and rapidly stabilizes around the age of thirty.

Question 9
Internet user: How can I make my tan last longer?  Are there any tricks?
Dr. Jean-Louis Peyron:  There aren’t any tricks to make a tan last longer. Tanning is due to the manufacture of pigments by epidermal cells that have been stimulated by the sun’s rays. When this stimulation stops, the cells gradually decrease their activity and the skin, which undergoes continuous renewal, will progressively lighten. Unless you are able to prevent the skin from renewing itself (which is impossible), I don’t see how you could make your tan last longer.

Question 10
Internet user: Is it absolutely necessary to put a moisturizing cream under a sun cream or is the cream alone enough?
Dr. Jean-Louis Peyron:  Normally, it is not necessary to use a moisturizing cream under a sun cream. But if you want to use a sun protection during the day and have already applied a moisturizer in the morning, there is no contraindication to using these two creams together.

Question 11
Internet user: Is it true that a sun protection index under 20 is totally useless?
Dr. Jean-Louis Peyron: In theory, a protection index less than or equal to 20 corresponds to a good ability of the solar product to protect from sun.  In practice, the real protection index of these products is much lower because they are never applied heavily enough and thus their protective power is weak. For this reason, it’s better to choose a higher index (for normal skin, an SPF of 30 is a good compromise).

Question 12
Internet user: What do the SPF and UVA index found on solar products mean? In what way are they different from each other? Which SPF should I choose with which UVA?
Dr. Jean-Louis Peyron: The abbreviation SPF signifies Sun Protection Factor and corresponds to the ability of the solar product to protect from sunburn. The UVA protection index simply corresponds to the ability of a solar product to more or less block ultraviolet radiation. There is thus no real link between the two. And why do we need to know the UVA index? Simply because UVAs are responsible for a significant number of the effects of long-term exposure (harmful melanomas, aging, etc.). A good external sun protector should have a high SPF (30 or more), as well as a high UVA protection index (it should be equal to at least a third of the SPF).

Question 13
Internet user: What can I do to enjoy the sun safely? Can I still have fun in the sun?
Dr. Jean-Louis Peyron: Just use common sense: adapt exposure to your skin type, avoid going out in the sun in the middle of the day and protect yourself with clothing or external sun protection. Under these conditions, sun is absolutely not an enemy and you can still have fun in the sun!

Question 14
Internet user: If I become badly sunburned, does this mean that I am using up my skin capital faster in the area concerned?
Dr. Jean-Louis Peyron: You are absolutely right. This is why we see “scarring” that appears more rapidly on an area of skin that has been sunburned (shoulders in particular): pigmented spots and, eventually, skin cancer.

Question 15
Internet user: What do you think about sun products that promise eight-hour protection with only one application per day?
Dr. Jean-Louis Peyron: An ideal product would, of course, be one that you only have to apply once a day.  In practice, proof of long-lasting sun protection for this type of product during the day is still limited. Personally, I advise re-application of products according to the type of activity (perspiring, swimming, etc.).

Question 16
Internet user: Does sun cream dry the skin?
Dr. Jean-Louis Peyron: It’s not sun cream that dries skin; it’s exposure to the sun. It is advisable to use a moisturizing cream after exposure.

Question 17
Internet user: I was out in the sun a lot as a child and during adolescence. During all these years, I tolerated the sun and extreme heat very well. However, during the past few years, I get sunburned much more easily and my skin seems more fragile. Is this normal? How do you explain this evolution?
Dr. Jean-Louis Peyron: You have indeed used up a large part of your solar capital, and unfortunately, the damage is done. This is the natural process of “actinic” aging (due to the sun).  Conclusion: avoid sun and protect yourself as much as possible.

Question 18
Internet user: Why is it that with a mineral or chemical solar protection with index 50 (I have rosacea), my skin turns red with pimples at the end of the day, even if I haven’t been in the sun?
Dr. Jean-Louis Peyron: Skin with a tendency to rosacea is exceptionally fragile and very intolerant of creams. I advise you to see a dermatologist.

Question 19
Internet user: My skin keeps a bit of its tan from one year to the next. Should I worry about this?
Dr. Jean-Louis Peyron: Not at all; this merely means that your skin type is rather dark and that your melanocytes (pigmenting cells) remain active during most of the year.

Question 20
Internet user: Does the number of moles have a relationship to the way someone has been exposed to the sun? Is there a relationship between the number of moles and the risk of skin cancer?
Dr. Jean-Louis Peyron: Yes, those who have been exposed to the sun for long periods, in particular during adolescence, have a tendency to have more moles. There is a relationship between the number of moles and the risk of skin cancer, but the possibility of having a melanoma depends on other factors that have nothing to do with the number of moles. This is just one risk factor among others.

Question 21
Internet user: Are there foods that enable better resistance to the sun?
Dr. Jean-Louis Peyron: As far as I know, no. Pre-tanning capsules have substances contained in foods, but in a much more concentrated form. It would be necessary to eat enormous quantities of tomatoes or carrots, for example, to obtain a rate of beta-carotene equivalent to that found in these capsules.

Question 22
Internet user: Are mineral screens healthier than chemical filters? Are they less allergy-provoking?
Dr. Jean-Louis Peyron: Mineral screens are inert substances that do not react with skin and are not absorbed by the skin. Thus, they do not cause allergies, unlike chemical screens, which can sometimes cause cutaneous allergies.

Question 23
Internet user: How do you explain the fact that the number of skin cancers increases year after year?
Dr. Jean-Louis Peyron: The main reason is an increase in time spent under the sun: outside recreational activities, trips to tropical countries, and so forth, enormously encourage exposure. Skin cancers will probably continue to increase because it takes years for them to appear. In our area of the globe, the decrease in the ozone layer does not seem to have an effect.

Question 24
Internet user: Is it possible to develop an allergy to mineral screen?  If so, what can be used for protection?
Dr. Jean-Louis Peyron: It is not possible to develop an allergy to a mineral screen, but you might develop an allergy to the product’s excipient, that is to say, to the medium that contains the mineral screen.

Question 25
Internet user: I have acne. I have the impression that sun inhibits the appearance of blackheads and red pimples.  What do you think?
Dr. Jean-Louis Peyron: Exposure to the sun does seem to diminish the activity of acne: tanning masks redness and the thickening of skin under the sun makes the lesions “re-enter” the skin.  However, this is only a temporary improvement and blemishes are twice as numerous by the end of summer.

Question 26
Internet user: Is hair as vulnerable as skin to the sun? Is it necessary to protect hair during exposure to the sun?
Dr. Jean-Louis Peyron: Yes, hair is damaged by ultraviolet radiation. This radiation lightens hair and makes it more fragile and brittle by altering the keratin layers structuring the hair. There are hair products with solar filters that may help to lessen this alteration.

Question 27
Internet user: Which indexes do you advise and for which age?
Dr. Jean-Louis Peyron: It all depends on three factors:
1 – skin type.
2 – activity (what you are doing).
3 – age
In practice, for someone with a “normal” skin type (someone who gets sunburned often but tans easily), a protective index of 30 is enough, if it is re-applied frequently.
A very light sun type (always sunburns and never tans) must use an index equal to or greater than 50 and avoid exposure during the middle of the day.
Children need sun protection that is above all provided by clothing, with sun protective cream as a complement.
Prefer mineral screens with a protective index that is equal to or above 30.
Extreme conditions of exposure (mountain, glacier, tropics, etc.) require a maximum protective index and very frequent re-application.

Question 28
Internet user: Should a specific sun protection product be used if someone has acne?
Dr. Jean-Louis Peyron: This is preferable because patients with acne have oily skin, and if they use solar products that are too oily, they risk aggravating the acne. Nearly all brands have specific lines for skin with acne; in general, these are liquid preparations.

Question 29
Internet user: I would like to know whether it is as dangerous to expose yourself for a half-hour to the sun every day of the year (or almost) as it is to stay in the sun for hours on end during vacations. 
Dr. Jean-Louis Peyron: There is not really an answer to this question. However, chronic exposure to the sun (a half-hour or more every day of the year, as is the case for outdoor workers, for example) can lead after a number of years to skin cancers known as epitheliomas (or carcinomas).  These cancers have a relatively less serious outcome; it is sufficient to remove them surgically. However, brutal exposure and sunburn, in particular for children, can give rise to a much more serious skin cancer, malignant melanoma. It is thus exceedingly important to protect children from the sun.

Question 30
Internet user: Do my four-year-old son and my four-month-old son require the same solar protection?
Dr. Jean-Louis Peyron: Absolutely not. The four-month-old baby should not be in the sun at all. Babies should not be exposed to sun before a minimum of eighteen months. The four-year-old must have sun protection, beginning with clothing (hat and tee-shirt), which should be completed with a sun cream, preferably with a mineral screen.

^{This transcription does not necessarily represent all the discussions that occurred during the chat..}