Protect Yourself in the Sun; Better Application!
I regularly give interviews about sun protection. And I am incredibly happy that I get the opportunity, as the more people that know how to protect themselves in the sun the better. Not only, of course, to prevent skin ageing, but also to stop the explosive increase in the number of people with skin cancer. Did you know that more people die each year of skin cancer than road traffic accidents? Strange then isn’t it that we learn how to behave in traffic, but we don’t really know how we need to rub in sun protection. Seeing as my blog “The Quest for the Perfect Sun Cream” is the most looked at of all my blogs and that the summer holidays are almost here, I am going to devote even more time on this. And if you want to click on the photo here, you can see a clip from ‘Koffietijd’ where I talk about sun protection.
Is all this sun protection really necessary?
The sun’s rays are really damaging to the skin! According to statistics, 1 in 4 Dutch people will have some form of skin cancer in the coming year caused, in part, by our tanning behaviour. Another disadvantage of the sun’s rays is that they make up 90% of the cause of skin ageing such as wrinkles, pigment spots and sagging skin. It’s not for nothing that both the Netherlands and the American Society advise us to apply at least a factor 15 daily; in summer and winter. Many people don’t realise that UVA (in fact the most damaging rays) also penetrate through clouds and glass. Research has revealed that regular use of sun cream in the first eighteen years of your life can reduce the risk of NMSC (non-melanoma skin cancer) by up to 78%. Having said that, the sun does have a very positive side; it makes us feel good and boosts our Vitamin D supplies. But this isn’t a reason to now stop using the sun cream. In fact, investigations carried out show that avid sun cream users don’t have any less Vitamin D in their blood than others. We also know that people who are in the sun a lot can still have a shortage of Vitamin D. So it is a genetic component which decides if you produce Vitamin D easily or not. Fortunately, though, you can also get Vitamin D from food or, alternatively, take a Vitamin D tablet. It’s a bit more safe!
So the answer to the question then is, yes, sun protection is essential! Let’s just put into perspective what I’ve said above; exposure to the sun is a cumulative risk. Just as with smoking and drinking alcohol, the effects are not immediately noticeable and that one time going unprotected in the sun is not good but is also not the end of the world. If you are having lunch and a glass of wine on a terrace somewhere, and you’ve forgotten your SPF, don’t worry, just enjoy it!
Which protection factor should I choose?
You should use at least a factor 15 or 30 daily (so also in winter) and combine it with ( a moisturiser with) anti-oxidants. A factor 15 or 30 is also good in the summer but apply it more frequently. Unless you have a very pale skin, a factor 15 or 30 is probably high enough. A factor 30 is advisable for people with light skin or who suffer from pigment spots. If you know, too, that you are not consistent with rubbing in then a factor 30 (or higher) is better. If you use a sun cream properly and follow the instructions, then a product with factor 15 will protect against 94% of the sun’s rays and a product containing factor 30 will protect against 97% of the sun’s rays. It is important to know that there is no filter that can give 100% protection against the sun’s rays! The very high factors are often not as pleasant to use and generally contain more ingredients which can lead to problems. Besides this, the above regime will ensure that your skin can still build up Vitamin D and some pigment (for protection) and, in addition to this, your skin, looks healthy all year round. It may sound crazy but this is honestly better than no protection all year round and then that one summer holiday with a total sunblock on!
How should I apply it?
More importantly than the factor, however, is the manner in which the cream is used. Investigations carried out have shown that people who apply very high factors have even more chance of getting skin cancer than people who use lower factors (such as 15 or 30). According to investigators, this is because people who use a high factor apply it less often and less thoroughly.
It is really a real myth that a sun cream will last for the whole day. You always need to apply this regularly. In order to reach the factor displayed on the bottle and for it to be effective you need to re-apply the cream every two hours. The effectiveness of the filters wear off after application. The speed with which the effectiveness wares off depends on your skin, the strength of the sun, your activity and the sun filter used. A sun filter should protect properly for two hours, but after that there is no guarantee, even for the products that should give prolonged protection, that they really do that. Not very handy but true!
What has been highlighted in different investigations is that frequently people don’t use enough sun cream. In order to make sure of the actual protection displayed on the product, you need to apply 2mg/cm2 onto the skin. The SPF factor displayed on the sun cream is determined by this amount. This is approximately half of a teaspoon for your face. You need around four tablespoons for your arms and legs, and for your torso (front and back) another 2 tablespoons. So in order to protect yourself better you need a lot of sun cream! It is estimated that people only use between 25-50% of the required amount (2mg/cm2). This means that your skin is less well protected than you realise. In addition to this, the value does not run in line with the amount of cream that you use: when you apply 2mg/cm2 of a SPF 50 then you get a SPF 50. If you now rub in 1mg/cm2 (around half a teaspoon) then your SPF has already fallen to below 10! A quarter of a teaspoon (0.5mg/cm2) provides SPF of even lower than 5! So apply more and protect yourself better!
If you are searching for a sun cream, it is better not to buy a spray. There are two reasons for this: firstly the probability of applying a sufficient amount of sun cream is low if a spray is used. Secondly sun creams often contain nano-particles. These particles are best not inhaled and, if you use a spray, you run that risk. So, it is best to use a cream. Make sure that a sun cream protects against UVB as well as UVA. According to the new ruling the UVA protection factor needs to be at least 1/3 of the UVB protection factor. Products that meet this requirement display the letters UVA within a circle on the packaging.
A foundation or day cream containing SPF or a separate product?
Although, if you are mainly inside, it is okay to protect your skin with a foundation or day cream containing SPF in the winter, I am still in favour of using a separate sun cream in the summer. Here are some reasons for this:
The amount of foundation (or powder) applied is, in fact, never enough to provide the protection displayed on the packaging. You can apply a good day cream with SPF more thickly but this contains active ingredients which, as a rule, don’t combine well with sun filters. Briefly explained; when the active ingredients in your day cream are combined with sun filters they become less effective. Furthermore, it is very expensive re-applying a thick layer of products, with high concentrations of active ingredients, onto your face every couple of hours. Besides this, filters have a relatively high chance of causing irritation or allergy; if your skin becomes irritated then you can easily swap your sun cream for another more suitable product. Finally, if you look at the ingredients list of a product you’ll see that there is actually no difference between a day and a night cream. Use a separate sun cream and you can then also use your day cream at night. This will save you some money!
How can I get my skin better prepared for the sun?
One thing is for sure, it isn’t a good idea to prepare your skin for the sun by using a sun bed. The rays that come from the sun bed consist mainly of very powerful UVA rays. These rays penetrate more deeply into the skin than UVB. Although these rays don’t burn you they are potentially more dangerous than UVB. The risk of getting melanoma ( the most dangerous form of skin cancer) increases by 75% in people under the age of 30 who regularly use a sun bed. Sun bed tans provide minimal protection against burning. A self tanning tan gives hardly any extra protection. It is much better to get your skin into top condition by eating well and strengthening the barrier function. Skin that is healthy and contains enough anti-oxidants can better protect itself against sun damage and burns less easily.
Incidentally, an investigation by the University of St. Andrews (Scotland) showed that people with un-tanned skin were seen as more attractive and healthy than people with a sun or sun bed tan. If you still wish to have that brown colour then it is important that you realise that your skin turning brown is a sign of damage. Even when you don’t burn. Part of the damage is already done before you become brown and the brown colour does protect you somewhat against the sun’s rays but is equivalent to an SPF of around 5. If you still really want to be brown then a self tanner is a good solution. Be well aware that this brown colour will not protect you against sun rays. If you are not a fan of self tanning cream and you still want to have that brown colour then I would advise you to avoid sitting in the sun during the hottest part of the day, always wear a sun protection factor in the sun and use a sun cream product in combination with a cream containing anti-oxidants. A very recent study has revealed that the extra anti-oxidants that you use in combination with the sun filter are very useful and can provide extra protection for your skin. Be aware of, and if you can, avoid photo-toxic substances if you are going in the sun. These are substances that can accelerate sun damage when combined with the sun without noticing anything on your skin. They can also leave you with unsightly pigment spots. Substances that can do this are:
- Plant extracts/oil such as citrus, orange, bergamot, mandarin, grapefruit, lime, lavender, rosemary, fig, angelica, st. Johns wort, tea tree and ginger
- Oxybenzone (funnily enough this is a sun filter)
Is it better to use an aftersun?
The sun causes free radicals to form in your skin that can eventually lead to ageing skin and skin cancer. So you are better off without than with these free radicals! Although your skin naturally contains anti-oxidants for the purpose of getting rid of these free radicals, factors such as exposure to the sun, smoking, environmental pollution and ageing quickly lead to a shortfall here. Reason enough to make sure that this shortfall is replaced as quickly as possible. Therefore, applying a cream containing anti-oxidants (that can eliminate free radicals) is also a must. There are many different types of anti-oxidants. Certain vitamins have an anti-oxidative effect (for example Vitamin C and Vitamin E) and there are many plant ingredients that also have this effect (for example green and white tea).
It is important, if you are regularly in the sun, that your skin barrier recovers, thereby supplementing the skin’s moisture content. If you don’t do this your skin will become more dry, lose its elasticity and small lines will appear. You can prevent this by using ingredients such as Niacinamide, Hyaluronic Acid or Glycerine.
If your skin is a little burnt, in spite of using sun protection, then soothing substances, such as liquorice extract (Glycyrrhiza Glabra) Aloe Vera or Beta-Glucan, can work wonders.
A good day-night cream or body lotion will contain anti-oxidants and soothing, as well as, barrier recovering substances. A good aftersun should also contain these substances. In fact, a good aftersun product is just a good cream and a good cream likewise a good aftersun product! So, you can just choose one of these products, without the need to combine both. But, first of all, you need to read the ingredients list of the product to make sure that the one you choose contains active ingredients.
Now, with these tips, you should be able to not only spend the summer with lovely skin but still look lovely and radiant after the summer!
I hope everyone has a wonderful holiday!
(Dr. Jetske Ultee-Research Physician Cosmetic Dermatology)