What does melanoma mean? How much sunscreen do you really need? Below, the answers to your top five SPF questions.
Vogue Arabia, March 2019. Photo: Francesco Scotti
You’re either religious about daily sunscreen application, or you’re questioning why it exists – well, that’s if recent Google searches into the matter are anything to go by. While SPF is every dermatologist and skin expert’s non-negotiable product to prevent skin cancer, premature aging, hyperpigmentation and collagen depletion, the message still hasn’t been received by everyone. And, when the internet – where “homemade SPF” has become a thing – is in the mix, sometimes you need experts and science to help sort fact from fiction.
So, we asked two dermatologists their thoughts on some of the most-Googled SPF questions in previous months.
What is chronic sun damage?
Also known as photoaging, chronic sun damage refers to the cumulative effects of prolonged sun exposure on the skin over time. “Photoaging manifests as fine lines, deep wrinkles, dark spots or pigmentation, sagging and thickened skin that loses its elasticity,” explains Dr Catriona Maybury, Dermatica medical lead and consultant dermatologist. “More concerning is that chronic sun damage increases the risk of developing precancerous and cancerous skin lesions, which can harm your overall health if left untreated.”
This damage manifests in different ways on different skin tones. On fair skin, noticeable signs may be fine lines and pigmentation, while for darker skin, “the natural melanin stores offer greater protection against things like wrinkles, but you’re more likely to develop pigmentation,” explains Dr Hiva Fassihi, consultant dermatologist for La Roche-Posay. “This could mean that any acne scarring you have becomes more pronounced, or if you have an inflammatory condition like eczema, you might find the pigmentation that accompanies it may stay for a very long time.”
Those with very light skin who haven’t been diligent with sun safety will almost certainly have what Dr Fassihi calls “subclinical chronic damage”, which sits deeper in the complexion and isn’t visible. “There is a certain amount of damage that you accumulate over time before you hit a threshold, when the pigmentation pathways are activated and you start to see sunspots or fine lines.”
Do you need sunscreen in the shade?
It’s an emphatic yes from both experts. “Even when you’re in the shade, you’re still exposed to UV rays,” says Dr Maybury, explaining that surfaces like sand, water, snow and certain types of other matter can also reflect UV rays, allowing them to reach the skin. “Additionally, UV rays scatter in the atmosphere when they interact with molecules or droplets in the air, making it possible for them to reach shaded areas, like under trees or umbrellas.”
As well as wearing a high, broad-spectrum SPF every single day – even on cloudy ones – try and engage in sensible, sun-safe behavior, like avoiding the strong midday sun and wearing sunglasses and a hat.
Can you tan through sunscreen – and should we be tanning at all?
There is no such thing as a “safe” tan, says Dr Fassihi. “A suntan is a sign that our skin has been damaged by UV radiation. Tanning is the skin’s way of trying to protect itself from this UV radiation, which causes both direct and indirect damage to the DNA in our skin cells.” Of course, sunscreen works by blocking UV rays, but it will never be able to block 100 per cent of UV rays, so some tanning may still occur, especially “if you spend extended periods outdoors without proper reapplication of sunscreen, or during peak sunlight hours”, explains Dr Maybury. Ultimately, tanning is a form of sun damage that accelerates premature aging, making skin appear older, faster, not to mention excessive exposure also increases the risk of skin cancer.
Is sunscreen bad for you? And can it cause cancer?
“Too many people avoid wearing sunscreen because they think it might be harmful to their skin, or they think it’s healthier to have a tan,” says Dr Fassihi. “There is no evidence of this, but plenty of evidence that excess sun exposure is very harmful to the skin.”
While a few studies have raised concerns about certain sunscreen ingredients, such as oxybenzone, retinyl palmitate and parabens, potentially causing cancer, this research is “pretty questionable”, she says, adding that there is no clear data to show that UVR filter chemicals convey an increased cancer risk. On the other hand, “there is clear evidence that sunscreens reduce cancer risk.”
While chemical sunscreens are very effective at absorbing UV rays, mineral (or physical) sunscreens – which contain ingredients like zinc oxide and titanium dioxide – were previously thought to reflect and scatter these rays, as well as visible light. “More recently, data has demonstrated that mineral sunscreens also absorb these rays,” says Dr Fassihi. “The problem is that they traditionally leave a white residue on the skin and can feel greasy. More recent formulas nano-size these mineral blockers, making them less white on the skin, however this process changes their properties. They are good at protecting against UVB but lose their ability to block visible light.”
The moral of the tale? It’s best to use a sunscreen that contains a mix of chemical filters that block either UVA or UVB and mineral blocks, which protect against UVR and visible light.
What does a melanoma mole look like?
Melanoma can present in many ways, so it’s incredibly important to get your skin checked regularly – early detection can save lives. “Spotting skin cancer early vastly improves your outlook but for skin of color, skin cancers are often not diagnosed until a later stage, so vigilance is key, regardless of how many or few sunburns you’ve had,” says Dr Fassihi.
The characteristics of melanoma can be identified by the ABCDE rule:
- Asymmetry: One half of the lesion is different from the other.
- Border: Irregular or poorly defined edges.
- Color: Multiple colors, uneven distribution, or very dark hues.
- Diameter: Bigger than 6mm, although early melanoma can be smaller.
- Evolving: Changes in size, shape, color, or symptoms such as bleeding and itching.
Keep a keen eye on your skin, be vigilant and always, always wear SPF, no matter what you read on Instagram.
Originally published in Vogue.co.uk
