Sun Protection 101

We hear a lot about keeping our skin safe from the sun. We know it's important, though we don't always do as well as we should. For inspiration, we sat down with Dr. Elizabeth Foley Bucher, who is board certified in Dermatology and Mohs Surgery and a New Orleans native. A partner at The Skin Surgery Centre, she specializes in Mohs micrographic surgery and excisional surgery for the treatment of skin cancer, abnormal moles, benign skin growths and nail lesions. She credits her childhood pediatrician and visits to his medical-poster-bedecked office for triggering her interest in medicine, especially the visible, palpable parts of the science, such as dermatology.

Why is it so important to protect our skin?

Your skin is the only one you get. The negative effects of UV rays are cumulative. Over the years your body may not be able to keep up with repairing the UV-induced damage, which may not show up for decades.

What are some of the things we do wrong?

I think two main ways we go wrong (and I will include myself here) are we don't put on enough sunscreen, and we don't reapply often enough, if at all. An adult needs 1 oz (or a shot glass sized amount) per application. And no matter what the sunscreen packaging says, none are truly waterproof and should be reapplied every two hours, and any time after sweating or swimming. Finally, people don't really understand the difference between the two main types of sunscreen and how quickly—or not—they are effective.

Sunscreen can be confusing. How do we know which ones to use?

The best sunscreen is one that you like and that you will use. It really varies from person to person. You want to be sure to have daily sunscreen protection from a broad-spectrum product, and you should look for SPF 30 or higher. Broad spectrum products protect against both UVA and UVB rays. SPF 30 blocks 97% of UVB rays, and higher numbers can protect against slightly more, but no product blocks 100% of the sun's harmful rays.

What is the difference between the sunscreen types?

There are two main types of sunscreens: chemical blockers and physical blockers. Chemical blockers do a wonderful job of absorbing the sun's rays, but they take up to twenty minutes to absorb and bind. So, they must be applied early to be effective. Don't wait until you get to the beach or pool—or even to start your day—to use them. And once you put them on, be careful. Most people don't know that they can rub off before they are absorbed. So, if you lie down on a towel or wrap yourself in a coverup before the 20 minutes are up, you may be wiping off all your protection. Physical blockers, such as zinc oxide and titanium dioxide, have an immediate effect. But some people don't like their texture or the fact that they often can be seen on your skin. Overall, sunscreens have gotten so much better, easier to use, less irritating to your skin and eyes and less likely to cause allergic reactions. There are countless brands, and they don't have to be expensive to work well. But I suggest you check with your board-certified dermatologist to see what they recommend for you.

What is incidental exposure?

This is the damage your skin receives due to lifestyle and habits. So, we’re not talking about going to the beach on an afternoon, but daily activities. There's a lot of incidental exposure driving in a car, for example. We’re seeing increased skin cancers and sun damage on the left side of the body here in the United States compared with the right side in countries that drive on the opposite side. There's a famous photo in one of our textbooks of a woman who worked at the same desk for decades in an office where her left side faced the window. After that time, the left side of her face was vastly older looking due to photo damage than her right side.

Additional advice from Dr. Mary P. Lupo, MD of Lupo Center for Aesthetic and General Dermatology

"My number one recommendation is to use a sunscreen with DNA repair enzymes if you have had or you are at high risk for skin cancers. And if you already have a lot of sun damage, talk to your board-certified dermatologist about ways to safely and effectively remove the damage and reduce your risk of future skin cancers."

What are some other tips?

Wear a broad-brimmed hat. Visors are cute, but they don't protect your scalp and baseball hats only shield your forehead. When you apply sunscreen, please don't forget your scalp, the tops of your ears, lips, hands or your nose.

What about SPF labeled clothing? Is that a scam?

No. Protective clothing is fantastic—and these days you can find it everywhere from chic boutiques to Walmart. I always wear a long-sleeved rash guard and wide brimmed hat at the beach and keep as covered as possible. They’re great for children, too. Recently, I saw a man at the beach completely covered in every way in a full body swimsuit, including a hood. I told him: "You’re a dermatologist's dream!" He said: "Well, I had a melanoma so I don't mess around, and I love to surf." So, for him, this was a solution and the trade-off to enjoy his sport. It's very hard to protect your skin when you spend hours in the water surfing or doing other outdoor jobs or hobbies.

What about cloudy days?

If you can see a shadow, you can get sun damage.

Any sunscreens you recommend?

I’ll say it again, the best sunscreen is the one that you will use. Ask your board-certified dermatologist for suggestions. At our office we carry three great brands: Elta MD, Skinbetter Science and Revision. These great brands offer a variety of formulations from creams and lotions to sprays. There's even one in a compact. It doesn't hurt to try sunscreens with ingredients such as antioxidants or hydrators, things like Vitamin C and hyaluronic acid can be an added bonus. You need to choose something that matches your lifestyle.

Any you don't like?

No specific brand, but I am not a fan of aerosol sunscreen. Not because it doesn't work, it does—if used correctly. Unfortunately, so many people just spray them and don't stop to rub them in. The application is spotty and inconsistent. The result? They get burned and blame the sunscreen, but it's really a user error sort of situation.

There are sunscreens for the face and sunscreens for the body. Does it matter which we use?

You don't need to use a specific type for your face or body. But for people prone to breaking out, check for the words "non comedogenic" on the label. This will be best for your face. It is always good to check ingredients for things like fragrance or botanicals if you are sensitive or allergic to those additives.

What about nutrition or vitamins? Will any of that help?

Antioxidants, such as those found in green leafy vegetables or green tea, are always good. There's a vitamin called Nicotinamide, which has been shown to lower the number of new skin cancers in those who are at a higher risk or who have had it before. Also, an herb called polypodium leucotomos offers benefits in terms of neutralizing free radicals produced from UV damage.

Do procedures such as peels or lasers make our skin more vulnerable to damage?

After doing any procedure, talk to your board-certified dermatologist for post-procedure care. Botox and fillers go deeper, unlike lasers and peels, and should not make you more vulnerable to skin damage.

We’ve heard there are many new procedures to help the appearance of sun damaged skin?

Yes. There are many now. Some are geared toward increasing collagen and others toward brightening or exfoliating. While not a procedure, a prescription cream called Retin A acts as a chemical exfoliant, helping your skin cells turn over faster, decreasing the appearance of fine lines and wrinkles and reducing the appearance of sun damage. All of these should be done under the supervision of your board-certified dermatologist.

Anything else we should know?

See your board-certified dermatologist once a year, more often if you have a history of skin cancer, many moles, or skin problems. Remember that genetics, exposure history and lifestyle all play a role.

Thoughts from Sarah Valentine, Owner/Esthetician, Skin by Sarah

"I could talk sunscreen all day long. I make this analogy a lot to my clients in regards to sunscreen to drive home the point that it should be worn daily: We’d never dream of leaving the house without brushing our teeth. Applying SPF every day is just as important! Make it a non-negotiable in your daily routine. As a culture we get so caught up in the immediate gratification of a quick fix like an injectable to make us look younger, but in essence, wearing sunscreen daily is THE BEST anti-ager on the market. The sun accounts for the majority (upwards of 90%) of the extrinsic aging we see in our lifetime."

Skin by Sarah

Skin by Sarah is a Mid-City based, cozy, plant-filled studio specializing in organic skincare and custom facials. Owner/esthetician Sarah Valentine recommends two treatments for sun damage and pigmentation: The Glow UP (a dermaplaning with a Hydrojelly mask) and MicroChanneling (to break up pigmentation and stimulate collagen). Skin by Sarah, skinbysarah.glossgenius.com.

Four Seasons Hotel New Orleans and The Spa at Four Seasons Hotel New Orleans

Like most Four Seasons resorts around the world, this riverside hotel provides sunscreen to guests at its pool, a 75 foot-long, crescent-shaped marvel. "We offer SunBum complimentary at the pool, and we also carry Soleil Toujours for purchase in the Spa, which is a combination of sun care and skincare. Fabulous stuff!" says Vicki Bristol, Director of Public Relations. At the The Spa at Four Seasons Hotel New Orleans three treatments have been designed to help combat damaged skin and the signs of aging caused by UV exposure. Seed to Skin Facial Rituals is a luxurious facial to help firm and oxygenate the skin; The Awakening Body Ritual renews all-over skin with rich marine products (such as spirulina); and Body Method boosts elasticity and firms via a full body exfoliation. Four Seasons Hotel and The Spa at Four Seasons Hotel New Orleans, fourseasons.com/neworleans.

The Windsor Court and The Windsor Court Spa

This award-winning hotel's newly renovated rooftop pool is abuzz with action, with chic new cabanas and comfy lounge chairs complete with shady umbrellas. Keeping guests safe, the Pool Welcome Station puts out 18-ounce pumps of Supergoop Play (SPF 50) for guests’ complimentary use. (Alternatively, The Windsor Court Spa sells Hampton Sun products, which are also offered for cabana rentals.) Step into the gorgeous Windsor Court Spa for the Sun Goddess Calendula Carotenoid Repair Facial, a brightening and soothing treatment that harnesses whole plant derived Vitamin C, flavonoids, and anthocyanins to treat hyperpigmentation. The Windsor Court and The Windsor Court Spa, windsorcourthotel.com.

On Model, handwoven Freya hats with SPF 50+ protection, available at Em's, and Krewe sunglasses worn throughout.

Committed to the elimination of skin cancer, Wallaroo Hat Company donates 1% of its profits each year to skin cancer research, education and prevention. Try the Marseille Wide Brim Sun Protection Hat, in a flexi-weave fabric with UPF 50+ fabric and a 4 1/2" brim for maximum protection. Wallaroo Hat Company, wallaroohats.com.

Josh Rosebrock's fabulous, dual-action Nutrient Rich Daycream (SPF 30) makes easy, everyday application a joyful act. With zinc oxide, it can be used by all skin types. Vibrant Market, thevibrantmarket.com.

Inspired by the historic French Quarter's captivating cast-iron balconies, adorned with a touch of filigree, the vintage-looking St. Louis Classic Sunglasses are round-shaped shades that suit every visage. Krewe, krewe.com.

Triple-action tinted SPF 50 UVA/UVB and that no makeup look you want for the beach come together with Odacité's Mineral Drops Tinted Sunscreen SPF 50, complete with a creamy mineral sheath to put your best face forward. Blue Mercury, bluemercury.com.

Earthsavers Correcting Vitamin C Serum delivers what experts know: Vitamin C boosts collagen, fights aging and diminishes fine lines. Earthsavers, earthsaversonline.com.

C-Shells SPF 30, a mineral, antioxidant-powered sunscreen, boasts a serum like texture for all day use without that white residue. Glass Skin, getglasskin.com.

Made from packable straw for discerning fashionistas, the water-resistant, sand-hued Halston hat keeps the rays away with UPF 35+ protection and loads of elan. Pied Nu, piednunola.com.

The NOA One Piece by Jonathan Simkhai can by layered with any coverup, rash guard or bottom for multiple looks. This classic staple offers both style and performance. FeBe, febeclothing.com.

The Seafolly Essential Coverup is your all day segue from beach and pool to indoors play. Made from cotton, with a V-neck, it hits just above the knee for flair. Basics Underneath, basicsunderneath.com.

PQ's Bree Boho Pants in Calipso bring the fun with a festive stripe and comfy drawstring waist that will have you dancing in your beach chair, hopefully under a shady umbrella. Saks Fifth Avenue, saksfifthavenue.com.

Shelter yourself like a bygone cinema siren or a character from a Tennessee Williams play. The San Francisco Umbrella (SPF 50) seals the deal with its impenetrable Sunbrella™ Fabric—approved for sun protection by the American Skin Cancer Foundation. Bella Umbrella, bellaumbrella.com.

Pack the EveryDay Sunday Natural Linen Cover Up Tunic Shirt for your next getaway. This flattering piece complements all figure types and can be purchased with matching shorts to be worn in countless ways. Bra Genie, thebragenie.com.

All the experts say wear a hat— but not just any hat. Wear the one with the widest possible brim. For the shadiest results, don this Women's Oasis Sun Hat. Masseys, masseysoutfitters.com.

Who needs to fly across the pond for a vacation? Just slip on the chic Porto Sunglasses, meant to evoke the beauty of Portugal's Douro River Valley, for an instant escape. Moxlox, moxlox.com.

Lululemon's Waterside UV Protection Long Sleeve rash guard comes in three, easy-to-pair colors for an added layer. The light, UPF40+ fabric makes covering up a breeze. Lululemon, lululemon.com.

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