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Q&A: A Dermatologist Explains Sun Damage, Vitamin D, and Cancer

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Welcome to sunscreen week at the Cut, where we provide you product reviews, tips, and news you'll need for sun safety. But first, here's this: Protecting your skin from harmful UVA/UVB rays is the best beauty tip. Ever.

In part one of this interview, Dr. Heidi Waldorf answered questions about proper SPF usage, water resistance, and the new regulations changing sunscreen this summer. Below, she gets into saving your scalp, reversing sun damage, and more of the Cut's burning questions on vitamin D, cancer, and more.

What’s the best and most effective way to repair sun damage? 
There are many ways to improve sun damage depending on the type of damage. We use various lasers to treat telangiectasia (red vessels), lentigines (brown spots), and wrinkles caused by photo damage.  For actinic keratoses — the red, rough, scaly pre-cancerous spots that appear on sun damaged skin — we can use lasers or light therapy, cryotherapy (freezing), or topical chemotherapy creams or lotions. Regular use of a topical retinoid (like tretinoin or tazarotene) has also been shown to improve sun damage. Topical antioxidants, growth-factors, and certain peptides may also be helpful to prevent or reduce damage, but there isn't the same rigorous testing for cosmeceuticals as there is for prescription medications.

Which areas of your body are more prone to cancer? Many times, it seems moles get removed in areas that rarely see the sun (like your back). 
The areas at highest risk are the areas most exposed. Most basal cell carcinoma and squamous cell carcinoma occur on the face, ear, neck, lips, and back of the hands. Melanoma is more common on the upper body in men and on the lower legs in women. In darker-skinned people, melanoma often appears on the palms, soles, or under the nails.

How long is too long in the sun? 
If you are changing color, you've been in the sun too long without adequate protection.

What’s the best thing to put on your skin after a burn to help heal it?
As soon as possible after excessive sun exposure, take an oral anti-inflammatory agent, like aspirin or an Advil, to reduce the inflammatory cascade. A topical steroid like over-the-counter 1% hydrocortisone cream can be applied along with bland moisturizers. Cool milk compresses are soothing.

What’s the best sunscreen product for my scalp and hair? Should I just put sunscreen cream in my hair?  
Sunscreen isn't necessary for the hair itself, but exposed scalp is at risk. Balding areas and parts in the hair can be treated with sunscreen sprays or lighter lotions. The best protection is a hat with at least a three-inch brim all around to protect the scalp, ears, neck, and face.

What’s your take on sunscreen veils or fluids?
The base of the sunscreen — cream, lotions, spray, powder, fluid/veil — doesn’t affect its efficacy. The part of the formulation that affects efficacy is the SPF, and whether it also contains adequate UVA protecting ingredients. The other important part is whether enough of the product is applied initially, and repeated often enough. I want a patient to find a product that is cosmetically elegant to that patient’s skin so that he/she will be willing to use it.

Research shows that even exposure to the sun, and vitamin D that comes from that, seems to guard against cancer, while bursts of intense exposure seem to be the cause.
Despite scattered studies, the overwhelming evidence is that ultraviolet exposure increases the risk of skin cancer. And the latest sun-exposure study that came out in Annals of Internal Medicine showed what we’ve also known for a long time: that people who wear sunscreen regularly have fewer skin signs of aging. So I recommend that my patients protect themselves from ultraviolet exposure, get a lab test for vitamin D levels, and take a supplement as needed.

Photo: Michael Ochs Archives/Getty Images

Copyright © 2013, New York Media LLC. All Rights Reserved. The Cut® are registered trademarks of New York Media LLC.

Copyright © 2013, New York Media LLC.
All Rights Reserved.

Copyright © 2013, New York Media LLC. All Rights Reserved.

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