Skin-Care Myths

You’re aware that the sun causes dark spots and fine lines, but it’s also behind a very scary threat to your health: skin cancer.

Sure, you’ve heard the warnings: Wear sunscreen, cover up at the beach, skip the tanning bed. Still, even though these sun-safe pronouncements are so prevalent, a lot of women disregard the message. Only 34 percent of young adults under 25 say that they regularly use sunscreen, reports a 2003 survey from the American Academy of Dermatology.

If you’re part of the sans-sunscreen group, then we need to clue you in to something: You’re basically inviting skin cancer. Consider the fact that just five sunburns at any time in your life double your odds of developing it.

Yes, it sounds harsh, but that’s because it is. Skin cancer is the most prevalent of all cancers. Melanoma, the deadliest form of the disease, is now the second most common cancer in women between the ages of 20 and 29, according to the American Cancer Society. And rates of basal-cell carcinoma and squamous-cell carcinoma — the two less lethal forms of the disease — have more than doubled in the past generation among 20- and 30-somethings, reports a 2005 study from the Mayo Clinic.

It’s enough for many dermatologists to consider skin cancer to be at record levels. “When I first started practicing 20 years ago, skin cancer was a disease of senior citizens — even seeing someone in her 30s with it was unusual,” explains Richard Fried, MD, PhD, clinical director of the Yardley Skin Enhancement and Wellness Center in Yardley, Pennsylvania. “Now, I regularly remove skin cancers from 20- and 30-somethings, and sometimes even teens, and I barely bat an eye.”

The skin-cancer surge can mainly be chalked up to our sun-worshipping culture, explains James Spencer, MD, clinical professor of dermatology at Mount Sinai School of Medicine in New York City. A major part of this is the popularity of tanning salons. Several studies have linked indoor tanning to all three skin-cancer types, and yet young women are still cooking themselves under sunlamps — convinced they look thinner and healthier with a year-round bronzing, says Dr. Spencer.

And here’s the crazy thing: Skin cancer is almost 100 percent preventable — if you strike a balance between enjoying the great outdoors and cutting your risk factors. But before you can commit yourself to taking the necessary steps, it helps to know the myths about what does and doesn’t lead to sun damage. Your primer for practicing safe sun starts here.

Myth #1: A sunburn does more damage than a suntan

It’s been dubbed a healthy glow, but surprisingly, a suntan is actually just as destructive to your skin as a raw, pink sunburn. “Both a tan and a burn are triggered by UVA and UVB rays, two types of invisible light emitted by the sun and indoor tanning beds,” explains Martin A. Weinstock, MD, PhD, professor of dermatology at Brown University Medical School and chair of the American Cancer Society Skin Cancer Advisory Group. Research isn’t clear on whether one type of ray is more closely linked to skin cancer than the other, but what researchers do know is that both can adversely affect the DNA of skin cells — a precursor to cancer.

Considering that both a burn and a tan are toxic to your skin, it is time to bury another long-standing sun lie: that getting a base tan protects your skin from subsequent sun exposure. “It’s not true — any little bit of color you weren’t born with is a sign that your skin has been exposed to UV rays,” explains David Leffell, MD, vice president of the Skin Cancer Foundation and professor of dermatology at Yale University School of Medicine. “Sun damage is cumulative, so the more you accrue, the greater your cancer risk.”

Myth #2: It takes years for the effects of the sun to show up

Though it’s impossible to know exactly how long it took for marks on your skin — like freckles, spots, little lines, and broken blood vessels — to develop, studies have found that they can appear within weeks of sun exposure, explains Steven Rotter, a dermatologic surgeon in Vienna, Virginia. How they form: UV rays alter pigment and weaken your skin’s collagen, the layer that gives your dermis elasticity.

The good news is, some sun damage can reverse itself. By avoiding UV exposure as much as possible — or at the very least, slathering your body in sunscreen with a minimum sun protection factor (SPF) of 15 when you go outdoors — you’ll give your skin the chance to repair some of the harm that can foreshadow skin cancer. “You can’t eliminate the odds of one day developing skin cancer because any sun exposure — even if you lay out a few times as a child — puts you at risk, but you’ll lower those odds greatly by vowing not to incur any additional sun damage,” says skin-cancer specialist Arielle Kauvar, MD, professor of dermatology at New York University School of Medicine.

To speed the healing of any unsightly creases and spots that your dermatologist has already checked out and deemed noncancerous, consider using over-the-counter or prescription retinoids — antiaging forms of vitamin A that boost collagen production. Your doctor can tell you if they’re right for you.

Myth #3: Throwing on a cover-up allows you to skip wearing sunscreen

Hitting the beach in a light-colored long-sleeve tee is certainly better than baring your arms and torso to the sun. But the truth is, the typical thin white tee shirt — the kind you’d wear on a hot day — has an SPF of only 7. This means that UV rays will start to broil your skin through it in about 70 minutes. (It takes a fair-skinned person about 10 minutes to get burned sans protection in the midday sun; multiplying this number by the SPF number of the garment or sunscreen tells you how long it’ll take before a burn sets in.) “Most summer clothes block very few rays because the fabric is usually cotton or polyester, which isn’t woven tightly enough to keep out UV light,” says Susan Weinkle, MD, assistant clinical professor of dermatology at the University of South Florida in Tampa.

This isn’t to say that sunscreen is the only protection you need; dermatologists agree that wearing a minimum of SPF 15 sunscreen, as well as tightly woven garments, is the smartest way to stay sun safe. Also, the darker the garment’s color, the more protection you’ll get from it.

A few other sun-repelling requirements: a canvas hat (like the beachbum kind Ashton Kutcher is always seen in, not the straw type your grandmother wears) and sunglasses that block both UVA and UVB rays.

Myth #4: When you’re not in direct sun, you have nothing to worry about

Unfortunately, the reality is that just being outside means you have to worry about sun damage and skin cancer. “Seventy percent of all UV rays penetrate through clouds, so your damage odds are actually almost as high on an overcast day as they are on a bright day,” says Dr. Rotter.

Clouds aren’t the only things UV light easily penetrates. Sixty to 80 percent of UV radiation is transmitted through the first 12 inches of water in a pool, so staying submerged won’t keep your skin safe. “Water also reflects 100 percent of UV light, so you’re at risk from the additional rays bouncing off the pool or ocean surface and onto your body,” says Dr. Spencer.

Even taking cover in the shade is dicey. Sand and concrete reflect 25 percent of UV rays. “No matter how little direct sunlight you think you’ll be getting, if you’re going to be outside for more than a few quick minutes, be safe by putting on sunscreen,” says Dr. Rotter.

Another skin-protection slipup: not slathering on sunscreen during the winter months. UV radiation may not be as strong in January and February as it is in July, but you can still accumulate major damage during cold-weather months…especially if you hit the slopes.

“Some of the worst sunburns I have seen were on skiers; they get double the sun without realizing it because they’re at higher altitudes,” explains Deborah Sarnoff, MD, associate clinical professor of dermatology at New York University. “Also, snow reflects 85 percent of UV rays, so you get even more harmful exposure.” And no matter what season it is or how low your altitude, you’re not necessarily out of harm’s way just because you’re indoors. “UVA rays go right through glass, whether it’s a window in your house or your car windshield, so wear sunscreen when you’re spending a lot of time next to a window or driving, just as you would when you’re out side,” says Dr. Kauvar.

Myth #5: If you get a mark or mole, your doctor can cut it off before it turns cancerous

The problem with this logic is that by the time many people consult a dermatologist about a suspicious mark, it may already be cancerous.

“Skin cancer can be fast growing; a mole can appear on your skin and turn into melanoma within six months,” explains Albert Lefkovits, MD, assistant clinical professor of dermatology at Mount Sinai School of Medicine in New York City.

Luckily, if the melanoma hasn’t spread beyond your skin, your survival rate over five years is 98 percent, according to the American Cancer Society. But if it has moved into your lymph nodes, those odds sink to 64 percent. (Basal-cell carcinoma rarely spreads past your skin, and squamous-cell carcinoma is less likely to do so than melanoma, though both can still be serious cancers.)

Remember, skin cancer is almost 100 percent preventable, so it seems pretty foolish to wait until you’ve been sporting a weird spot for a while before taking action by seeing a derm. “Another problem is that the longer you wait, the larger the spot may get — meaning a bigger, more visible scar when it is finally cut off by your dermatologist,” says Dr. Rotter. “I’ve had to remove part of patients’ noses or eyelids because they ignored a red bump or scaly patch when it was in an early stage.”

Myth #6: Tanning salons are a safe way to get color

It’s amazing how many sun-savvy chicks stretch out inside a tanning bed like a rotisserie chicken for 30 or so minutes on a weekly or even daily basis, truly believing that frying their skin indoors is somehow safer than roasting in the sun outside. But indoor-tanning beds are at least as harmful as the sun. “The typical salon uses lamps that emit UVA and UVB rays. The amount of UVA rays is about 10 times more UVA light than you’d get by lying out in your backyard,” says Dr. Spencer. “So 20 minutes at a salon triggers the same damage you’d rack up after more than three hours outdoors.”

A slew of studies suggest a strong sunlamp-skin cancer connection. One, from Johns Hopkins University in 2001, found that just 10 indoor tanning sessions sparked skin changes linked to cancer. Research from the Journal of the National Cancer Institute in 2002 showed tanning-bed use upped a person’s odds of developing squamous-cell carcinoma one-and-a-half times and boosted the risk of basal-cell carcinoma 50 percent. And a 2003 Norwegian and Swedish study revealed that one or more indoor tanning sessions a month increased a woman’s melanoma risk by 55 percent.

Tanning beds may also trigger more skin damage (those wrinkles, pigment changes, and broken blood vessels) because of the concentrated levels of UVA light. “When I see a patient, I can tell if she’s an indoor tanner; her skin will have a ‘leathery’ look,” says Dr. Fried. Plus, since you lie under a sunlamp naked, you expose skin that normally never sees the light of day, like your butt and boobs. “Because these areas are usually covered, you’re less likely to notice a suspicious mark there,” says Dr. Leffell.

Myth #7: Dark-skinned women aren’t in danger

Bottom line: The darker your skin tone, the less likely you are to develop skin cancer, especially melanoma: Rates are more than 10 times higher among whites than African-Americans, according to the American Cancer Society. “Darker-hued people have higher levels of melanin, the natural chemical that gives skin its pigment,” says Dr. Spencer. “Melanin is also a first line of defense in repelling UV rays, so the more you have naturally, the more protected you are.”

However, women with olive to ebony skin tones are hardly in the clear. Remember, UV light has a harmful cumulative effect on your dermis, and that’s true no matter what shade you sport. The more unprotected sun exposure you get, the greater your odds of triggering the development of a cancerous growth. “A darker-skinned woman who spends all of her time in the sun without sunscreen is more at risk than someone with a lighter skin tone who rarely goes out in the sun,” says Dr. Spencer.

And when people with darker skin do get skin cancer, it tends to turn up along body areas with less pigment — like the soles of the feet, the palms or under a fingernail or toenail. “Because these body regions aren’t always in plain sight, cancer that develops there often isn’t caught until it’s at a later, more serious stage,” adds Dr. Rotter.

Myth #8: The SPF added to some makeup provides plenty of sun protection

Beauty gear with built-in SPF sounds like a match made in heaven. But unfortunately, while they give you an added boost, many of these products generally don’t have a high enough SPF — at least 15 — to keep you safe from the sun for very long, says Dr. Sarnoff. Also, since they don’t get fully absorbed like a lotion does, they’re likely to loosen and clump up in the pores of your face, leaving some parts of your skin susceptible to UV damage, according to research at Wake Forest University in North Carolina.

Another problem with cosmetics-sunscreen combos is that most aren’t made with broad-spectrum ingredients. “This means they defend you against UVB rays only, not UVA rays,” says Dr. Sarnoff.

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