Dr. Shari Lipner on sunscreen myths and summer skin care advice

Episode Transcript

faithWelcome to Health Matters, your weekly dose of health and wellness updates from NewYork-Presbyterian. I'm Faith Salie.

Sunny days are back, but don't forget the sunscreen! A recent survey found that 52% of Gen Z adults didn't know that sun exposure can increase the risk of skin cancer and premature skin aging. To help raise awareness about sunscreen safety and the importance of sun protection, we resume our conversation with Dr. Shari Lipner, Dermatologist at NewYork-Presbyterian and Weill Cornell Medicine. We cover sunscreen ingredients, mole monitoring, and making smart choices when it comes to summer fun.

faith: Dr. Shari Lipner, thank you so much for joining us.

Dr. Lipner: I'm glad to be here. Faith.

faithAs the weather gets warmer and summer approaches, can you start by addressing some of the myths and misconceptions about sun protection? I feel like there are a lot of misconceptions out there.

Dr. Lipner: This is an area where we really need to educate the public. And, you know, our perceptions about skin health and the sun have also changed over the years. So, when it comes to myths, you know, a lot of people believe that you don't need sunscreen. Because you don't burn easily. So if you don't burn easily, you don't need to protect yourself from the sun, you don't need sunscreen. Some people with darker skin think that you don't need sunscreen, as they've been told for years, but now we know that everyone needs to protect themselves from the sun, everyone needs to use sunscreen. Because long-term exposure to the sun not only causes sunburn, but even if you don't burn, it also increases your risk of all three types of skin cancer and it also causes skin aging.

faith: So, one thing I've always wondered about is vitamin D. Do you need to be in the sun to make it?

Dr. Lipner: Right. So for many years, people believed that they needed to be in the sun to get the vitamin D they needed.

faith: right.

Dr. Lipner: This is a myth, because too much exposure to the sun without protection can lead to skin cancer and skin aging. So what we encourage everyone to do right now is to protect yourself from the sun. Use sunscreen. If you're deficient in vitamin D or your doctor has told you to increase your vitamin D intake, you can increase it through your diet or supplements, but never lie on a roof.

faith: With this being a time when people are spending more time outdoors, do you have any advice on the best way to protect yourself from the sun?

Dr. Lipner: There are many simple steps you can take to protect yourself from skin cancer and premature skin aging. First and foremost, avoid the sun during peak hours whenever possible, which is generally between 10am and 2pm.

When you go outside, it's important to wear a broad-spectrum, water-resistant sunscreen. We recommend SPF 30, which blocks 97% of the sun's rays. If you apply more and more sunscreen up to 100, you'll get a little more protection, but it won't give you 100% protection. So, you still need to be careful, and you should reapply sunscreen, especially after going in the water or sweating. In addition, wear sunglasses, a wide-brimmed hat, and long sleeves or UPF clothing if possible.

faithDr. Lipner, I am going to be aggressive with sunscreen. I am very fair-skinned and have lots of moles. I know this is important, but the sunscreen situation is very confusing as I keep hearing more and more about how questionable sunscreen is.

Dr. Lipner: So there's been a lot of coverage in the media about this topic. I think there's a lot of anxiety among the general public. And we as dermatologists are trying to help people understand what this means in terms of what the FDA is saying and what the media is saying. And I think I can simplify things.

The sun is a carcinogen. The sun is a known carcinogen, so we must do everything we can to protect ourselves from sun exposure. Sun exposure can cause basal cell carcinoma, squamous cell carcinoma, and melanoma, a deadly form of skin cancer. So it's still important to use sunscreen. I think some of the controversy comes from the fact that the FDA is still studying the ingredients in these sunscreens, but the FDA hasn't said that sunscreens are carcinogenic or that you shouldn't use them. The FDA is just studying more how the body absorbs these sunscreens. And there are two types of sunscreens:

Chemical sunscreens contain ingredients like oxybenzone and evabenzone, which act like a sponge to absorb the sun's rays, and mineral sunscreens include zinc oxide and titanium dioxide, which work a little differently as they block the sun's rays.

Mineral sunscreens are less elegant and tend to leave a white film behind, which as you know, may not be acceptable to some people, but the FDA is still studying some of the ingredients in chemical sunscreens, so I think mineral sunscreens are OK for people who don't feel 100% safe, but there's no indication yet that chemical sunscreens are unsafe.

faith: If a moisturizer or makeup product has SPF in it, it's a tinted moisturizer, but generally speaking, does that provide enough protection?

Dr. Lipner: Look, people typically only put on about 25% of the amount of sunscreen they should. They don't put on enough, and when they're wearing moisturizer and makeup, they put on even less. So in general, if you're just running to your car, you're probably OK, but if you're really going to walk more than 10 minutes, I think you should put on some real sunscreen.

faith: You said you only use about 25% of the amount of sunscreen you should use, did I hear you correctly?

Dr. Lipner: Yes. People use sunscreen very sparingly. Generally, a shot glass full is all you need to cover your entire skin. So they put a little on their fingertip and think that's enough to cover their entire skin. They don't want it to look cakey or white. When it comes to applying sunscreen, I think it's better to apply more than less.

faithSun exposure is known to trigger skin damage, and it can even cause cancer. You've also said it can cause aging. Can you talk us through how that works? What exactly is happening to our skin?

Dr. LipnerWhen it comes to skin aging, UV rays can destroy elastic fibers and collagen, causing wrinkles, and can also stimulate pigment-producing cells called melanocytes, resulting in the so-called melasma. UVB and some UVA rays can damage DNA, leading to genetic mutations and the accumulation of DNA damage that can lead to cancer.

faith: How does sun damage show up on the skin? How does it show up?

Dr. Lipner: Dark spots may appear on the skin, known as solar lentigines. They may also cause premature wrinkling. Moles may appear or change. Changes in certain moles may be a sign of melanoma, the most deadly form of skin cancer. The things we look for have an acronym, ABCD E, which makes them easy to remember.

A stands for asymmetry, meaning if you draw a line across the mole, both sides should look the same as each other. If they don't, that's a warning sign. Another warning sign is B, borders, meaning the borders should be round and smooth. They shouldn't be jagged, irregular, or ragged.

C is color, meaning if it's light brown it's OK, but if it's multiple shades of brown, multiple colors, or black it could be a warning sign of melanoma. D is diameter, meaning a mole that's 6 millimeters is a concern. Think of a pencil eraser. Any mole bigger than an eraser is cause for concern. And then E is the most important. I think E stands for evolution, meaning if you have a mole that's changing and getting bigger, you should probably take it to a board-certified dermatologist.

faith: How often should I check my moles?

Dr. LipnerI think that's really important, and I think everyone, especially if you have a lot of moles or a family history of skin cancer, should go see a board-certified dermatologist and get their moles checked, but there are other things you can do besides just protecting your skin, so doing monthly self-skin checks is important.

So, set an alarm on your phone once a month when you get in the shower or when you get out of the shower. Keep an eye out for moles. Your back, buttocks, the backs of your legs are hard to get to, but you can check them with a mirror. You can even get your partner to help you. This is very important.

faith: What are some key takeaways you want to share with our listeners about taking care of your skin, especially in the sun?

Dr. Lipner: Taking care of your skin doesn't have to be complicated or time-consuming. Just like brushing your teeth in the morning, we recommend applying a broad-spectrum sunscreen with SPF 30 before going outside. Cover up as much skin as possible with a hat, sunglasses and long sleeves. Also, have your skin checked by a board-certified dermatologist once a year and once a month when you step out of the shower to check for any changes.

faith: That sounded very simple and easy to use.

Dr. Lipner: I think it's easy. I think it becomes easy once people make it a part of their daily lives.

faithThank you so much, Dr. Lipner. Not only have you cleared up a lot of mysteries, but you have also shed a lot of light on everything.

Dr. Lipner: It was a lot of fun. Thank you, Faith.

Many thanks to Dr. Lipner.

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