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Burn Notice: How to Protect Yourself from the Sun

Limiting sun exposure requires a commitment and some planning, especially for those of us living along Florida's west coast. Read along as the Chief of Dermatology at USF's School of Medicine puts us all on Burn Notice.

According to the U.S. Centers for Disease Control and Prevention, nearly 700 deaths from sun-related exposure are reported annually. Heat exhaustion is one of the milder forms of heat-related illness. Symptoms include:

  • fatigue
  • heavy sweating
  • headache
  • muscle cramps
  • nausea and a headache
  • fast and shallow breathing

If untreated, heat exhaustion could lead to heat stroke, which is a medical emergency requiring professional treatment. But there are a few things you can try at home.

Based upon information offered by the Centers for Disease Control, and their Prevention Guide for Emergences and Disasters, treatment includes: 

  • drinking cool water
  • rest
  • taking a cool shower or sponge bath
  • remaining indoors, in an air-conditioned room
  • if symptoms or reddness persist, call 911 or go to an emergency room for treatment

Older Americans must also take special precautions in the sun. The National Institute on Aging recommends four types of exercises  including endurance activities such as walking, biking, or swimming, strength training (light weightlifting to reduce muscle loss), stretching and balance exercises for seniors.  Yet it is critical to be aware of Florida's warm weather, rising temperatures and their impact on dehydration. Seniors should look for symptoms such as lightheadedness and changes in body temperature, especially if walking or exercises outdoors. Babies younger than six months should be kept out of direct sunlight. When outdoors, they should wear brimmed hats and protective clothing.  

But the sun's harmful rays can cause other problems - which are well-documented, for children, adults and seniors. 

I sat down with Neil Fenske, a physiician at USF for 33 years and the Chief of Dermataology and Cutaneous Surgery. He says sun exposure can pose an array of health risks. Simple measures such as wearing a wide-brimmed hat, slathering on sun protective lotion with a sun-protective factor (SPF) of at least 30, and wearing sunglasses that block at least 99 percent of UVA radiation, can make a huge difference in protecting your skin.

The American Cancer Society cautions that consumers should also check the labels of sunglasses. Those that say "cosmetic", block only about 70 percent of radiation and one should not assume sunglasses without labels block any radiation at all. 

Fenske strongly advocates an annual skin check with a dermatologist for early detection of harmful skin changes. Patients with certain risk factors, such as previous removal of moles or bouts with melanoma, should be checked more often. He also encouraged folks to perform regular self-check skin exams, which can help spot new growths, or changing skin conditions early on.

"Preparation and prevention is a repsonsibility we should all take seriously," said Fenske, pointing out that the sun's rays accelerate aging of the skin. 

Those rays can cause tumors, fine wrinkles, discoloration  and three types of cancers- basal cell carcinoma, squamous cell carcinoma and melanoma. Fenske said prevention is critical to limiting the damage. He advocates using sun protection lotion starting in children as young as six months of age. He also lists these vital precautions:  

- wearing UPV-resistant clothes

-  wearing tightly-woven, darker,  long-sleeved shirts

- wearing a brimmed hat to shade your face

- wearing sunglasses providing ultraviolet (UV) protection

Feske also offered that SunGuard is a laundry additive that offers clothing a sunscreen called Tinosorb. It adds a level of ultaviolet protection, or UPF of 30, which lasts through at least two dozen washings.

Sunscreen plays a vital role in blocking harmful penetration of the skin. A tan, Fenske said, is also a sign of skin injury. It is the body's natural way of thwarting sun damage, but means there has been too much exposure. Fenske advocates against tanning beds, pointing to a mounting body of scientific evidence that supports his position that they cause melanoma. The World Health Organization has declared tanning beds to be a carcinogen and 32 states have legislation  making it illegal for those younger than 18 to use without parental consent.

"Don't do it," said Fenske.

As for sun lotions and SPFs, not all lotions are equal. SPF only refers to protection against B radiation. Instead, Fenske encourages use of broad spectrum sunscreens providing protection against both A and B rays. To complicate matters, not all broad spectrum sunscreens are equal. The FDA  has approved a new four-star system to clarify both A and B protection offerde by a sunscreen. Labels will include information that reads something like this- "SPF 30 for B and 4-star for A rays".  Until releasd, consumers should be savvy shoppers, carefully reading labels and opting for broad spectrum lotions that offer protection against both A and B rays.

Still, Fenske still prefers a physical barrier such as zinc oxide or titanium dioxide, which he says cause fewer skin reactions and provide full coverage. In general, he suggests applying SPF lotion 30 minutes prior to going outdoors. He also said being consistent about applying lotion is critical, since sun damage can be  related to cumulative exposure. 

Cindy Bidwell, a Physician Asistant at Bayside Family Care in St. Petersburg, Fla., concurs.

"Every day we see patients with skin injury or damage that is the result of prolonged sun exposure, " she said. 

Both Bidwell and Fenske caution that sunscreen should be reapplied every two to three hours, while in the sunshine. Applications should be more frequent if one swims, or sweats. The key is to maintain skin coverage and sweat or water can interfere with the blockage provided by SPF lotions.

Hydration is also important, so drinking a lot of water can help protect our bodies against heat exhaustion and dehydration. Fenske also suggests trying to avoid the sun between 10 a.m. and 3 p.m., when the sun’s rays are the strongest. Fenske said there are three lines of defense:

- staying out of the sun whenever possible and especially, midday

-wearing highly protective clothing

-using a good, broad spectrum sunscreen

"A burn," he said, " demonstrates a lack of discipline, and moderation is the key."

While he rarely sees third degree burns in his practice, he does get calls about the redness and swelling associated with first degree burns. Fenske recommends using soothing creams such as Noxzema that has been refrigerated, soaks with cool milk compresses and Motrin or non-steroidals for the inflammation and pain.

Second-degree burns, which include blistering, require some monitoring. Do not apply ice or ointments and do not break the blisters, which could introduce infection. Fenske recommends a gentle, cool ( but not cold) shower . In some cases, he may prescribe Silvadene cream which helps heal burns.  Aloe can bes oothing, but some patients develop allergic reactions.

Repeated sunburns are cause for concern. Skin damage leads to development of mutated cells. If the body doesn't or cannot repair one correctly, there will be a greater opportunity for development of cancerous  cells, that's exactly why prevention is vitally important. That's why we're all on burn notice.

For more information, Fenske recommends these peer-reviewed sites:

American Academy of Dermatology 

Skin Cancer Foundation

American Cancer Society 

USF Department of Dermatology and Cutaneous Surgery

Brian Hosking May 11, 2011 at 08:34 PM
Nice job Judy. Keep the good info coming.
G Walker May 13, 2011 at 08:39 PM
Neil Fenske is MY dermatologist.

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