Now that the summer solstice is in the rearview mirror, it is time to start reminding patients about the importance of and appropriate use of sunscreen. People of all ethnicities and skin colorations can benefit from sunscreen, though lighter skinned people tend to benefit more. Damaging radiation from the sun is in both the UVA and UVB spectrums. Keep in mind that the widely-touted SPF factor refers only to protection from UVB radiation, yet UVB accounts for only 5% of the ultraviolet radiation reaching the earth. UVA accounts for most of the other 95%, and parts of the UVA spectrum are damaging to skin.

A few points to emphasize with patients:

1. In purchasing sunscreen, it is important to look for products labelled “broad spectrum” or which contain wording that the product protects against both UVA and UVB. Looking at the SPF number alone is not enough.
2. Sunscreens should be applied 15 to 30 minutes prior to being exposed to the sun. All sun-exposed areas need to be treated and the volume of product needed is generally more than most people apply.
3. Sunscreens need to be re-applied every two hours.
4. In children under 6 months of age, it is better to provide sun protection with clothing rather than sunscreens.
5. For young children, it is safest to use sunscreens using titanium dioxide or zinc oxide.
6. Some, but not all, clothing can help block UV rays from reaching the skin. Most clothing is not labelled with the degree of UV protection it provides. Generally speaking, tighter weaves, darker colors, and less stretchy fabrics provide better UV protection.

While primary care clinicians have educated patients about the importance of sun protection for years, we don’t appear to be succeeding. Our cautions about the risks of skin cancer and premature aging of skin appear to be bouncing off people much more than the ultraviolet rays we are warning about. A just-published online-survey study from The Journal of the American Academy of Dermatology found less than half of women and less a fifth of men regularly use sunscreen on their faces. Clearly, we have more work to do, and the current season provides a good reason.

Richard Fleming, MD