Top Ten Summer Skin Care Tips

Transcription

1 THE LONDON DERMATOLOGIST S: Top Ten Summer Skin Care Tips the london dermatologist 1

2 Contents Choosing the right sunblock page 4 The best way to apply sunblock page 6 Sensible sun care when on holiday page 7 How to manage sunburn page 9 Allergic reactions to sunscreen page 11 Protecting children from ultraviolet light page 13 When should you be concerned about your moles? page 15 Dealing with insect bites page 17 Dealing with excessive sweating page 19 Prickly Heat and polymorphous light eruption page 21 2

3 The long, warm days of summer are here. Children are off school and may spend hours outside, families dine al fresco, and holiday travel peaks, often to places where the sun is strong. Some skin conditions may improve in the summer, particularly those caused by skin dryness. But the main danger to the skin in the summer is high levels of ultraviolet light, the cause of sunburn, skin aging and skin cancer. It s important to take steps to protect the skin from UV, especially before the age of 18. But how should you choose a sunblock, what s the best way to apply it and how else should you be protecting your skin when on holiday? What happens if you develop an allergic reaction to sunscreen and how can you avoid this? What about if you notice a change in one of your moles? What if you develop a bad insect bite reaction? What can you do if you are noticing uncontrolled embarrassing sweating? And what should you do to avoid and treat prickly heat and light reactions? Here are The London Dermatologist s Top Ten Summer Skin Care Tips. 3

4 1 Choosing the right sunblock Using sunblock correctly is one of the most important ways to protect the skin against ultraviolet light the main cause of sunburn, skin aging, and skin cancer. Skin cancer has increased by about four times in the last 30 years. The main reason for this is because of increased sun exposure particularly short sharp bursts of sun exposure, as tend to occur during sunny holidays. Thirty years ago many families in the UK would holiday at home, whereas now it is much commoner for people to travel abroad several times a year. When choosing a sunblock it is important to choose one with a high Sun Protection Factor (or SPF). An SPF of at least 30 is desirable. In Europe any sunblock higher than SPF 50 is described as 50+. But remember that SPF only describes the filter against UVB. Ultraviolet light is divided into UVA and UVB. UVA is also a major cause of skin damage. The best way to protect against UVA is to ensure that when you are buying sunblock you choose one that has a broad spectrum protection. It is also worth choosing one that is water resistant if you are likely to swim. Remember that most ultraviolet light comes straight through the 4

5 clouds so that dangerous levels of exposure can occur on cloudy days in the summer. My favourite sunblocks at the moment are Altruist (economical, popular with patients, designed by a dermatologist and only available on Amazon), Anthelios (made by La Roche Posay and available in multiple different formulations including gels, creams and oils and with a good UVA blocker), and Sunsense (a popular Australian brand which has multiple formulations including a Sensitive version for those with allergy or sensitivity to sunblocks and also a good children s sunblock). 5

6 2 The best way to apply sunblock The most important consideration with sunblock is to use it! It is very easy in the height of summer to forget to apply sunblock and to end up with sunburn, which is one of the major risk factors for melanoma, the most serious form of skin cancer. Remember that on a cloudy day, 75% of ultraviolet light still comes through clouds meaning it is more than possible to burn when it is cloudy. If you have fair skin, meaning that if you went out on a sunny day without sunblock you would tend to burn before you tan, then you should consider using sunblock whenever you are outside for any significant length of time between April and October between 11am and 3pm. As a dermatologist, I commonly remove skin cancers from nooks and crannies on the face, areas where people often fail to apply sunblock, so when you apply, don t just rub it into your cheeks, make sure you cover the nose, the corners of the nose and cheeks, underneath the nose, the lips, the eyelids, the ears including the tops of the ears, inside the ears and the back of the ears, the sides and the back of the neck. Watch a video blog in which I demonstrate how to apply sunscreen to the face. 6

7 3 Sensible sun care when on holiday An almost guaranteed way to make my patients look at me as if I am crazy is when I tell them if you go on a summer holiday you should aim to come back with your skin the same colour as when you left. But this is the correct advice. It s amazing how the sun tan is still so desirable to some people. This is fashion and conditioning pure and simple. Before the second half of the 20th Century a sun tan was often thought to be unattractive and undesirable and in many parts of the world this is still the case. Even in the Western world, the tan has lost some of its appeal. Just have a look at historic advertisements for sun creams from the 1970s and 1980s with deeply bronzed models, a colour that you just don t see in advertising these days. If you think about it the behaviour of many holidaymakers is pretty bizarre. Lying for hours in strong sunlight, with minimal sun protection, exposing themselves to dangerous levels of UV, turning over occasionally almost like a piece of meat over a fire, making sure they get properly cooked! 7

8 We know that these types of short sharp sunburn increase the risk of skin cancer, and that the supposedly healthy tan is a sign of permanent sun damage that will cause long term aging. Why do it? Dermatologists enjoy sunny holidays too! We use a high factor broad-spectrum sunblock which we apply 30 minutes before sun exposure and reapply later in the day. Between 11 and 3 in strong sun we seek shade, under a parasol on the beach for example. If we go out into strong sun we use clothing to cover the shoulders and a broad brimmed hat to cover the face, perhaps even covering the shoulders with a rash vest when splashing in the pool or sea. After 3 or 4 o clock UV levels are lower and it s safer to lie in the sun and enjoy the warmth, which is infrared rather than ultraviolet light and, which hangs around for later in the day. It s important to be super careful the closer to the equator you are because the sun is probably much stronger than you are used to, so that you can burn after just a few minutes exposure. 8

9 4 How to manage sunburn It s important to avoid sunburn, which is a sign of serious ultraviolet injury to the skin. Sunburn increases the risk of melanoma, and can also lead to permanent photo-aging of the skin. But we ve all had sunburn from time to time. So what should you do if it occurs? Firstly avoid further UV injury by completely avoiding sunlight either direct, through the clouds or even through a window. If you go outside cover the area with clothing that is tightly woven enough to block light- try holding the item of clothing up to the light and choose clothing that does not allow light through and avoid loosely woven fabric such as thin linen garments. Take cool showers or baths regularly to reduce discomfort and avoid washing the area with any soap or shower gels which can dry the skin. Applying cold flannels may also be soothing. Apply a simple soothing moisturiser, perhaps containing aloe vera, and try keeping the moisturiser in the fridge. Consider taking ibuproben and paracetamol for pain relief. Drink plenty of fluid to stay hydrated- you should be peeing regularly and your urine should be a light colour. If you have any steroid creams such 9

10 as hydrocortisone (available over the counter) or something stronger then applying this may reduce inflammation. If you develop blisters leave them alone and avoid bursting them to reduce the risk of infection. But if you start to feel unwell, develop multiple blisters, severe headaches, chills, fevers or shivers then you should seek medical advice urgently. 10

11 5 Allergic reactions to sunscreen Sunscreens contain several different components. These make them effective at absorbing UV, pleasantly-fragranced and give them a shelf-life. Most people will not react to these at all, but if you are unlucky you might develop a specific allergic reaction to one of these chemicals that produces red, itchy or uncomfortable reaction like eczema called a contact allergic dermatitis. Sometimes it might even blister. You can become allergic to something you have used without any problems for years, but once you have become allergic, it is likely that you will be so from that point onwards. Sometimes it is not the chemical itself causing the problem, but a combination of the chemical and sunlight, causing a photocontact dermatitis. If you do have problems with reactions to sunscreens switch to a different brand or it look for sunscreens designed for sensitive skin which contain mostly physical blocking agents like titanium dioxide and less chemical sunblock molecules. Examples include Sunsense Sensitive, P20 and Actinica. 11

12 If you are sensitive then test the sunblock by using it on a small patch of skin on your forearm for a few days. If you develop a rash at the site of application then avoid that product completely. The most accurate way of assessing for possible allergy is to have patch testing done by a dermatologists specialising in this. This should tell you exactly which component you are allergic to, and enable you to select a sunblock without this chemical. 12

13 6 Protecting children from ultraviolet light We know that childhood sunburn is one of the most important preventable causes of malignant melanoma, the most serious form of skin cancer. Kids are especially vulnerable because they have thinner skin, a less developed immune system and because their behaviour means they spend much more time than adults outside playing in the sun. Some studies have estimated that a person receives 80% of their lifetime ultraviolet exposure in childhood. Just a few serious sunburns can increase your child s risk of skin cancer later in life. Any reddening of the skin should be avoided in children, and if your child s skin is starting to look pink then get them out of the sun! Tanning is also a sign of skin damage, and if your child is developing a significant suntan then they have had too much UV exposure. What steps should we take to protect our kids? The first is simply to remember the importance of sun protection! This is especially 13

14 the case at the brightest time of the year in the height of summer, but care needs to be exercised from April till October. Clouds do not provide enough protection to prevent sunburn and skin damage and will only filter out about a quarter of UV rays, so remember to take steps to protect children s skin even on a cloudy day. Covering up with clothing or a parasol is the most reliable way to protect your kids from the sun. If you have small children on a beach, don t chose swimming trunks or cute bikinis, select a funky UV protecting suit that covers the shoulders, trunk and upper arms. Give them a broad brimmed hat, or a baseball cap with an attached sun cape on the back. Cover exposed areas with a high SPF (at least factor 30) broad spectrum sunblock, applied minutes before exposure and reapply it in the middle of the day if needed, particularly if they are swimming. Don t forget backs of necks, ears, noses, lips, hands and feet. If your kids don t like the texture of a cream, then try an oil or gel sunblock. Finally, don t forget eye protection. We know that childhood exposure to UV can cause cataracts in later life, so find a pair of shades, perhaps wrap-around, with good UVA and UVB filters. 14

15 7 When should you be concerned about your moles? Summer is a time when dermatologists suddenly see much higher numbers of patients worried about moles, not because moles become nasty at this time of year, but mainly because people take their clothes off and notice them more! The golden rule is if in doubt get it checked out. Skin cancer is the commonest cancer in the world and is almost always fully curable. However, removing melanomas early is absolutely vital, because once they have spread they can be deadly. This makes picking up the signs of an early melanoma really important. If you have a mole which is changing in SIZE, SHAPE or COLOUR you should see your GP or a Dermatologist. Melanoma skin cancers can sometimes be identified by the ABCD rule. They may be ASYMMETRICAL, with a jagged BORDER, containing more than two COLOURS and be more than five millimetres in DIAMETER (about the size of the end of a pencil). Another 15

16 helpful sign used by dermatologists is the ugly-duckling sign - melanomas often stand out in appearance compared to other moles on a person s skin. If you have multiple moles, particularly if some are large and slightly irregular looking, it is worth seeing a Dermatologist for an assessment and discussion about what to look out for and whether you need monitoring. 16

17 8 Dealing with insect bites Insect bites and stings are commoner in summer when the numbers of bugs increases dramatically. Mosquitos are a common cause of holiday discomfort. Remember that mossies start to bite in the evening, so this is the time to cover up or to use effective insect repellants, particularly those contacting DEET, which is a powerful anti-mossi spray. Concentrations of 25% are often effective, but higher concentrations are also available. If you or your children get uncomfortable bites try these simple measures: Apply a cold compress, such as a wet flannel that has been in the fridge or freezer for a while. Try this for minutes every hour or two. If you have some oral antihistamines such as cetirizine, loratidine or chlorpheniramine (e.g. Piriton) then take them. Remember that chlorpheniramine can be sedating so this is a good one to take before bedtime. Topical steroids such as Eumovate cream or 1% hydrocortisone applied twice a day may be helpful. A useful trick for children is to put a little moisturiser in the fridge 17

18 and allow them to apply it when they like. The placebo effect can be quite powerful! If you develop very significant swelling or blistering then you may wish to see a doctor who might prescribe a strong steroid cream, or even steroid tablets for a few days. 18

19 9 Dealing with excessive sweating Sweating is an important way for the body to lose heat by evaporation and to control temperature. Our skin in covered with sweat glands there may be 50,000 in the armpits alone. The other areas where we have the highest concentrations of sweat glands are the palms, soles and forehead. About 3% of people have excessive sweating, described by Dermatologists as hyperhidrosis, and for these people hot summer weather can be particularly embarrassing, causing marking of clothing and sweat beads to form that may be visible to other people or causing wetness of the palms that can make handshaking or physical contact distressing. Strong antiperspirants containing 20% aluminium hexahydrate can be obtained from pharmacists. These should be applied at night to clean, dry skin. Iontophoresis treatments, use a low level electrical current to bathe the skin in a small hand bath and can be used to switch off hand and foot sweating. Botox injections are very effective for armpit and forehead sweating and can also be used to the hands. Finally, for people who have sweating 19

20 affecting the whole body, tablet treatments may help. Lots of help is available and Dermatologists can guide you through treatment. 20

21 10 Prickly Heat and Polymorphous Light Eruption Prickly Heat (also known as millaria) is a red, bumpy rash that comes on in areas of increased sweating, often areas that are covered by clothing. It often causes a prickling or itchy sensation and is due to blockage of the sweat ducts towards the top of the skin. It tends to occur more commonly in hot, humid environments. It can be prevented by avoiding excessive heat and by wearing loose fitting clothing with natural fibres such as loosely woven cotton or linen. Polymorphous Light Eruption (PLE) is a different rash that tends to occur in areas of light exposure, particularly in the spring or early summer or at the start of a holiday. It is thought to affect up to one in ten people and causes a rash which can be itchy or painful and which appears within hours of sun exposure, often in areas which are covered during the rest of the year and then usually disappears over the next 1-7 days. The rash is red and may be bumpy, contain small blisters or even cause large blotches. If you are prone to PLE you could find it helpful to see a 21

22 Dermatologist. Use of sunblock is important, but it must contain good UVA filters and be broad spectrum. Your Dermatologist can supply you with strong steroid creams or even steroid tablets which you could start at the first sign of trouble. Sometimes tablets or even ultraviolet light treatment before you go away can prevent the problem occurring. 22

23 Do you need specialist advice? see a dermatologist > who is the london dermatologist > the london dermatologist 23