If you’re experiencing bothersome side effects, talk to your physician about cutting back on how frequently you apply the topical medication, but keep in mind that if you cut back too much you won’t get any benefit. If you’re using your prescription product less than three times per week, and it still causes irritation, you should talk with your physician about using a different medication or trying a lower dose, which your skin may tolerate better.
In our research and personal experience, we’ve noted that there are doctors who recommend prescription and over-the-counter products and usage steps that don’t seem to make sense, at least to us, and likely not to you, either—we hear from a lot of people who are dissatisfied with their doctor’s advice. Despite these issues, you must follow your doctor’s recommendations—or get a second opinion from another medical doctor or pharmacist.
Chapter 6
Sun Damage and Sunscreen Questions Answered
Sun Damage Is Never Pretty
Sun protection is so important it has its own chapter and merits us repeating as often as we can: Daily exposure to UV light without protection, even for a minute, is the single worst thing you can do to your skin. Research has made it clear that repeated, unprotected sun exposure, getting sunburned, or repeatedly getting tan causes DNA damage that triggers skin cells to mutate. [8,9,37] Over the years and in the absence of sun protection and sun-smart behavior, these mutations often turn into skin cancers.
Even if you’re lucky enough to avoid skin cancer, years of unprotected sun exposure or, worse, deliberate tanning either from the sun or a tanning bed, puts your skin on the fast track to aging. You’ll see wrinkles, sagging, brown spots, texture changes, large or misshapen pores, and reduced skin healing (including from acne breakouts) far sooner than those who are diligent about protecting their skin from UV light. [7,41,42]
We emphasize “UV light” because, although the sun emits other wavelengths of light as well, UV light is what really causes sun damage to skin, even on cloudy or overcast days. In other words, sun damage isn’t only a threat when the sun is shining; it’s a threat whenever and wherever you see daylight. And the damage starts happening the first minute your skin sees daylight! [43,44] That research shocked even us. Protecting skin every day of the year, rain, snow, or shine is critically important if your goal is to have healthy, young-looking skin for as long as possible.
The problem is that the topic of sunscreens and all the details surrounding their use has become a confusing mess of incomplete or misleading information—which is what this chapter aims to sort out!
How and When You Apply Sunscreen Is Important!
Using a daytime moisturizer with sunscreen and knowing how to apply it is a complicated, confusing, and controversial issue, and we certainly can understand if you’re wondering what to do. This is especially true about the recommendation to reapply sunscreen every two hours—no matter what! This seems ridiculously inconvenient, to say the least. If you’re wearing makeup, are you supposed to wash it all off, reapply sunscreen, and then redo your makeup every two hours throughout the day? Who has time for all that?! We straighten that out below.
There’s no question that wearing sunscreen daily, 365 days a year, minimizes signs of premature aging. Whether you decide to be sun smart is up to you; we know lots of you still feel that a summer or vacation tan is a must or that getting “just a little tan” is fine, but please at least consider the information below because, and we’re not exaggerating, your skin’s life depends on it.
The following research-supported facts will help you make sense of sunscreen, so you can get the best protection from the sun’s harmful rays:
“SPF,” which stands for Sun Protection Factor, is an indicator of the length of time that your skin can be exposed to sunlight without turning pink (meaning your skin will start burning) when wearing an SPF-rated product.
Although using a product rated SPF 15 is acceptable, the latest research suggests that higher SPF ratings are far more desirable because they provide better protection. [45,46] Look for sunscreens rated SPF 30 or greater, and/or consider layering SPF products for enhanced anti-aging protection.
The two types of UV rays that damage skin are UVA and UVB. UVA rays are far more damaging because they’re present all day long, year-round, and penetrate deeper into the skin than the shorter wavelength UVB rays. UVB rays are present with visible sunlight and can cause sunburn, while UVA rays promote tanning. UVB rays are strongest in sunny climates and between the hours of 10:00 a.m. and 2:00 p.m. UVA rays maintain a consistent intensity during daylight hours, throughout the entire year. [9,47]
Sunscreens labeled as providing “broad-spectrum” protection should protect your skin from both UVA and UVB rays. [9,47]
All sunscreens with an SPF rating provide reliable UVB protection, as there are numerous UVB filters approved for use in sun-protection products. The best active ingredients for reliable UVA protection are titanium dioxide, zinc oxide, avobenzone, ecamsule (Mexoryl SX), and Tinosorb (which may be listed as methylene bis-benzotriazolyl tetramethylbutylphenol). [9,47]
You must apply sunscreen liberally to obtain the benefit of the SPF number on the label. Unfortunately, most people don’t apply sunscreen liberally and that is detrimental for their skin. This common mistake might lead you to believe that the sunscreen you applied isn’t effective. [9,47]
What about the recommendation you often see about reapplying sunscreen every two hours even if you’re not swimming or sweating? That’s a great question, with a somewhat complicated answer—but hang in there and we know you’ll get it.
Does the sunscreen you apply in the morning still work in the late afternoon, following a day at the office or at school? The answer is yes, depending on how much time you spend outdoors because the sunscreen actives break down in response to direct exposure to daylight, not in response to the passage of time during a single day. [9,47]
On an average day (if you’re in an office or otherwise indoors), your morning application of sunscreen is still going to provide sufficient UV protection on your way home, assuming you applied a liberal amount of an SPF 30 (or greater) in the morning.
If you spend the majority of your day outdoors, then the recommendation is to reapply every two hours, especially if you’re perspiring or swimming. This recommendation to reapply every two hours is based on the following.
Most people don’t apply sunscreen liberally, and if you don’t you won’t get the SPF protection rating shown on the label. If you’re one of those people who does not apply sunscreen liberally, then the apply-every-two-hours guideline makes sense, however impractical it may seem. The thinking goes like this: If you aren’t good about applying sunscreen liberally, then reapplying every two hours after direct daylight exposure will add up to liberal application because of the extra layers of sunscreen you’re putting on. [8,9]
How much to apply: There are many measurements given to help you figure out how much sunscreen to use, but in reality how much to use depends completely on the size of the area you’re covering. What we like to suggest is to smooth a layer of sunscreen over the skin that will be exposed to the sun so you can see it and then gently smooth it into skin and let it absorb. And, yes, we understand that it may feel a bit unpleasant until it is absorbed, but the protection it affords is worth this temporary feeling. Don’t forget your chest, arms, and hands (or any other areas of exposed skin)!
How often to apply: We know this one is repetitious, but we’re on a mission to ensure the best skin of your life starts now, and this is the first rule to make sure that happens. Aside from everyday use (no exceptions), a single application each morning