Sun Smarts

A Plastic Surgeon’s Wish to Retire

For more than 30 years, I’ve been a plastic surgeon and not your average plastic surgeon fixated on cosmetic surgery, but a surgeon focused on fighting skin cancer. Today, skin cancer is by far the most common cancer. Every day I spend long hours examining people, head to toe, looking for malignant or pre-malignant skin lesions. And every week spend more time removing suspicious spots and moles and repairing areas where wide excisions were made when removing a malignant melanoma. My aim is to eventually put myself out of business, not by quitting, but by educating my patients, their relatives, and friends on how to avoid UV sun damage. My mission is to educate everyone on how to live a preventative lifestyle, with the goal to ultimately eradicate skin cancer or significantly reduce the number of incidents.

On any given day, during a visit, I try to encourage and coach patients to change their lifestyles, to minimize their sun exposure and to protect themselves when they are outdoors. I tell my patients there are only two ways to protect oneself from harmful UV rays: use the proper sunblock and wear protective clothing.

Sunblock and Sunscreen are NOT the same thing

While sunscreen has become the generic term for the liquid sun protection we put on our skin, there’s a difference between sunblock and sunscreen. Sunblocks, such as zinc oxide and titanium dioxide, can leave a pasty whitish film on the skin, but these sunblocks are highly effective protecting against both UVA and UVB rays, the types of UV radiation that causes sunburn and skin cancer. These mineral sunblocks are called physical blockers because they stop and block out UV rays. Mineral sunblocks have improved their textures and appearances, but they are not completely invisible. They are your safest and best coat of armor against UVA & UVB rays.

Sunscreens tend to be invisible on the skin and often contain chemicals like benzophenones to protect against UVA and cinnamates and salicylates to protect against UVB. A chemical sunscreen works differently than a physical sunblock. One major drawback of these sunscreen ingredients is how they quickly break down and the need to be reapplied frequently.

When selecting SPF sun protection, it’s essential to not just look at the SPF number (higher doesn’t always mean better), rather look for one that blocks the entire UV spectrum. Most skin cancers that result from prolonged and repeated UVB exposure are basal cell carcinomas, the most common type of skin cancer. Exposure to UVA light can result in the more dangerous and potentially deadly skin cancers: melanomas and squamous cells. Your best defense is a broad spectrum UVA/UVB protection, and I recommend a sunblock. Don’t just quickly grab an SPF with a high number; this is just a measure of how long it takes you to burn (UVB rays). It may be a high number, but it may not have UVA-blocking ingredients. This means you may think you’re protected and spend hours in the sun without a burn, yet meanwhile, deadly UVA rays are deeply penetrating your skin. The American Academy of Dermatology recommends at least SPF 15; however, people with fair skin are at higher risk for skin cancer. I recommend SPF 30. What’s more, I tell all patients to use a sunblock that includes transparent zinc oxide in the ingredients list. Clear zinc oxide will appear white at first, but with a vigorous application, it will become invisible on the skin. I’m not an advocate of sunblock sprays for the simple reason the act of rubbing, vigorous rubbing of sunblock promotes absorption into the skin. Proper absorption provides sun adequate protection when applied frequently and correctly. Wear UPF 50+ clothing to cover most areas of your skin, then use sunblock on any exposed skin.

 

What is this UPF 50+ clothing all about?

The simple truth is people apply sunscreen or sunblock, and as people, we are human and we err. We’re often in a rush to get outside. We don’t apply it properly or with enough coverage. We miss places. And we don’t reapply often. Sunscreens and sunblocks are only effective as the proper application. So, I recommend the most effortless sunblock there is – UPF 50+ clothing. It covers the skin, it’s comfortable, it’s so wearable and it won’t lose potency after a few hours or wash off with swimming. Sun-blocking clothing is measured by a different standard. Rather than SPF for lotions that only measures UVB (burning) rays, the Ultraviolet Protection Factor (UPF) which measures a fabric’s effectiveness against both UVA and UVB rays; it measures broad-spectrum blocking. UPF 25 means the fabric will allow 1/25th   of the radiation to pass through it. Any fabric that is labeled UPF 50+ allows only 1/50th of or about 2% of UV light to pass through.

Some people falsely assume a cotton tee-shirt will protect them at the beach. While they might not see a sunburn, the average white cotton T-shirt is rated UPF 5. That means at least 20% of the sun’s UV radiation is passing through the fabric and directly to the skin. A UPF 50+ tee-shirt blocks 98% of the rays from ever reaching the skin. The right tee-shirt at the beach matters.

After talking about with patients about ultraviolet light, explaining sunblocks, I highly encourage UPF 50+ sun-blocking clothing. I tell my patients, with total honesty, that I have been incredibly impressed with Coolibar as a sun blocking company. I tell them that I personally own and wear several Coolibar pieces including shirts, bathing suits, wide brim hats, head coverings, and pants and never go biking without a Coolibar long-sleeve shirt under my cycling jersey. When I travel overseas, which is quite often, most of my clothing is Coolibar because they always provide sun protection, are incredibly comfortable, lightweight and attractive. I let my patients know that I am a paying Coolibar customer, and I do not receive payment to endorse them. I just count on their high quality as the best form of sun protection for me and my family. I tell my patients all of this because I want to help them and protect them. I want them to have beautiful, healthy skin, continue to enjoy their outdoor activities. I want their skin cancer to go away.

Many skin cancers are preventable. Education is the first step in eradicating it. With enough education, my wish is that patients will no longer need me:  at least not for skin cancer checks and removals and I can finally retire happy.

-Dr. Mark Manstein

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