Alex + Team Coolibar

Dr. Jennifer Trent, MD, FAAD of American Dermatology Associates, Inc, has provided information on an often-forgotten way for getting sun exposure. This helpful advice will guide you towards behaviors and suggestions to help you be safe in the sun.

I think by now, everyone knows they must wear sunscreen when participating in activities outdoors in direct sunlight, to protect against premature aging from the sun, as well as skin cancer. However, most are still unaware that they can get sun damage and ultimately skin cancer from just driving in the car. Car window glass, not to mention airplane window glass, does not block out the sun’s harmful cancer-causing UVA rays. It is important to use proper sun protection even when you are driving to work or sitting in the car waiting to pick your kids up at the end of the school day. That is why most cancers occur on the left side of the face and body, the driver’s side. Sunburns do cause skin cancers, but cumulative sun damage does as well. If you are exposed to 10 minutes of UV a day, by the end of the week your body has been exposed to 70 minutes of sun. By the end of the month, that exposure time jumps to 300 minutes or 5 hours!

Sunscreen is very important to use daily. But what a lot of people don’t realize is sunscreen only lasts about an hour or two. It will last for even less time if you are sweating or swimming, then it will last even less time. It is critical to reapply every 1-2 hours, even when you are in the car, or immediately after swimming or sweating or wiping your face. Some sunscreens require application 30 minutes prior to sun exposure. It is important to read the directions on the back of the sunscreen bottle or tube. Also, using sunscreen just on your face isn’t enough. You must apply it to all exposed areas of the body, including ears, lips, neck, chest, arms, hands, and legs, even if you are only in the car. To get the benefits of SPF listed on the bottle or tube of sunscreen, you must apply enough. A nickel size amount will cover your face, and 1 oz will cover your body.

If you are like me, I do not like putting sunscreen all over my body. It gets all over the car and your clothes. I feel sticky and slimy before I even get to work. I prefer wearing sun protective clothing in the car and reserving sunscreen for my face only. Choose clothing that’s stylish, lightweight, breathable and very comfortable. I always feel cooler when I am covered up rather than exposed to the intense UV rays of the sun. I can truly feel my skin burning when I am not covered up.

I choose Coolibar for my sun protection because it works well for me. Coolibar subjects their clothing to the very rigorous testing standards of the Australian sun protection clothing manufacturers. Sun protection clothing is given the designation UPF (Ultraviolet Protection Factor), which is similar to SPF of sunscreen. UPF is the rating system for clothing, which tells you how much UV radiation can penetrate the fabric. For example, the UPF 50 Coolibar clothing only allows 1/50th of sun’s UV radiation to reach the wearer’s skin. In other words, it blocks out 98% of the sun’s harmful cancer-causing UV rays.

I always leave one of my Coolibar jackets with thumbholes in the car. Because it is so lightweight, I put it on over my regular clothes to protect myself while I am in the car. It protects my arms, hands, neck, and chest. If I am feeling too hot while I am in the car, I may put it on backward, just to protect the front of my body. If I am already wearing a V-neck sunscreen shirt, I may just wrap my sun shawl around my chest and neck. If I am wearing my high neck sunscreen shirt, I may just use my neck gaiter. If my shirt doesn’t have thumb holes I will put on my UV gloves. By the way, these gloves are great to use when getting a UV cured gel manicure. If I am wearing shorts or a skirt, I throw my sun shawl or jacket over my legs. I always keep extra sunscreen and chapstick with sunscreen in my car and purse, just in case I am out longer than expected and need to reapply.  Also, it is important to protect your eyes with UVA/UVB protection sunglasses. I keep a pair in my purse and one in the car. A wide brim UPF hat is a staple in my car as well so that when I must get out and walk, I am prepared.

Windows may make you feel like you a being protected from the sun they often do not block UVA rays. Remember to be prepared and take your sun protective steps even when you are going on a car ride or know you will be sitting by a window in direct sunlight and avoid those unneeded and unintended hours of sun.

Here are some Coolibar suggestions

A skin check is an important part of your melanoma prevention checklist. If you’ve never had a skin check before this will help you frame your expectations for the visit. The earlier you find a skin cancer, the easier it is to treat successfully. Both skin self-examinations and professional skin exams are useful for early detection of skin cancers, including melanoma, the deadliest form of skin cancer.

Dermatologists have special training that includes the diagnosis and management of skin cancers. When you see a dermatologist for a complete skin checkup, expect a 10-15-minute visit, including a review of your medical history and a head-to-toe skin examination.

For a full body, head-to-toe exam, you will be asked to remove your clothes and sometimes undergarments, in exchange for a gown.  On average, your full body skin exam will take approximately 10 minutes, sometimes longer if your skin tends to have more moles. In most cases the doctor will use a hand-held dermatoscope, which looks like a flashlight, to magnify and illuminate the layers of your skin.  This will allow them to get a closer look at your skin.

The doctor may start with your scalp, carefully moving your hair around to gain a closer look. Believe it or not, “hidden melanomas” are often found in unexpected areas like the scalp, behind the ears, soles of the feet, under nails, palms of the hands and the groin area.  For this reason, you should expect the dermatologist to inspect every inch of your body, which will include beneath your underwear if you were permitted to leave any on under your gown.  A medical assistant may join the dermatologist during your exam to help ensure everything is properly documented in your medical record.  Photographs may be taken and securely stored in your medical chart to use as a comparative at future visits. This is a good time to ask about any spots you are worried about; your dermatologist can educate you about what to look for, such as any changes in the size, color, borders, or shape of a mole.

Your dermatologist may identify an area that requires treatment and will generally take care any minor procedure right after completing your skin exam.  The two most common treatments are:

Cryotherapy– A quick spray of liquid nitrogen which is used to freeze and destroy skin growths or patches that do not look like the skin around them. Ask your doctor for their post-treatment recommendations and follow up protocol.

Skin biopsy-  A sample of skin will be removed and sent to a laboratory for further examination under a microscope, to diagnose or rule out any diseases of the skin.  There are a few ways to perform a biopsy and some may require stitches. Ask your doctor why a biopsy is being done and which procedure they will be using.  Be sure to understand any post-procedure recommendations and follow up expectations.  You should also inquire when and how your biopsy results will be provided to you. Results are typically available within 7-10 days.

Before your doctor leaves the room, ask them what your follow up schedule is based on their discoveries during your exam.  Your doctor may talk to you about your skin cancer risk factors which are derived from your lifestyle, personal history and the results of your exam.  Understand your follow up recommendations and instructions before your dermatologist leaves the room.  Depending on your results, your doctor may recommend more frequent exams.  At a minimum, you should schedule your next annual skin check prior to leaving the doctor’s office and ask them to mail you a reminder card.  Make your annual skin check a priority because early detection is a key factor when it comes to skin.

Dr. Cynthia Bailey of Advanced Skin Care and Dermatology Physicians, has provided information on what to expect during your skin check. This helpful advice will guide you through your appointment and make you feel empowered when you get to your next skin check visit. 

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 1/25^th   of the radiation to pass through it. Any fabric that is labeled UPF 50+ allows only 1/50^th 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

Dr. Cynthia Bailey of Advanced Skin Care and Dermatology Physicians, has provided information on what to do before, during, and after a skin check. This helpful advice will guide you through your appointment and help you get the most out of your visit.

Woo hoo! You’ve made the decision to get your skin checked. What a great way to add to your sun-safe lifestyle.  When we think of melanoma prevention, we often think of the usual: using sunscreen, covering up, not burning, avoiding tanning beds, etc. and forget an important part. Finding a suspicious mole or spot and having it checked out by a professional is considered one of the most important steps to preventing melanoma and it’s awesome that you are taking that step. Use these suggestions to frame your visit and you’ll be set to get the most out of your appointment.

Here is your pre-appointment homework:

1. Choose a dermatologist. Refer to our how to pick a dermatologist post for helpful information on how to choose the best dermatologist for you.
2. Take note of any areas on your skin or scalp that stand out to you.

Do your own self-exam and know what you are looking for by referencing the ABCDEs of skin cancer.  Know your skin because early detection is key. Do not be shy, point out notable concerns to the doctor during your appointment.

3. Remove all nail polish from your fingernails and toenails.

Believe it or not, melanomas can develop in areas that have little or no sun exposure, including underneath nailbeds.

4. Remove all make-up or foundation.

Your clean face allows your dermatologist to have total visibility to the skin on your face, neck, and ears which are sun prone areas.

5. Make a list of all medications you are currently taking or have taken in the past.

Share this list with your doctor to avoid any possible interactions and to provide a quick overview of your treatments for a more thorough examination. They also want to know your medications because some make you more sensitive to the sun.

6. Be prepared to provide your UV exposure history.

Tell your doctor if you have ever used tanning beds, worked outdoors or if you have had ever experienced a sunburn.  Did you spend a lot of time at the beach/pool when you were a child or do you still?  Have you ever been diagnosed with any type of cancer or have you received radiation therapy for any medical condition?  Make sure you are upfront and honest with your history to help the doctor make a more comprehensive assessment of you.

7. Know your family history as it relates to skin cancer.

Have any of your family members been diagnosed with skin cancer?  How were they related to you and what type of cancer did they have?

Here is your appointment day homework:

1. Stay focused.

While time away from work and home is hard to come by and it is tempting to ask the dermatologist about a curious rash or the latest wrinkle cream while they are right in front of you, DO NOT DILUTE YOUR VISIT. Remember, you have 10 minutes with the doctor so dedicate this visit to your skin check.

2. State your purpose for your appointment.

Remind your dermatologist you are there for your head-to-toe skin exam. Dermatologists are very busy with some practices seeing 100 patients per provider per day.  Minimize your chit-chat and get right to the point. Be sure to state your medical history and point out suspicious moles or other marks.  An exam that follows the TSBE method should only take about 10 minutes.

3. Take control of your visit.

If your doctor starts talking about wrinkles, rashes or other skin concerns during your exam, bring them back on track.  Thank them for their feedback and tell them you will return to see them regarding their suggestion, but that you are most interested in their full attention to a thorough skin and scalp exam during this visit.

4. Pay attention and ask questions.

Don’t be afraid to ask your dermatologist to show you areas they are concerned about.  Be sure to pay close attention to your identified suspicious areas and do self-exams at home. (Go ahead and photograph suspicious areas yourself a baseline reminder.  This is a great way to inventory your moles to look for changes in color, size, and asymmetry.  The AAD has body mole map you can download and use to track your moles from year to year.)

There are 3 common types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma and a whole host of other terms your dermatologist may use to describe “discoveries” on your skin.  If you do not understand something your doctor says, ask them to repeat what they have said or have them explain it to you in a different way.  Chances are you are not formally trained in medicine and this is not your area of expertise. It is perfectly normal for you to ask your doctor questions, you are worth it.

Congratulations you are ready for your skin check! Bring this with you on your visit so you remember what you need to do while you are there. We hope you find this a valuable resource for your next visit too.

This May, we are getting gross. Coolibar’s mission is to help protect the world from sun-related conditions and to support that mission we want to help educate people about skin cancer during the month of May. The ugly truth is that skin cancer is not fun or glamorous. We want to share the not-so-wonderful side of what happens after a skin cancer diagnosis with the hope that we can all help protect and prevent others from a potentially fatal or life-threatening form of cancer. Bear with us as we share stories to provide awareness, education, and spur prevention. We are among friends –now let’s get gross.

Over the past three decades, more people have had skin cancer than all other cancers combined. In fact, in 2017, more than 160,000 Americans are expected to be diagnosed with melanoma, the most dangerous form of skin cancer, with one American dying every hour of every day.

Unlike other forms of cancer which form internally, skin cancer can often be caught early. In most cases, there is something visible on the surface of the body in the form of a mole or changing freckle. Early detection is key and many people do not know what to look for. The “Let’s Get Gross” campaign invites survivors to share their stories, photos, treatment images, and scars, to help bring awareness and education to the forefront.

We are featuring valiant stories from skin cancer survivors Summer Sanders, TV host, reporter and 1996 U.S. Olympic Swimming champion and 3x Melanoma survivor, Ian Leonard, FOX 9 Chief Meteorologist, and media notable Judy Cloud, among others. With a purpose of prevention from this potentially fatal form of cancer, our campaign shares explicit photos, gripping and reality-based stories and informational facts about skin cancer to encourage annual skin checks, self-protection from UV exposure with UPF 50+ clothing, hats and SPF 30+ sunscreen and by making a difference through knowing and sharing the facts.

Each survivor simply doesn’t want anyone else to endure what they’ve experienced and they don’t want anyone to go through losing a family member or friend to this vicious cancer.

Exposing the reality, the ugly truth unites us all in helping one another.

We want to share the person who inspired this campaign: Emma Betts. Emma was diagnosed with Melanoma at the age of 22 and had a terminal diagnosis. Some stories are not pretty or fun to tell but Emma knew telling her story could save a life, change a behavior, and prevent melanoma.

Emma described her blog Dear Melanoma as an authentic glimpse into the roller coaster that is life with Stage 4 Melanoma. As soon as any of us at Coolibar clicked to follow, we were on that roller coaster with her.

We got to know Emma through her pictures and stories. Read her heartbreakingly honest posts, watched her plan a wedding to the amazing Serge, followed along with her treatments and then when she stopped her treatments, smiled when she posted pictures of Ralphy her dog, was excited to see when she bought a place and enjoyed watching her renovate the kitchen, cheered her on as she raised money, advocated, educated, and spread awareness about Melanoma. She was more than a person with Melanoma that we were learning from – we felt like we were friends with Emma even though we never met her in person.

There’s a perception that skin cancer occurs primarily among older demographic or with fair skin types. We’ve read all the statistics and data surrounding skin cancer, and melanoma does not discriminate by age, gender or race.  Emma, through her pictures and writing, showed us a human side to the data. She showed us what life can be like when you are diagnosed with a terminal disease. She made it real. She inspired us to want to do anything to protect everyone from going through this ugly disease called Melanoma. Unfortunately, the statistics are against us.

 “Every hour of every day one American dies from melanoma – that’s approximately 10,000 per year.”

-Melanoma Research Foundation

“In 2017, over 160,000 Americans are expected to be diagnosed with melanoma. Of these, approximately, 87,000 will be diagnosed with invasive (Stage I, II, III or IV)”

– Melanoma Research Foundation

Emma lived to the fullest, jumping into her dreams even though her body had an unknown expiration date. She had an impact on us and I hope now on you too.

Emma passed on April 8^th, 2017. She was 25 years old.

To the people who were close to Emma, know that there are people out there, like us, who share Emma’s passion to prevent others from experiencing this deadly disease. Know that her pictures and stories matter; they live on to make a difference even all the way around the world in Minneapolis, Minnesota. We will work to change the statistics. We encourage everyone to go back and read her blog “Dear Melanoma” from the beginning and see the legacy that continues today. Dear Emma, this one is for you!

Take action today:

• Get your skin checked
• Protect yourself with UPF 50+ clothing, hats and SPF 30+ sunscreen
• Make a difference by knowing and sharing the facts
• Be part of the Let’s Get Gross Campaign by checking our Facebook page, sharing your story, reading our blog posts, and sharing them with those around you.