Back in the 80s and 90s, three dermatologists misdiagnosed me with “eczema” and advised me to maintain a mild tan in tanning beds. No, that’s not a typo. They advised me to use tanning beds. Tanning is still often recommended by dermatologists for eczema, according to friends of mine who actually do have it. Back then, they thought tanning beds were much safer than the sun. I followed their instructions, and now I’m paying the price. I have a lot of sun damage on my face, and an increased risk of skin cancer.
My current dermatologist advises me to stay out of the sun as much as possible and wear sunscreen every single day, no matter the weather nor how long I expect to be outside. This advice is supposed to reduce my chances of skin cancer, but also prevent some of the premature aging that sun exposure tends to cause. This is her advice to everybody.
There’s some controversy about this. Some dermatologists believe some sun exposure is okay. But this is what I’ve found:
- You can get enough vitamin D from supplements. Rather than getting D from unprotected sun exposure, the best sources I’ve found recommend wearing SPF whenever your outdoors and getting your Vitamin D from your diet and/or supplements. I take multivitamins and calcium supplements – between them, I get the Vitamin D I need.
- Do sunscreen ingredients cause cancer? I did a lot of research on this, and found that those who claim they do cause cancer don’t provide citations or numbers to back up their claims. In the end, what made the most sense to me was Paula Begoun’s take on sunscreen ingredients and cancer. She addresses a number of different concerns about sunscreen ingredients: here she talks about avobenzone and oxybenzone. In short, I don’t feel there’s convincing evidence that these ingredients cause health problems.
My SPF rules and routine
The truth is, nobody knows for sure what you should do. Tanning only became fashionable less than a century ago, and during that time we’ve thinned the ozone layer out considerably. And we’re living longer, which gives skin cancer more time to grow. No one can give you a single, definitive answer that will guarantee you never have skin cancer. The good news is, though, that if you watch your skin for signs of skin cancer and get them checked out by a dermatologist quickly, your chances of successful treatment are good! If you can, see a dermatologist yearly for a full body scan – the doctor will look over your whole body for signs of skin cancer, and remove (quickly and easily) anything that even looks like it might turn cancerous someday. This treatment is working, so when prevention fails, it’s not the end of the road.
That said, here’s what I do every morning. It is not intended as instructions for what YOU should do. You decide that yourself. This is just food for thought.
- After washing my face in the morning, I put on a topical medication my dermatologist prescribes because it needs direct contact with the skin.
- Then I put on Cerave, a great moisturizer that also shields my sensitive skin from anything I put on after that (according to my dermatologist – it seems to work!).
- Then I put sunscreen on every inch of skin, face and body, that will not have clothing over it. I use Neutrogena Dry Touch because it dries quickly to a nice semi-matte finish that’s easy to put makeup over. I don’t get sunscreen in my eyes, but I do put a little under the browbone and above my cheekbone, toward the lower lid.
- My next step, which I sometimes leave out, is a primer. That’s another nice thing about the Dry Touch sunblocks – I can skip primer and still get a good look.
- My next step is foundation (and then the rest of my makeup). I do use a foundation with SPF, but I didn’t choose it for that reason. Layering SPF does not provide more protection. The only real benefit here is that if I forget to put sunscreen on one morning, at least I have SPF 15 on my face.
- Paula Begoun thinks makeup with SPF 15 is good enough on days when your sun exposure will be nothing but walking from a car through a parking lot. She’s probably right, but I can’t bring myself to stop putting on that extra layer of plain SPF. Because no way are you actually getting SPF 15 from a foundation – they say you have to put on a quarter to half-teaspoon of regular sunblock to get the actual SPF, and that’s a HUGE amount of stuff to slather on your face.
- No, on a daily basis, I do not put on anything like the quarter to half teaspoon some dermatologists recommend. I instead use SPF 55 or higher, in an amount my skin can take in, knowing I may only be getting about 20 SPF in actual protection. But really, SPF 15 is about as much protection as you can get, so this is not bad.
- If I know I’m going to get a lot of sun exposure one day, I slather on the SPF and skip makeup so I can reapply to my face and body liberally.
- You can get UV rays through the windows of your car, so I put on SPF even if I’m just driving to a drive-thru and not getting out at all.
I sound obsessive, don’t I? Then again, I live in a very sunny area that has only a few overcast days per year, so I actually need to take more precautions than most people. If I ever move to a place with a more variable climate, I’d relax this routine somewhat.