People keep making the same mistake, even when the consequences could be cancerous- a warning from our dermatovenerologist


07. 06. 2021 Dermatovenerology

The sunnier the days get, the more we are tempted to sunbathe. However, many people underestimate the power of the sun and often get sunburned. Although the skin has several mechanisms through which it can recover from repeated burning, one day its capacity may be exhausted, warns dermatovenerologist Helena Michalíková. What’s the best treatment for a sunburn? And is it true that even a few minutes in the sun is adequate to get our daily dose of vitamin D?  

What are the risks to the skin from exposure to the sun?

I would divide them into three categories of consequences. The first would be the acute damage- a sunburn and its associated skin conditions (peeling of the skin, uneven pigmentation). The second would be photoaging (premature aging) associated with profound and numerous wrinkles and lines, pigmentation, dryness and roughening of the skin. And the third, and most severe, are cancerous skin tumours.


Is it true that the skin has a “memory” for sunburns?

That is true, but the real threat comes from the increased likelihood of getting burned again. And repeated exposure to a large amount of sunlight even without an acute reaction – i.e. sunburns - is also risky.


What is the biggest threat of sunburns?

In addition to local acute symptoms - redness and blisters that can present with a painful, burning sensation, hotness, and sensitivity- a sunburn may be accompanied by more general symptoms such as chills, fever, nausea, and vomiting. Later down the line, the burns may start to weep/fester which increases the risk of a secondary infection. Eventually, the skin starts to peel off in unpleasant layers which can result in a change of pigmentation. Most of these changes are temporary, however, in some cases pigmentation can persist and there may even be scarring from more severe burns (blistered or infected areas). But the most serious consequence is the damage done on a DNA level, which affects the immune processes in the skin. Fortunately, it is true that the skin has an incredible regenerative ability, however, its capacity can get depleted, and DNA damage is the first step to cancerous tumour formation.


What’s better- a SPF cream or oil? And what if you get a sunburn despite using protection, what’s the best way to treat it?

Unfortunately, we can only focus on symptomatic treatment of sunburns such as reducing redness, pain, and itching. Water emulsions with a small proportion of lipids (oil-in-water emulsions) are suitable for topical treatment. Evaporation of the water cools and reduces inflammation, lipids help repair damaged skin barriers and reduce dryness. Spray foams and lotions are ideal as a form of protection, and their application is easy and painless. Aloe vera products are often recommended. Of the total drugs administered, analgesics, sometimes non-steroidal anti-inflammatory drugs, or antihistamines are helpful. In case the burnt area gets infected, local or general antibiotics may be prescribed. In severe cases, it is possible to replenish fluids through an IV, however, these procedures need to be done under the supervision of a medical professional. Topical or systemic corticosteroids are of little benefit.

Manufacturers usually distinguish products for use on the face and body and further differentiate according to skin type. Gels, sprays and “fluids” are more suitable for oily skin types, whereas oils will suit a mixed or dry complexion.   


During which months should we use creams with an SPF factor?

This really depends on your skin’s phototype (I.-IV.)  and whether the skin already has some issues (e.g. pigmentation) that can worsen in the sun’s rays. Of course, it is also important how long we are outside and in what weather. For our usual climatic conditions, I would recommend using SPF from April, but it certainly won’t hurt to use creams with SPF all year round. There are currently many daily moisturising creams on the market that contain an SPF factor, so it is not necessary to apply two creams on top of each other.


You have already mentioned that the skin can show signs of premature ageing due to tanning. What other negative effects of excessive tanning should we look out for?

The formation of pigment spots is a typical consequence of excessive sunbathing. Collectively, these changes are referred to as photoaging. This can be described as a combination of premature aging (e.g., deeper, and more frequent wrinkle lines and dryness, and a general appearance of the skin that is not representative of the individuals age) with manifestations typical of sun damage (pigment spots, inconsistent skin tone and a rough skin surface). However, the most serious of consequences are skin tumours.


What about vitamin D? When does it get into the skin the most?

The production of vitamin D in our body requires sunlight, specifically its UVB component (290-315 nm). How much UVB radiation passes to the earth's surface depends on several factors. One of them is the so-called zenith angle (the angle between the sun's rays and the earth’s perpendicular), the larger it is, the lower the UVB intensity. The angle of the zenith is given by latitude, season, and time of day. The passage of UVB radiation is also reduced by clouds and air pollution. The effect of UVB on vitamin D production is further influenced by the skin’s phototype (melanin absorbs UVB, therefore the more melanin you have, the less UVB can be used for vitamin D production), in addition, its synthesis is lower in the elderly. In our geographical conditions, the period from April to September, between 10 am and 4 pm, is optimal for getting your daily dose of vitamin D. It is good to know that the amount of exposure to UVB radiation to maintain optimal levels of vitamin D are much lower than the amount of exposure that leads to sunburns. For example, exposure of the face and hands to sunlight every day for 10 minutes is sufficient.


Do sunscreens prevent the production of vitamin D?

Yes, they do. But it should be taken into considerations that these protective creams also prevent the most serious side effects of UVB radiation, such as DNA damage, which may be the first step in the development of a skin cancer. In addition, the significant decrease in vitamin D levels demonstrated in the laboratory (when applying the cream with SPF) was not so significant in studies in volunteers. In addition, this vitamin can be obtained in food or taken as a dietary supplements.


You can read the whole article on the website: Ústeckýdení

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