Transcription:
Protecting Your Skin

Prakash Chandran: Our skin is our body's largest organ, but sometimes we take that for granted and we don't treat it in the best way that we can. We're going to talk about it today with Dr. Tom Raisanen, a Dermatologist for Aspirus Health. This is Aspirus Health Talk, the podcast from Aspirus Health. I'm Prakash Chandran. So Dr. Raisanen, it's great to have you here today. The first question that I have is why is it so important to keep your skin protected?

Dr. Raisanen: First of all, thanks for having me. So skin protection is really important, and we can think about that from a few different standpoints or at least a couple of big standpoints. One of which is sun protection. And then also just protecting the barrier of our skin as a natural barrier against outside irritants. As a dermatologist, often the first thing that comes to mind with protection is sunscreen and keeping our skin protected against chronic sun exposure or short-term sun exposure. So we can think about that in different ways, on a day-to-day basis, going back and forth to work in and out of the car, we experience low levels of sunlight or UV radiation, which has been shown to cause even changes at the cellular level, the DNA level in our body and our skin, and the best way to protect against that is to make sure we have some baseline sun protection on our skin. So that might be something like a moisturizer that has sunscreen in it that you put on every day.

Again, this is just for going back and forth to work, you know, getting low levels of sunlight. Then I think about a little differently. If I was say out in the yard, working, maybe going to the beach, etcetera, where you're getting a lot longer, maybe more intense sunlight, maybe mid day sun. In those instances, we want to be a little bit more aggressive with our sun protection and use a, maybe an official, you know, a sunscreen, something, a broad spectrum sunscreen that will apply, you know, we'll apply that every couple hours or more often, if you're doing a lot of sweating or if you're swimming. You know, the alternative is also used sun protective clothing, and that can sometimes take a lot of the thinking out of it. If you're wearing long sleeves or wide brimmed hats, sunglasses, that's the built-in automatic sun protection there, and it might be able to eliminate or greatly reduce the amount of sunscreen that you need to be putting on multiple times a day. So sometimes that ends up being a lot easier and again, just takes the thinking out of it.

And if we start thinking about skin protection, as far as protecting our barrier, then I'm thinking more about moisturizers and things to keep our skin intact and feeling good and not itchy and irritated. So that's especially important when we get to the dry winter months when especially some of us will be more predisposed to getting irritated and itchy skin, dry skin. The humidity is naturally a lot lower than the winter, and that has that effect on our skin as well. So using a good bland moisturizer frequently throughout the day, especially after you shower or bathe, that's a great time to put it on all over, but then putting it on your hands or areas that are more frequently exposed. They after hand washing as well, those are all really good times to use moisturizers, to help protect our skin and maintain that natural barrier.

Host: Thanks for that comprehensive answer. You covered a couple of different things which go from, you know, keeping your skin moisturized during the dry winter months to keeping your skin protected from the sun. And I want to focus a little bit on the latter first. So the first question that I had is we hear a lot about the importance of getting Vitamin D. So how do you balance keeping your skin covered and protected with making sure that you get outside enough to get the Vitamin D that we all desperately need?

Dr. Raisanen: Protecting your skin from the sun has not been shown to significantly impact our ability to produce natural Vitamin D. So there's not a strong thriver in my mind, and in many dermatologists mind that we need to be supplementing with Vitamin D if we're protecting our skin appropriately from the sun. However, that being said, some will consider just to remove any of that doubt. They will consider supplementing with Vitamin D if they're particularly concerned about it. So that's always an option as well, where you could add in Vitamin D supplementation. However you wish to do that. If that's through diet or the pill form of supplements, that is an option that I would never discourage someone from doing if they have concerns. But again, there hasn't been strong data that would suggest that wearing sunscreen throughout the day, or protecting yourself with some protective clothing, etcetera, is going to negatively impact your Vitamin D levels on a significant level.

Host: So, I wanted to talk to you a little bit more about skin health. So many of us associate getting too much sun with skin cancer. So when does it become a problem and when should someone be proactive and see someone like yourself?

Dr. Raisanen: Yeah. So that's a great question. Maybe a couple of questions even intertwined there. So first of all, when did it become a problem? So if someone is noticing an abnormal skin growth and abnormal can be very subtle. It might just be a pink shiny bump that maybe bleeds or scabs over every once in a while. But otherwise it's not so bothersome. That could be an early skin cancer. If we're talking about melanoma, we're talking about your regularly shaped Brown spots, most commonly. So something that has a asymmetric shape, has funny looking borders, maybe has multiple colors within it, is bigger than a pencil eraser and is changing. And also just looks different than your other spots. Those are warning signs for possible melanoma and something that should be investigated further. If we're going back to sort of sun protection about windows, this sun exposure, sun protection become an issue. Really, this is from even early age.

So, it's important to be protecting our kids even as young children when they're out at the beach and then growing on through adulthood, because a lot of these skin cancers that we see when people are 50, 60, 70, 80 years old, are the result of some exposure that they've experienced over a lifetime, or perhaps a few severe sunburns they had as a kid. You know, we have some evidence that suggests that those types of exposures or even tanning bed use as a teenager, that's going to put you at increased risk for these skin cancers down the line. You know, so they might not, they can show up within 10 years, 20 years, but sometimes it's 40, 50 years later where you're seeing the effects of that sun exposure. So that's one of the challenges too, for all of us to be adhering to these things, because it's for a long-term benefit necessarily, you know, more so than the short-term gains that we're going to see.

Host: So, you mentioned tanning beds, and I want to unpack that a little bit. A lot of us want to stay nice and Brown year round. And I wondered if you had a rule of thumb or really just a frequency in which we can use them safely.

Dr. Raisanen: The only rule of thumb that you would hear from me and from the vast majority of dermatologists would be to avoid them completely. There hasn't been any safe level of tanning that's been established, so really want to be avoiding tanning beds completely. And if we think about how the skin and DNA changes, relate to what we see on the skin, even becoming tan, even without sunburns, that tan skin is an evidence of DNA damage. So there's no part of dermatology that promotes getting a tan or that's a healthy tan, even though that there maybe a misconception or sometimes it can feel that way as if you're tan, maybe we look better, feel better, but from a skin perspective, that would be considered an unhealthy behavior to be seeking a tan.

Host: That is good advice. So I wanted to move on to UV rays. I think there's a lot of confusion around what UV rays are if they're associated with direct sun exposure, how we get them? So maybe talk a little bit about that in detail.

Dr. Raisanen: Absolutely. So there are different types of UV rays and UV radiation. The most common are UVA and UVB. And these are both seen throughout the day. UVA tends to be kind of constant throughout the day. UVB is one that peaks more with mid days. And we're talking about getting most bang for your buck in preventing against these sunburns. The UV index is a number that's been established in basically how quick would someone get a sunburn? That's sort of a factor related to that. And this is peaking in those midday hours. So say from 11:00 AM to 3:00 PM, or if you want to be more cautious, I always like to use sunscreen if it's anywhere between say like 10 and even 6:00 PM where you're getting a decent UV exposure. But again, we talked earlier about those low level exposures as well, but most of that, the most intense sunlight does come in the middle of the day. And when we talk about the UVA and UVB, but also brings to mind, you know, sunscreens. And that's the importance of getting a sunscreen that's labeled as broad spectrum, which the vast majority of them are broad spectrum these days, well that's something you want to ensure that your sunscreen is labeled as, because that means it's going to block both UVA and UVB Rays.

Host: That was really helpful. And you talked about that broad spectrum sunscreen. One of the things that I've heard before when you're applying sunscreen is that you need to do so 30 minutes before you actually expose yourself to the sun. So it can absorb into your skin. Is that true?

Dr. Raisanen: Yeah, that's typically what's recommended is that put on 20 to 30 minutes before your kind of going outside, going in the sun. And another thing you want to keep in mind is that you really want to be putting on more than you think they say about a shot glass size would cover the whole body. So, you know, sometimes we just do a couple little squirts and put it on our face and our forearms, and then we call it good, but we want to make sure we're putting on thick enough and covering all of the exposed areas to really do the best job possible, protecting our skin.

Host: And I want to ask you a question about sitting next to a window. You know, a lot of us, especially working from home might be sitting next to a window where we're getting exposed to the sunlight on half of our body or a part of our skin as we're working on the computer all day. Is that something we should be concerned about?

Dr. Raisanen: Yeah. I think again, if you're wearing a, some sort of a sunscreen each day, even if it's say mixed with your moisturizer, that should be enough to protect against that low level sunlight. If you're worried, you know, right in the sun, in a location where you know where you're getting that daily sun, you might want to do it a couple of times a day, but that is something we're not all UV rays are absorbed by window glass. So you are getting some of that UV through and it's worthwhile taking that into consideration.

Host: And just as we wrap up here, you know, just as a dermatologist, do you have any recommendations around when people should be proactive and come to see you outside of noticing something on their skin, but is there a time they should just come to visit to make sure that their skin health is up to par?

Dr. Raisanen: I'm always happy to see patients at any time, anytime they have questions or concerns, you know, they can come in as a teenager, a young child, a middle-aged person, older adult, if we're thinking, okay, when is maybe their risks starting to increase? When do dermatologist typically see some of these skin cancers showing up? I would say most commonly, at least start getting into our forties and fifties. Then in my mind, when I'm doing a skin check, I'm more prepared to find something. I'm less surprised if I find a skin cancer in patients that are in their forties, fifties, sixties, but certainly we do find them in people that are in their twenties or thirties, some of the more common types of skin cancer that have developed for one or another. So I would say, you know, when you're starting to get getting those middle-aged years, I think that's when you should start paying perhaps more attention, because that's going to be more commonly see them in that age bracket or those brackets. But it's certainly, if anything suspicious comes up, even at a young age, I think it's worthwhile getting it checked out.

Host: Just as we close here. There's one question I always like to ask, being a dermatologist, seeing, you know, potentially hundreds of patients, what is the one thing that you wish more patients knew before they came to see you?

Dr. Raisanen: A good question. If there was one thing I could pass along to the public, even the, or to all potential future patients, it would be to don't underestimate the power of protecting your skin against the sun from an early age and being consistent with that. They can have great benefits in protecting against potential skin cancers. In addition, though, and sometimes even more importantly to patients that can also just make our skin look better in our later years. So those exposures at an early age can lead to more Brown spots, more wrinkles, et cetera, this concept called photo aging. So I would never want patients to underestimate the power of sun protection for both skin cancer prevention and also for prevention of this photo aging phenomenon and making our skin look nice throughout all of our years.

Host: Well, Dr. Raisanen, and I think that is a perfect place to end. Thank you so much for your advice today. It was extremely informative. That's Dr. Tom Raisanen and a dermatologist for Aspirus Health. Thanks for checking out this episode of Aspirus Health. Talk for more information, head to aspirus.org. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks. And we'll talk next time.