Scott Webb (Host): Have you ever wondered if you should use sunscreen on cloudy days? Me too. And today I'm joined by Grace Devine and Danielle Buser from Summa Health Dermatology to discuss sunscreen and skincare facts and myths.

This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. It's great to have you both here. Welcome to the podcast.

Grace Devine, PA-C: Thanks for having us. Happy to be here.

Danielle Buser, PA-C: Thank you so much for having us. Me too. Happy to be here.

Host: Yeah, it's always maybe a never a bad time maybe is the right way to put it, to talk about sunscreen, because I know we all have these questions and there's myths and social media and all that stuff out there, Danielle, so let's start here. What's the difference between chemical and mineral sunscreens and how do they work exactly?

Danielle Buser, PA-C: Absolutely. Great question. So mineral sunscreens that you're probably starting to hear more about on social media are made up of active ingredients such as zinc oxide and titanium dioxide. When you think of those, you probably think of the lifeguards with like the zinc on their nose from a long time ago, but I promise they're getting better at formulating them so they don't leave as like a white residue.

But basically what those do, because they're minerals, they act as a physical barrier on your skin to reflect the rays, whereas chemical sunscreens made up of ingredients such as oxybenzone, actually absorb the sun's rays before they get to your skin.

Host: Grace, how often I, this is one of those questions that I struggle with, especially with my kids when they were little. How often should sunscreen be reapplied during the day, especially when indoors?

Grace Devine, PA-C: Another good question. So with sunscreen, you want to apply sunscreen to your exposed areas to the sun, 15 to 20 minutes before you're going to go outside. So it's always best to do it before you are at the pool or at the beach. Do it before you go. The key that everybody forgets is to reapply every two hours.

That's typically what gets most people and what we see them, when they get the sunburns. If you're going in the pool, the ocean, the water, keep in mind that that will wash off and you're going to want to reapply sooner than that. As far as indoors go, if you're indoors, it's not necessary that you have to wear sunscreen.

However, I do want to keep in mind that people thinking they are inside, sun rays can penetrate through the windows. All of that can also accumulate over time. You walking into your mailbox, you driving in your car, all of that sun does stay with us over time and accumulates. So it is a good idea to wear sunscreen every day, even if you are indoors, per se.

Host: This is another one of those age old questions, right? As I don't even remember sunscreen when I was a kid. Everyone used tanning oil, Hawaiian Tropic or something when I was a kid. So as we began to have more protective sunscreens, and then the SPFs came out, and then the SPFs went up. So is SPF 100 really better than SPF 50?

Grace Devine, PA-C: Not necessarily. So, research has shown, and according to the American Academy of Dermatology, SPF of at least 30, blocks about 97% of our UVB rays, and these are the rays that cause sunburns on us. So, if you go up in SPF 50, 75, a hundred, you might get a little more coverage against those UVB rays, but there's no SPF a hundred that actually blocks 100% of those bad rays.

One also thing to keep in mind is just because you're getting a higher number SPF doesn't mean it lasts longer, so you know, it doesn't mean that SPF 30 will last two hours and SPF 50 lasts three hours. You still need to reapply that sunscreen.

Host: Yeah, I've often wondered about that because I'm thinking, well, there's 50, but 100 must be better. It must protect better, it must protect longer. But as you're saying, maybe that's one of the myths that we're trying to bust here today. Right, Danielle? And I had a roommate when I was in college, we used to play basketball outside and he was African American and we used to debate whether or not he should put sunscreen on and he would tell me that he didn't have to.

He didn't need to, and I wasn't sure that he was right about that, and I don't think that he was. So, I just want to ask you, with people with darker skin tones in general, can they skip sunscreen?

Danielle Buser, PA-C: The short answer is no. Basically with darker skin tones, whether that be African American, Italian, Filipino, basically it means that they have more melanin in their skin. While this is protective against your UV rays, it should not be used as your sole protector from the sun. Every time that our skin is exposed to the sun, our immune system is creating more melanin to try to protect ourself.

So it's still sun damage every time you're getting exposure. While skin cancer is less common in people with darker skin tones, it's not impossible by any means. Wearing sunscreen can also protect against things that are not necessarily skin cancer, but different sorts of aging like hyperpigmentation, melasma, wrinkles can still occur in any skin tone, which sunscreen can protect against.

Host: We've referenced here some of the myths. There are a lot of myths about sunscreen. There's a lot of so-called experts. I'm using air quotes, on social media. So what are some that you'd like to debunk today?

Danielle Buser, PA-C: I think the most common one is that sunscreen is unsafe to use. There are FDA regulations regarding sunscreen and a lot of new studies being looked into about what these ingredients will do if absorbed or on our skin because as we, Grace was just explaining the way that we're supposed to apply our sunscreen is everywhere that sun exposed, that's a lot of body surface area.

So as of right now, there is no evidence to suggest that any of these chemicals are harmful, especially if you're using mineral sunscreen.

Host: Here's one for you, Grace. I referenced it in my intro and my kids have argued with me many times over the years of about this. They're like, dad, the sun's not even out. Why would I need to use sunscreen? And then I try to explain it to them and I don't do very well. So we give you the opportunity, explain it to my kids and everyone else, why we need sunscreen, even when the sun's not out.

Grace Devine, PA-C: The sun emits its UV rays that are harmful year round. Even in the winter time, even when it's cloudy, about 80% of the harmful UV rays can actually penetrate through the clouds and on our skin and cause sunburn. So it still is important to wear sunscreen even when it's cloudy or if you, you know, are working in construction jobs in the winter and you're outside 24/7.

Who needs to wear sunscreen? I say everyone. Skin cancer doesn't discriminate. Anyone can get skin cancer. It doesn't matter your age, your race, your gender, your skin tone. The reality is one in five Americans will develop skin cancer in their life. So that's about 20%. And skin cancer is the most common cancer in the United States.

So it's a good habit that everyone starts getting into this and using sunscreen if they're not already.

Host: Throw you a curve ball a little bit. How do you feel about the SPF shirts? Like this shirt that I'm wearing, I believe is meant for like to play golf in and have as SPF built into it or something like that. How do you feel about the hats and the clothing and things that are also meant to protect against sun damage?

Grace Devine, PA-C: All of that is great. They are making those clothes with the UPF clothing like sunscreen built in, and we highly encourage all of that. Again, seeking shade during the hotter times of the day. The sun's the strongest between 10 and 2, hats, sunglasses, all of that stuff. Highly encourage.

Host: For sure. Just want to finish up Grace, you know about SPF as you're saying, we have to reapply no matter what we buy, 35, 50, a what would be your final, related to SPF, words of advice when we're standing there at the store and we're trying to figure out which one to buy, what do you recommend?

Grace Devine, PA-C: Good question. So it can be overwhelming when you go and you see all of these different sunscreens on the shelf. So you're going to see lotions, creams, gel sticks. I say I want you to get the one that you're going to use, the one that you're going to be consistent with and use frequently. In general, the couple things you should look for is a broad spectrum sunscreen, so it's covering the UVA rays and it's protecting against those UVB rays as well. Just a little tidbit, the UVA rays, those are our like aging rays. So that is what causes like our wrinkles or our age spots, dark spots. This type of UV ray can pass through the windows, like through our car.

The UVB rays, as I mentioned earlier in this talk, are those like burning rays or the bad rays. Those are what can cause sunburns on us. Those rays actually do not penetrate through the windows. So again, broad spectrum. It covers both UVA and UVB. Water resistant. Really no sunscreen is like water protected, but it's resistant. And then I always say an SPF 30 will do just fine. If you prefer greater, that's okay too.

Host: You're probably just spending more money and it, it's maybe just for peace of mind, but as you say, we really just need to use it. We need to reapply it. And the best one is the one we'll actually use. Right?

Grace Devine, PA-C: You got it.

Host: That's perfect. Danielle, let's shift to skincare routines and basic skincare. And these are things that are foreign to me. Because again, I, you know, I look in the mirror and I go, eh, I look fine. You know, I am what I am. I'm in my mid fifties, right? But for other people who do take care of their skin, especially related to the sun, what are some essential steps in basic skincare routine?

Danielle Buser, PA-C: Definitely. So this is a really common question I get. My honest answer is that skincare is something that's highly customizable. You know, it's personalized to you. Things that you're trying to focus on. The bare bones of any skincare routine should have a cleanser, a moisturizer, and a sunscreen.

After that, you're trying to target different things that are specific to either your skin type or any sort of sun damage that you've had. Like if you have dark circles, texture, that type of thing. And there are lots of different things that we recommend for that. So if you ever, if anyone ever comes to our office, we have different recommendations for that as well.

Some examples with that would be adding different serums if your skin is drier. Or if you have texture, dark spots, talking about adding in a retinoid, to try to use. But the key with any skincare is those three elements, and also just consistency, using it every day.

Host: Yeah. I use it about once a month, but, uh, that's me. My wife on the other hand, all of her products, everything she uses has SPF for her lips, for her face, all of that. So want to get a sense from you, like how does a sunscreen fit into the morning skincare routine, and what should we look for if we do, are the maybe the type of people who buy moisturizers when it comes to SPF.

Danielle Buser, PA-C: Basically if you like us a routine that's more than one step; you always want to apply like your moisturizer or your serums first, right on your skin, and then your sunscreen on top of that, ideally mineral-based to act as a barrier.

If you are not really into that many steps, you just want to do the basics or you like to wear like skin makeup, you can do a one-stop shop with a moisturizer with a built-in SPF or like a foundation with a built-in SPF, but always remember that reapplication is key. In terms of like specific ones, you're kind of looking for something that matches your skin tone.

For example, if you have oilier skin, you might like gels. If you have drier skin, you might like a cream or a lotion. And that may change throughout the year too. I know I use a different one in the winter than in the summer. So, it's kind of just based on your skin tone.

Host: Well, it's been great having you both here. Last word to you, Grace. I'm thinking about my takeaways today, and one of them is reapply, reapply, reapply. From you, uh, what are your final thoughts or takeaways?

Grace Devine, PA-C: Again, my final thoughts and takeaways are going to be to reapply your sunscreen and get one that you're going to use.

Host: Perfect. I want to thank you both here, appreciate your expertise, uh, helping us to debunk myths if you will. Uh, so thanks for your time.

Grace Devine, PA-C: Thanks for having us.

Danielle Buser, PA-C: Thank you so much for having us.

Host: And you can book an online dermatology appointment@summahealth.org/dermatology. And if you enjoyed this episode of Healthy Vitals, we'd love it if you'd leave us a review. Your review helps others find our educational content. I'm Scott Webb. Thanks for watching and listening and I'll talk to you next time.