The dermatologist's advice for a summer in the sun without risk

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"To be successful, keep looking tanned, live in an elegant building (even if you’re in the cellar), be seen in smart restaurants (even if you nurse one drink) and if you borrow, borrow big". The quotation is from Aristotle Onassis, the legendary Greek tycoon who, with these words, definitively sealed the status symbol role of tan, which had already been cleared and launched in the fashion world, it is said, by Coco Chanel in the Twenties. Ironies and anecdotes aside, it is undoubtedly true that for a century now the golden color of the skin given by the sun has been synonymous with well-being (physical and financial), life in the open air, leisure, holidays, freedom, energy, health. Besides, it makes practically everybody look better...

But really being in the sun is always synonymous with health? When? And above all, under what conditions?

With the arrival of summer in the northern hemisphere (the clarification is a must for an international platform such as IHW), the "tan" issue becomes important and involves aspects that go far beyond aesthetics.

The Journal of Italian Healthcare World talked about it with the Dr. Sara Pruneddu, Italian dermatologist in London recently entered into IHW network, which, as she explained to us herself, after a training that essentially took place in Italy, carried out a traineeship at a London hospital where she was then established definitively. She privately works at Doctor London.

Dr. Sara Pruneddu

Dr. Pruneddu, good morning and welcome. To fix ideas straight away: is sunbathing good or bad?

The sun undoubtedly has beneficial effects on bones and their growth and is an important source of vitamin D. As in everything, the key word to enjoy the benefits by avoiding the harmful effects is: moderation.

What then are the greatest risks of a reckless sun exposure?

Photo-aging is skin aging caused by chronic damage caused by ultraviolet rays and exposure to the sun. Certainly the greatest danger to health is constituted by skin tumors, of which the melanoma is among the riskiest. Unfortunately, so-called NMSCs (Non-Melanoma Skin Cancer), such as basal cell carcinoma and squamous cell carcinoma, are also very common. The latter, which at one time were considered cancers of senile age, are now increasingly diagnosed even in very young patients. Skin tumors are among the most widespread tumors ever, but unlike many others they are often preventable if the right precautions are followed.

Which are the right precautions then?

By now the potentially harmful effects of an incorrect and prolonged exposure to the sun are known. It is therefore essential to avoid exposure in the central hours of the day (between 12 and 16) in the summer months and to use an adequate broad-spectrum photoprotection, which includes UVB and UVA and which is at least with a factor of 30 or higher. Since there are no sunscreens that can protect us all day (even if they were sponsored as such), it is very important to remember to renew the cream every 2 hours if you are out, after each bath, and apply an adequate amount for the surface of the body to be covered. To understand, in an adult this is equivalent to about an average cup of coffee filled with sunscreen.

And instead the mistakes to avoid?

Expose yourself in a prolonged manner and do not use sunscreen and photoprotective clothing or use low protection ones. Furthermore, as just mentioned, it is wrong to use insufficient amounts of cream compared to the body surface.

In this period the tam-tam of tips to get an ideal tan starts: vitamin A supplements, carrot diet, preventive skin preparation with sun beds, tanning accelerators, self-tanning, just to mention some of the most heartfelt. Which are really effective and which can be harmful?

A balanced diet rich in vegetables and fruit should be sufficient to give us the right amount of vitamins. The sun beds are definitely to be abolished, because they increase the risk of developing skin cancers exponentially. In many countries they have already been banned. In general, too intense coloring is a symptom of excessive sun exposure and therefore an increased risk of developing skin cancers, not to mention photoaging! Let us remember that the risk of skin cancer is associated in many cases not only with acute damage (ie sun burns), but also with a cumulative factor of UV rays absorbed by the skin over time.

In case of burns or visible damage, when it is sufficient to adopt do-it-yourself remedies or to contact the beautician and when instead it is necessary to go directly to the dermatologist?

Any blemish or lesion that appears on the skin should be seen by a dermatologist to have a correct diagnosis before venturing into procedures that can destroy or incorrectly remove it. Faced with precancerous or cancerous lesions, the therapy is mainly surgical and must be entrusted to the experts. 

Are there environmental factors that increase the risks related to sun exposure?

Certainly some latitudes and the inclination of the sun's rays have an impact on the intensity of the damage they can cause on the skin. Light refraction also plays an important role. Refraction is greatly increased by white or reflective surfaces, such as snow or water, for example by standing on the shore.

Doing the medical profession, do you find differences in the approach to the "tan" among your patients also according to the country of origin?

Certainly I have noticed that awareness of photoprotection, especially children, has increased almost everywhere. Obviously what we see today in adults is the result of the sun damage due to the reckless and cumulative exposure of the past years, when still a lot of information about the risks were not yet well known and disclosed.

We thank Dr. Pruneddu for the practical suggestions she offered to the readers of Journal of Italian Healthcare World while remindig: sunbathing is ok, but in moderation!

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