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Abigail Trafford
Abigail Trafford
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Health Talk: Summer
Protect Your Skin

Hosted by Abigail Trafford
Washington Post columnist

Tuesday, June 25 at 2 p.m. EDT

Protect your skin! This important organ of the body is the first line of defense against all the microbes and other hazards in the environment. Summer is a particularly high-risk time for skin -- when you want to be outside sunning yourself in the backyard, boating on the lake or hiking up the mountains. But too much exposure to sun can be dangerous and even fatal. And besides, those long summers of getting a sun tan will translate into wrinkles later on. Find out how to keep your skin healthy and looking good.

Join Post Health columnist Abigail Trafford and her guest, Dr. Christine Lee of The East Bay Laser & Skin Care Center, Inc., to talk about taking care of your skin under the summer sun on Tuesday, June 25 at 2 p.m. EDT.

The transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.


Abigail Trafford: Hello everyone. Planning to be outdoors this summer? We have some good advice for you! Send us your questions and comments.


Abigail Trafford: Hello and welcome Dr. Lee. Summer is when we want to be outdoors. It's also when we do damage to our skin. What are the main dangers to skin?

Dr. Christine Lee: The main dangers to the skin are from UVA and UVB rays (ultraviolet A and B)--these cause accelerated aging, photodamage which appears as freckling, broken blood vessels, dull sagging and wrinkled skin. It also causes damage leading to skin cancer.


Abigail Trafford: What's your general advice for enjoying the sunshine and protecting your skin?

Dr. Christine Lee: Avoid peak hours of sun which is between 11 am to 3 pm. Wear protective clothing, hats, sunglasses and sunscreen with a minimum SPF of 30 or higher. The sunscreen should contain zinc oxide or Parsol 1789 (avobenzone).


Rockville, Md.: Hello. I am very fair, have red hair, blue eyes and freckles. I have gotten sunburns in the past as a child, but as an adult I've been as careful as possible. I'm religious about putting on sunscreen, using hats, and always having an umbrella at the beach. I've noticed that even with all that, I've been getting more freckles over the years. Is there any way to stop this or reverse this occurrence?

Dr. Christine Lee: I commend you for all your efforts and want to encourage you to keep it up but do not assume that you're not getting sun exposure even with the best preventative measures. Sunscreens are mainly a filter that help to block out damaging rays but even an SPF of 100 would not bring sun exposure to zero. Sunscreens wear off after 2 hours and have to be reapplied. They have to applied thickly (about 1/4 inch thick) and cover the entire surface area. People get significant sun exposure just walking to their cars in the parking lot and sitting in the car. Think about how many hours people spend in the car--it's almost like sitting outside with all the reflection through the windows. One hint is to get UV tinting for your car windows--you need a doctor's prescription to get this protective coating installed. Sitting at the beach under the umbrella helps but remember you still get a lot of reflection from the water and sand. Same when skiing. Best thing is to avoid the sun during peak hours 11 am - 3 pm (that means staying indoors or in the shade).


Fairfax, Va.: Hi,

I'm 20 years old and doing my best to protect my skin. I wear SPF 15 on my face every day year-round, and in the summer I always put on sunscreen before spending time in the sun.

The problem is, I still feel that young people think the tanner the better. I've talked to women my age just in the past couple weeks who have said things like, "I'm going to a tanning salon before vacation," or "I'm getting such a great tan!" I wonder how this can be when it's so well-known how much damage the sun can cause to your skin! Why is is still fashionable to be darkly tanned? And while I know there are sunless tanning lotions, gels and sprays available, I don't want to bother with it. Why can't we just forget about getting a tan!?

Thanks for letting me rant, and I love your Health column Abigail.

Abigail Trafford: You've hit on a major syndrome--I call it the "culture says" syndrome. The culture says you look better with a tan. The culture says: go golden! The culture says: beach bash your way to beauty. The culture-says message is much more persuasive than the restrictive health message to protect yourself and not get a tan. How can the "culture says" syndrome be changed? Is it important to change it? Dr. Lee, what do you think?

Dr. Christine Lee: We can blame Coco Chanel for making tan models fashionable. One of the worst things you could do for yourself would be to go to a tanning salon. It doubles your chances of getting skin cancer. The media and Hollywood can be important allies in trying to change the perception that "golden" is beautiful. I think that's already starting to happen with actresses like Nicole Kidman who is famous for her milky white skin.


Washington, D.C.: I'm 28, medium skin tone, have had a few bad burns as a kid. What should I expect a doctor to do? My general doctor hasn't done more than a quick look at the moles on my skin.

Dr. Christine Lee: A shocking statistic is that melanoma is the number one killer of women under the age of 30. Not only is the incidence of melanoma dramatically rising, but the number of young people getting melanoma is rapidly increasing. If you have high risk factors such as family history or personal history of melanoma, many irregular moles, history of many sunburns, and fair skin, you should consider getting an annual skin exam by a dermatologist at least once a year.


Montgomery Village, Maryland: I have a 4 month old. Can I apply sunscreen to him? And if not, what can I do to protect him from the sun when we are in the car or out walking?

Dr. Christine Lee: You should wait until 6 months to apply sunscreen to your baby. Meanwhile you should protect him with UV protective clothing and hats and in a covered stroller. Also get UV tinting for your car windows (you need a doctor's prescription for this).


Rocky Mount, NC: Do you think it's possible to develop Melanoma from a tanning bed ?

Dr. Christine Lee: Their is a consensus that tanning beds cause skin cancer and melanoma. It increases your chances of getting cancer by at least double. There is a very powerful lobby by the tanning industry (just like the tobacco industry) to keep tanning salons going. There is absolutely no truth to building up a slow tan to prevent skin cancer. Tanning is damage to the skin. You don't need just a sunburn to damage the skin.


Alexandria, Va. I just returned from Jamaica and I did a lot of sunbathing, however, I always put on sun screen first. My daughter and I noticed that after three days we both had a rash on our bodies. We aren't sure if it is sun poison, or from eating too much fresh pineapple. It does not itch, however, it is on our arms, legs and shoulder areas. Any suggestions? Thanks!

Abigail Trafford: Or could it be from the sun screen? Did you consult a physician about your rash? Dr. Lee, what do you think?

Dr. Christine Lee: There are some things that cause "phototoxic" reactions or "photodermatitis" which is a reaction of the chemical being applied with sun to induce a rash. For example, some college kids could be drinking tequila shots and have lemon or lime on their hands which is a power photosensitizer and thereby develop a sun-induced rash in that area. Your rash could be a combination of what you're eating mixed with sun.


Germantown, Md.: We're taking my 9-month-old baby to her first beach trip next week. I am very concerned about exposing her skin to the sun. Besides sunscreen (is it really safe for baby's skin?) and keeping her under an umbrella, what else can you recommend?

P.S. She won't keep a hat on for more than five seconds!

One more question: What is your opinion on those "sun safe" suits that look like wetsuits and claim to block up to 98 percent of rays?

Dr. Christine Lee: Remember that 80 percent of the damage leading to skin cancer was caused prior to the age of 18. Babies have no protective layer therefore they have to be shielded from the sun! This is the parents responsibility! After 6 months you can safely apply sunscreen--better to use a special one made for baby sensitive skin (by the way, adults should not use this because it's not as strong as the standard strength sunscreens)--Getting specially made UV protective clothing with a guaranteed UPF (ultraviolet protective factor) or SPF due to its tighter weave is helpful.


Falls Church, Va.: I'm 37 years old and up until I was 26 or so I didn't always use sun screen. For the past 10 years I have used sun screen religiously but the damage has been done. I have big brown spots on my arms, hands and back from sun damage. Can lasers get rid of these? Also, what are the "white freckles" I see popping up on my legs? They look like drops of sun just fell on my legs and bleached out the skin. Can they be removed also? Is there an "all over" body treatment to get rid of all the brown spots? Thanks!

Dr. Christine Lee: Sun causes increased pigmentation and paradoxically also decreased pigmentation (known as "guttate hypomelanosis") this appears as a speckling of brown and white spots on sun exposed areas. Unfortunately there's nothing you can do for the white spots. Definitely do not try to get flesh colored tattoos to conceal these--they are a disaster because the pigment in the tattoo can change over time--you can end up with green or black spots instead! Freckling and brown spots can be removed with a variety of procedures such as chemical peels, glycolic peels, and lasers. Also try using bleaching agents (hydroquinone, kojic acid, azelaic acid) in addition to retinoids (ie: Retin-A).


downtown: Can we be careful here. Dr. Lee just made a reference to beautiful milky white skin. While that is wonderful, some of us have naturally golden, tan, olive, or whatever skin tone that is also beautiful. I think the point here is that excessive sun exposure is bad for anybody not what is considered beautiful.

Abigail Trafford: Good caution, downtown. The point is that natural skin whatever the color is beautiful and skin exposed to sun damage is not. In some quarters, milky white skin is considered ugly and even sickly. This all leads to another issue: the difference in skin types. Dr. Lee, are some skin types more immune to sun damage?

Dr. Christine Lee: Contrary to popular belief, even the darkest skin can get skin cancer. I've removed skin cancers off of people of every age and ethnicity (as young as 2 years old and in the darkest black skin). Patients with Hispanic, black or asian backgrounds do get skin cancers and melanomas--in fact when they get melanoma it's usually in areas without sun exposure such as the hands, feet and genitalia which also have a worse prognosis. Patients of all skin types need to worry about skin cancer. Also, don't forget the eyes, scalp, finger and toenails. Even though someone with dark skin does not sunburn--they can still get damage from overexposure to sun. All different colors of skin are beautiful unless it's sun damaged.


No. Va.: I was interested in your recommendation for a yearly exam, even when young. My in-laws both have had skin cancer (not serious). However, when my fair-skinned husband (early 30s) went to a dermatologist, at my urging, to get his many moles and freckles checked out, the doctor basically acted like there was no need to get an annual exam and he had nothing to worry about. Of course, my urging to go to the doctor then looked like paranoia. Should he find another doctor? I know two men who had skin cancer in their 20s and it worries me. Thanks.

Dr. Christine Lee: Any suspicious lesion needs to be checked out. We often talk about the ABCD's of melanoma which are basically Asymmetry, irregular Borders, irregular Color, and large Diameter, but i's difficult for an untrained eye to pick these out. People can get skin cancers at any age--their risk factors are much higher if they have many irregular moles, history of melanoma in the family, history of severe sunburns.


Woodbridge, Va.: Is it necessary to use sunscreen after 4:30 or 5:00 p.m. in order to prevent cancer? Does the danger of cancer correlate to the danger of burning, in other words, if I go out in the sun at a time of day or for a duration that I don't burn (I am fair-skinned), am I increasing my risk of cancer if I don't wear sunscreen? I have found that when I wear sunscreen I tend to count on it and stay out too long, and if I missed a spot I will have a spot of sunburn somewhere, but if I go to the pool late in the day I never burn.

Dr. Christine Lee: One of the things that really troubles us dermatologists is that even though use of sunscreen is higher, that the incidence of skin cancer is rising. No, this DOES NOT mean that sunscreen causes skin cancer. There are some possible explanations such as increased usage of sun because people feel that sunscreen is protecting them (if you don't sunburn, you might stay out longer). Just because you have sunscreen on does not mean you can stay out longer. You still need to apply sunscreen even when standing in the shade and sitting in the car because of exposure while walking around and from reflection.


Saint Paul, Minn.: Hi Dr. Lee,

I am fair-skinned, so I tend to stay out of the sun and lather on the SPF. I also have a bunch of moles everywhere. The last few years I have noticed that some of my moles have grown in size and lightened in color (They are no longer black/brown but light like the rest of my skin). My dermatologist says they are not suspicious, but I would like to have them removed. What are the mole-removal options these days? (Several are on my face and I am worried about scarring.)

Thanks

Dr. Christine Lee: Many people are born with moles. As you get older, you will also get more moles. Any mole that starts to look different from the rest, grow rapidly or change colors suddenly, become symptomatic (itching, burning) should be removed. Mole removal is still best done surgically. It's very controversial whether or not laser should be performed on a mole. If it's a suspicious looking mole, it should definitely be surgically excised. There are many well-trained dermatologists specializing in cosmetic surgery (they are usually called "dermatologic surgeons") who would be the best specialists to evaluate/diagnose the mole and to remove it with the best cosmetic result. Plastic surgeons can also remove moles but they usually do not have the training to recognize cancerous lesions or melanoma. If you live in an area without a good dermatologic surgeon, then the primary care physician often works with a plastic surgeon to get the mole removed.


Washington, D.C.: A general skin question:
I am a very pale white woman, although I tend to tan, rather than burn. I have dry skin. I use lotion on it regularly, and I wear heavy duty sun screen when I am outside.

I also have odd bumps all over me. (so do my siblings.) They look like goosebumps, from being cold. My mother always maintained that they were from dry skin (she didn't have them), but they have never gone away, even when I am religious about the lotion and don't really suffer from dry skin.

I've been told they are pretty common. What are they? Should I buy a new kind of lotion (what kind, specifically)? Or should I run to a doctor because they are something awful?

Dr. Christine Lee: Sounds like the bumps are keratosis pilaris--this is a common condition which results in plugged up hair follicles on the sides of the upper arms and thighs. There's not cure for this but you can minimize it with using a loofah or stiff brush when bathing along with scrubs containing glycolic acid (also known as AHA or alpha hydroxy acids) or lactic acid or salicylic acid. One of my favorite treatments are pads medicated with glycolic and salicylic acid (made by Topix) that you swipe over the areas. This will only help keep it under control but will keep coming back when you don't use these products. Use moisturizers with glycolic acid also.


DC: A co-worker from the U.S. Virgin Island mentioned to use lemon to treat sunburn. IS that safe?

Dr. Christine Lee: Using lemon would be the WORST way to treat a sunburn. Remember the previous response I gave to the lady who asked about eating certain foods in the sun causing a rash. Lemon and lime are potent photosensitizers--they CAUSE sunburns. They will only further irritate and aggravate your sunburn. Some helpful remedies for sunburn include soaking in cold milk or cold water compresses, and taking aspirin. If you have a serious blistering sunburn, you may need to seek medical attention so that any possible infections can be treated.


Rockville, Md.: My husband knows how harmful sun exposure can be, but wants to be tan. So he goes to the tanning salon. Isn't that just as bad?

Dr. Christine Lee: As I've already mentioned, and I want to emphasize again--tanning salons are like cancer boxes! Getting tan is just as bad as getting sunburned. The tanning salon industry wants you to think that getting gradual tanning is safer than sunburns. This is not true. Tanning salons double your chances of getting skin cancer. There is absolutely no safe way of getting UV exposure--whether outdoors or in a box.


Washington, D.C.: Why do you need a Dr's prescription for UV tinting?

Is that national or local law?

Dr. Christine Lee: I know that in California this is a law. It was in Texas too. I'm not sure if this is a national or state law. Here's a phone number you can call regarding UV tinting--the company that makes it is called Lumar UVShield (888-288-7443).


Canada: Once you are diagnosed with mm should you still be leery of the sun since the damage has already been done?

Dr. Christine Lee: Should be more leery of sun damage. One you have a melanoma or skin cancer, your chance of getting another one are at least 50 times higher than that of another individual--the question is not if you'll get another one, it's usually when.


Germantown, Md.: Dr. Lee,

I have lupus so I am very sun-sensitive. If I wear SPF45, my skin reacts after a couple of days and I can't use it anymore. What would you advise? Thank you.

Dr. Christine Lee: People with lupus and other collagen vascular disorders have extreme sun sensitivity. Also people on certain medications such as tetracycline and accutane are more sensitive to sunburn. Sunscreen might not be enough--you may have to avoid the sun altogether during peak hours and stay in the shade, wear UV protective clothing, hats, etc. There are some brands you might want to try that are formulated for sensitive skin. Sometimes switching different brands can help. Try Cetaphil with Parsol or Ombrelle with Parsol--sometimes the sensitivity is due to the actual moisturizer or vehicle containing certain preservatives.


re: cultural images: I agree that it's beautiful to have milky white skin like Nicole Kidman's. But what can a girl do when her skin on her legs, chest, arms, back, etc is ALREADY sundamaged, splotchy, freckley? In this case, I KNOW it's best to stay out of the sun, but the sight of my pale splotchy skin just drives me INSANE! It makes me want to get another tan to cover them up!!!

Abigail Trafford: Resist, resist! Now for some practical advice from Dr. Lee. How do you restore already sun-damaged skin?

Dr. Christine Lee: There are plenty of noninvasive rejuvenation procedures such as noninvasive laser using a visible light such as the KTP laser to remove freckling and sun damage combined with an infrared laser that helps to stimulate collagen production (to help reverse some of the damaging effects of sun)--The most popular procedure in my practice is a combination laser procedure using the Aura (KTP laser) and Lyra (Nd:YAG) lasers from Laserscope--when I combine this procedure with microdermabrasion to help enhance penetration of the laser, it's given the best results in terms of improving overall skin quality--and the best part is you can do this procedure over the entire body! And no downtime. Short of doing a procedure, you can apply various chemical peels to help remove sun damage. But a word of warning is that if you're going to go thru all this trouble, it's even more important to protect yourself from the sun afterwards!


washington, dc: I'm a sunscreen zealot and have been for many years. However, I have not been able to find a sunscreen with parsol or zinc oxide -- or titanium dioxide, for that matter -- that doesn't make my skin itch and breakout. (Which seems strange, especially since zinc and titanium are usually marketed as the "sensitive skin" or "non-chemical" alternative.) The only sunscreen that makes me happy is Banana Boat Faces 23 SPF, which promises UVA and UVB protection -- but it doesn't have those ingredients. Am I safe?

Dr. Christine Lee: Only zinc oxide and parsol 1789 (avobenzone) give maximum coverage to the whole UVA and UVB spectrum. The problem with other sunscreens that advertise "UVA and UVB protection" is that they don't tell you it's only partial. If you can't find a brand that you can tolerate with these ingredients, it's better to wear something than nothing so I encourage you to use the Banana Boat. You might want to try a brand with zinc oxide made by Skinceuticals--I found that many people tolerate this very well.


Alexandria, Va.: I have very fair skin and burn very easily so I am aware of my risk of skin cancer and pay attention to my skin. My boyfriend tans without burning, loves to look tan, and has 10 or 15 moles on his body. Most look fine (compared with pictures in books of "ok" and "bad" moles), but there is one in particular that I am concerned about. Half is mole-like, while half is freckle-like (i.e. not raised). Seems suspicious to me. Problem is, he doesn't have health insurance and doesn't like doctors. He did say if I found a free screening he would go, but is afraid they would want to cut it off just to make some money since the screening was free. Are there free or low cost skin cancer checks in the DC area? Any advice on how to convince him it should be checked out even if it costs money? It seems silly to price shop for health care, but for the uninsured its important. (and I'll stop now before I get on an insurance rant).

Thanks!

Abigail Trafford: Before passing on your important question to Dr. Lee, let me continue your rant on uninsurance. It's a disgraceful problem in this country that some 40 million Americans have no health coverage and millions more are underinsured. Just today at the National Press Club, Rep. John Conyers (D-MI) officially launched a nationwide grassroots campaign for "Health care for All" by 2004. The coalition has a ranged of religious, medical and social organizations. For more information, there's a web site: www.uhcan.org. Many health care leaders are working on this problem including the Robert Wood Johnson Foundation at CoveringTheUninsured.org. Now to your question about your boyfriend. Dr. Lee, what do you advise?

Dr. Christine Lee: The American Academy of Dermatology has an annual skin cancer screening day where local derms provide free skin cancer screening (call the AAD for this information). It generally costs about $85 to $150 to get a thorough skin exam if you're paying out of pocket. They wouldn't remove anything without first informing you and getting your permission. but if you have a bad lesion you probably want to find out about it earlier than later. Remember, melanoma is one of the few cancers that can be completely cured but early detection is key. The number for AAD is 888-462-DERM.


Washington, D.C.: I use an SPF 15 moisturizer on my face every single day, 365 days a year. In the Spring, I still get freckles across my nose and cheeks. Should I use something stronger?? What's going on?

Dr. Christine Lee: SPF 15 is the bare minimum. If you're going to be outside you should wear SPF 30 or higher. If active, use SPF 45 waterproof so it doesn't sweat off right away.


Arlington: I can't believe people spend more time in the sun today; after all, we used to farm and do other work outdoors, and now we are in offices all day. So why is skin cancer on the rise? Is it the thinning ozone layer not blocking UV rays? Could it be some other environmental factor, making us more susceptible to the rays?

Dr. Christine Lee: There is probably some thinning of the ozone layer. Also people are spending more time outdoors, have more leisure time.


Arlington, VA: Recently I started wearing sunscreen every day, regardless of how much I plan to be outside. I plan to do this year-round. My problem is finding a good selection of sunscreen choices that are high SPF, with the recommended ingredients, but are not greasy and do not have a strong odor -- since I don't want everyone around me to know I'm wearing it. And I'm worried that my options will shrink even more when summer ends.

What is a good place to find good brands of sunscreen for every day, year-round wear?

Thanks

Dr. Christine Lee: Dermatologists carry many brands from their offices that may not be available over the counter. My favorite brand is Skinceuticals which is not available over the counter. Over the counter, Cetaphil and Ombrelle, Oil of Olay, Clinique, and Neutrogena are well-tolerated brands. Almost all the brands do make a sunscreen with zinc oxide or Parsol you just have to read the ingredients carefully.


Sun Lover in Bethesda, Md.: Dr. Lee-

This may seem naive, but... with all of the advances in technology and medicine, don't you think someone will be able to develop a drug or a procedure down the road to help with all of american's sun damage? (not that that would be any excuse to go without my SPF today!)

Dr. Christine Lee: There's a lot of research going on trying to target the genes responsible for skin cancer and melanoma. The hope is that someday there may be a vaccine for melanoma. Also, hopefully there will be better treatments for skin cancer involving immunomodulators and not surgery. In the meanwhile, prevention and early detection are the best we can do. If you do get a skin cancer, you should see a Mohs trained surgeon--Mohs micrographic surgery is considered the best treatment for skin cancer, it has the highest cure rate and best cosmetic results (because it is a tissue sparing technique).


Minneapolis, MN: Is there any middle ground? It sounds like the options are only (1) to be extremely vigilant and apply sunscreen every 2 hours, and completely avoid going outside from 11-3 or (2) to suffer from horrible illness. Is it really this black and white, or is there something in between these two options?

Dr. Christine Lee: It's like smoking--we all know smoking causes lung cancer but many people still smoke. Is there a difference between smoking 2 packs a day versue 3? None of the options are perfect in terms of sun protection (short of being a Buddhist monk and living in a temple without ever going outside)--most people still need to live. Some people will never get a sunburn their entire life and still develop a skin cancer (remember there are other risk factors involved such as genetics). Also, people are living longer so their chances of getting a skin cancer at some point in their lives is much higher than in previous generations. Try to do the best you can and get your skin checked regularly by a dermatologist--these are your best defenses.


Alexandria, Va.: I am 45 years old, fair skin and now certainly lamenting those teenage years when we all fried ourselves with baby oil and iodine. I have had some laser treatment in the past on my face for dark spots and broken blood vessels which helped somewhat. Question is - every morning under my makeup I use a moisturizer with SPF 15 and SPF 15 makeup (although sparingly). I am usually just going to work and running errands (not outside a lot). Is this enough?

Dr. Christine Lee: This is probably good enough for your daily routine. If you are going to be outdoors on the weekends, I would increase the strength of sunscreen to SPF 30, wear a hat and sunglasses also. 80 percent of the your damage was already done prior to age 18. But you still need to protect yourself more than ever.


re " noninvasive rejuvenation procedures" to restore milky white skin: But these wouldn't be covered by insurance, would they?

Dr. Christine Lee: No, this is considered a cosmetic procedure. Now, if you do have a documented history of multiple skin cancers and precancers, you could possibly get insurance to cover a chemical peel to remove the areas affected by many precancers.


Fairfax, VA: Alexandria's BF might want to try the Queen Street Clinic in Old Town. My uninsured BF was there just last week to have a mole checked out. It's a flat fee of $45 for an office visit. (This after the Fairfax County clinic people told him that they weren't accepting applications until the end of September, and then it would be another 2 months before he could get an appointment.) Luckily, the mole was actually just a pimple gone awry.

Dr. Christine Lee: Thanks for the information.


DC: I've developed brown sun spots. My doctors said there is nothing to worry about with them. However, does that mean I could develop cancer if I have brown spots?

Dr. Christine Lee: Brown spots are usually a sign of sun damage. Usually they are benign and present no problems. However, it can be tricky is you have a ton of freckles but cannot tell if any of them are changing. Melanoma can develop anywhere on your body, either in a preexisting mole or freckle that used to look normal, or in normal skin. If any of the brown spots start to grow or change suddenly, have it looked at by a dermatologist.


Bethesda: Is there a certain brand of sunscreen that you recommend for people with very very sensitive skin?

I've used many types of 30 SPF and above sunblocks specifically for sensitive skin, and I always get very red and a rash.

By the way, I'm an Asian-American woman in her late 20's.

Thank you.

Dr. Christine Lee: As I mentioned before, some brands are formulated for sensitive skin. Cetaphil, Ombrelle by Loreal, Neutrogena, Clinique, Oil of Olay, Aveeno, Purpose, Basis, Almay, Physician's Formula tend to be well tolerated by sensitive skin individuals.


re: tanning salons: I too am very pale & can't be bothered with sunless tanners, but I am PROUD of my so-pale-my-veins-show-through skin 'cause it means I'm TOO SMART to hang out in the sun. Whenever I hear people talking about going to tanning salons, I just think about how leathery & wrinkly they'll be in ten years! By the time they're forty, their faces will look like old boots.

Abigail Trafford: Bravo! I agree.

Dr. Christine Lee: This is a great comment. Since I'm in the cosmetic and laser surgery business, I can tell you for sure that there are many people wishing they hadn't done so much damage to their skin and are welling to pay huge amounts of money to get it removed or reversed. I constantly hear from my patients, "..If only if.." Not to mention how traumatizing it is to get diagnosed with skin cancer. I can usually tell how someone is going to look in about 20 years just by hearing what their daily activity is.


College Park: My 4 year old son is half white, from me, and half Hispanic, from his father. He has that beautiful caramel complexion that many mixed children have. I put high SPFs on him throughout the day, but regardless, he always deepens his brown color. Is this healthy/normal-given his Hispanic genes?

Dr. Christine Lee: He does have built-in protection due to the increased levels of pigment in his skin but there are plenty of people with Hispanic, Asian, and black backgrounds who develop skin cancer and melanoma. It's normal for him to turn brown but it's not a free ticket to go and stay out in the sun--he has to worry about sun damage also and it won't manifest itself as a sunburn. Start teaching your son good habits when he's young. Try to get his school to be involved--make the kids stay in the shade during peak hours, let the kids have time to reapply sunscreen and encourage them to wear hats. encourage activities in the late afternoon after 3-4 pm


Arlington, VA: I think all of us participating in this forum are aware of the dangers of sun exposure. How would you recommend trying to reach those who may need reaching most - young teenagers trying to look like Jennifer Lopez? (I recall spending hours outside sunning as a young teen, and am sorely regretting it now!)

Dr. Christine Lee: This is a difficult issue--as one viewer rightfully pointed out--you don't want to be making generalizations about any one skin color being the beautiful color. We all have to watch ourselves when we comment that someone looks great because their skin is golden brown--some people are born that way (and they're lucky) but that doesn't mean that someone else without that genetic makeup should go out and fry themselves to try to achieve the same color. In fact, a fair skinned person will never have that color, they'll only turn red and then brown and freckled--it won't be the even color they're trying to achieve. I think we need to focus more on how every color is beautiful when it healthy and undamaged. Ads should be trying to run the gamut to show healthy white, olive, brown, and dark skin--No one color should be singled out but the emphasis on untainted, unsundamaged skin and educating people on what that means.


Abigail Trafford: We've gone way past the hour. Thank you very much for your terrific advice, Dr. Lee. So many questions, so little time! I'll be on vacation next week. (protecting my skin, of course.) See you all again on July 17.


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