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Dermatologist Dr. Joshua Fox, Even in the Smartest Cities in the U.S., Misconceptions Remain

When it comes to safe sun habits, many Americans are still in the Dark Ages. A new report from the American Academy of Dermatology (AAD) shows there is plenty of room for improvement across the country, but especially in the cities that fared the worst in its “Suntelligence” survey, which measured both beliefs and behaviors related to sun exposure in more than 7,000 adults nationwide. That survey found the smartest people, sun-wise, in Hartford, Salt Lake City, Denver and Tampa. The least sun-savvy folks were in Pittsburgh, Chicago, Cleveland and Seattle.

“Most people know that getting a blistering sunburn—or baking themselves brown every summer—isn’t good for their skin,” says Joshua L. Fox, M.D., a leading dermatologist and Medical Director of Advanced Dermatology PC of New York and New Jersey PC. “But we’re fuzzy on some of the finer points of sun exposure,” he says. “Many people don’t like using lots of lotion, or want to look tan without getting wrinkles—or cancer—so they’re willing to believe that their unsafe habits are perfectly fine.”

The AAD survey brought up several common misconceptions about sun exposure. Here are the five biggest—and the reality behind them:

• Getting a “base tan” is a good way to avoid sunburn (and sun damage).
“Trying to save your skin through preemptive tanning is an exercise in insanity”, says Dr. Fox (but it still makes sense to more than half the respondents). “A tan gives the equivalent of an SPF 4—not a lot of protection, and certainly not worth the damage and risk. The base tan itself causes skin damage.” Repeated exposure to UV radiation—even if it’s done with good intentions—leads to premature aging and possibly cancer later in life.

• You need sun exposure to get the Vitamin D your body needs.
About sixty percent of the people in the AAD’s study said that sun exposure was good for one’s health. A big part of that misconception comes from news reports on sunlight’s role in producing Vitamin D, which the body uses to help build bone, among other things. “But these reports are misleading”, Dr. Fox says. “Vitamin D is essential,” he says, “but sun exposure is not essential for Vitamin D production.” “Instead”, he says, “you should eat a healthy diet, with plenty of natural and fortified foods, and take a supplement of up to 1000 units of Vitamin D to make up for any dietary shortfalls.”

• Tanning beds have gotten a bad rap, but they’re still better than natural sunlight.
Nearly 30 million Americans visit tanning salons every year, and the AAD report found that only about one-third of adults realize they’re unsafe. “However, indoor tanning is associated with a seventy-five percent increase in the risk of melanoma, the deadliest form of skin cancer”, says Dr. Fox. Last year, the International Agency for Research on Cancer -a division of the World Health Organization – labeled indoor tanning a carcinogenic and put it in the highest risk category, right next to tobacco smoke. Many states have recently put restrictions on tanning beds for people under age 18 – some states now require parental consent and other states are considering banning tanning beds altogether for minors.

• Sunscreen with SPF 30 gives twice the protection of SPF 15. And SPF 90 delivers three times as much as SPF 30—enough to keep you safe on the planet Mercury.
The AAD’s study found that eight out of ten people believe this (it does seem logical: If you’re driving at 90 miles per hour, you’re going three times as fast as if you were driving at 30 MPH). “But there are a few things wrong with this theory”, says Dr. Fox. First of all, the sun protection factor, or SPF, refers to UVB rays. To get UVA protection, you need a sunscreen labeled ’broad spectrum‘ or one that contains a physical block like titanium dioxide. Secondly, UVB protection doesn’t increase proportionately with the SPF number. For example, SPF 30 screens about ninety-seven percent of the UVB rays, whereas SPF 15 screens ninety-three percent (SPF 2 stops about only fifty percent). “The difference in protection between SPF 30 and anything higher is relatively negligible”, reports Dr. Fox.

“Another factor here is application”, adds Dr. Fox. Using too little or reapplying too infrequently effectively reduces a product’s SPF—and leaves you exposed to sun damage. “The rule is to apply about an ounce—an amount equal to that which would fill a standard shot glass—over your body and to reapply it every two hours, more often if you’re swimming, sweating or playing sports,” he advises. “Don’t let an astronomical SPF number give you a false sense of security. In fact, in 2009 the FDA came out with a new regulation prohibiting manufacturers from claiming SPF’s of greater than 50+.

• Let’s face it: You look better—and healthier—with a tan.
Many associate a suntan with wealth and success (picture those rich, leisure-class types on their tennis courts and yachts). “But a tan is nothing more than a record of sun damage”, says Dr. Fox. “It’s the evidence of all the ultraviolet radiation that your skin has been exposed to—and had to protect itself against.”
Indeed, despite the evidence to the contrary, more than seventy percent of survey participants think people look more attractive with a tan. So instead of bucking the trend, Dr. Fox suggests using a self-tanner (with sunscreen, of course). “You’ll get that tanned look, but without the damage”, recommends Dr. Fox.

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