Sunscreen: Protecting Your Skin at 8000′

From the Aspen Daily News, July 12, 2011

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Living in our high altitude paradise with its endless outdoor activities and countless sunny days, our skin is exposed to climate and environmental aggressors that most people will never experience. We’ve long known, and it bears repeating, the best and most effective way to limit the signs of aging and decrease the formation of premalignant skin lesions is SUNSCREEN.For every 1,000 feet in elevation gain over sea level, there is an 8-10% increase in the sun’s intensity. A daily application of sunscreen is imperative for healthy skin, essential for reducing the impacts of aging, and crucial at Aspen’s 8000ft. Over-exposure, especially in children, can lead to melanoma, one of the deadliest forms of cancer. According to the National Cancer Institute, 8,700 Americans died in 2010 from melanoma. Daily use of a sunscreen, particularly at higher elevations, may save your life.

High altitude and physical activity can drastically change the efficacy of most sunscreens. Re-applying sunscreen while exposed (even to reflected sunlight) is required for proper protection at high elevation. The American Academy of Dermatology recommends two full applications of sunscreen spaced 30 minutes apart every morning before going outdoors, followed by one full application for every two hours of sun exposure. Start with at least one ounce (the size of a shot glass) of product to cover exposed body parts. The face and neck need roughly half a teaspoon of product; don’t forget the back of your neck and ears as well as your hands and lips.

Active mountain children need roughly half of the amount of product recommended for adults. Strong evidence suggests that cancerous lesions in adults begin with sunburn we had as children.

The FDA has announced new labeling regulations for sunscreens that will help consumers decide how to buy and apply sunscreen. These new requirements are part of an ongoing effort to ensure sunscreens meet modern-day standards for safety and efficacy and are based on the latest science available. Look for new labeling on sunscreens starting in the spring of 2012.In the meantime, when choosing a sunscreen, look for products that advertise broad spectrum UVA/UVB protection. Both UVA and UVB protection are necessary to be fully effective in preventing skin cancer. Sunscreen ingredients work in several different ways. Chemical sunscreens like Avobenzone and Octisalate absorb UV radiation and protect the skin from UVA rays. UVA rays are relatively long wavelengths of light that penetrate deeply into the skin, are more harmful than UVB rays and are linked to serious cancers of the skin including melanoma. UVA rays are directly linked to premature aging. Physical sunscreens such as titanium dioxide or zinc oxide reflect or scatter UV radiation and provide protection from both UVA and UVB rays. UVB rays, also known as the “burning” rays are linked to milder cancers of the skin such as basal cell carcinoma and squamous cell carcinoma.

The sun protection factor of a sunscreen is a laboratory measure of the effectiveness of sunscreen. The higher the SPF the more protection a sunscreen offers against UV radiation. For example, if your skin burns in the sun after 10 minutes with no sun protection, a SPF 15 will give you 15 times 10 minutes of protection or 150 minutes of protection before your skin starts to burn. Exposure before burn increases at higher elevations making it necessary to wear a SPF of 30 or higher on a daily basis at 8000ft.
One complaint I hear about sunscreen is that it makes the skin look white and greasy. Over the last several years, sunscreen has become more cosmetically elegant and the quality has improved greatly. There are several brands on the market today that offer excellent protection without compromising the appearance of the skin. I like Epionce Ultra Shield SPF 50 or Neocutis Journee SPF30; both blend translucently into the skin. When shopping for an over the counter sunscreen, look for products that contain at least one physical block, either zinc oxide or titanium dioxide.

If you have sensitive or acne prone skin, look for a formula that is hypo-allergenic and non-comedogenic with a higher percentage of zinc oxide. I recommend Obagi Sun Shield SPF 50.

I cannot emphasize enough the importance of sunscreen along with protective clothing for those of us living the good life at altitude. With the growing number of skin cancer and precancer diagnoses it’s imperative that we avoid tanning beds, schedule yearly skin exams with a dermatologist and use sunscreen every single day.