Skin Cancer Prevention Through Photoprotection: What Your Patients Should Know

As summer enters the picture and the incidence of UV exposure rises, it becomes imperative to reinforce the fundamentals of skin cancer prevention and optimal sunscreen use for patients. Practical Dermatology® reached out to Ariel Ostad, MD, spokesperson for The Skin Cancer Foundation, and a dermatologist and Mohs surgeon practicing in New York City, to delve into advanced strategies for educating patients about the risks of skin cancer during the peak sun season. In this interview, Dr. Ostad shares his expertise on photoprotection and best practices for encouraging patient compliance.

How can dermatologists educate their patients about the importance of sunscreen during the summer months, particularly in relation to skin cancer prevention?

Skin cancer is the most common cancer in the world, but the good news is that it is highly preventable. The majority of skin cancers are caused by ultraviolet (UV) radiation from the sun, so taking steps to protect yourself from the sun’s rays can decrease your risk of developing the disease. Daily sunscreen use is an important part of a complete sun protection strategy that includes seeking shade and covering up with UPF clothing, wide-brimmed hats, and UV-blocking sunglasses. One study found that regular daily use of an SPF 15 or higher sunscreen reduces the risk of developing melanoma, a dangerous form of skin cancer, by 50 percent.

Sun protection is necessary every day, regardless of the weather or season. Even when it’s cooler or overcast, ultraviolet (UV) rays that cause skin aging and skin cancer are reaching your skin. UVB rays, the main cause of sunburn, are the strongest in the summer. However, UVB rays can burn and damage your skin year-round, especially at high altitudes and on reflective surfaces such as snow and ice. UVA rays, the main cause of premature skin aging, remain constant throughout the year and can penetrate through clouds and fog. Environmental factors like water and sand can also increase your likelihood of sun damage. These surfaces can reflect up to 80 percent of UV radiation, so the sun’s rays are hitting you twice.

What strategies can be employed to encourage consistent sunscreen use among your patients, considering factors like skin type, lifestyle, and sun exposure habits?

At The Skin Cancer Foundation, we like to say the best kind of sunscreen is the one you’ll use. A product can’t protect your skin if you don’t use it because you don’t like it! Try different formulations of sunscreens with different ingredients to find what works best for your skin and lifestyle. This way, it will be easy to make applying sunscreen a daily habit, like brushing your teeth. For example, if you know you have sensitive skin, choose a sunscreen formulated with mineral UV filters to avoid irritation.

How do dermatologists address common misconceptions or resistance to sunscreen use among patients? What approaches have you found most effective in overcoming these barriers?

I tell my patients that skin cancer can affect anyone, regardless of race, ethnicity, or skin tone. Don’t assume you’re safe just because you don’t burn. If you tan, you’ve sustained skin cell damage. A tan is the skin’s attempt to repair sun damage and prevent further injury by increasing skin pigment.

I also find that people rarely apply as much sunscreen as they should. In order to achieve the SPF value on the sunscreen, you need to apply 1 oz — about a shot glass full — to the entire body and a nickel-sized dollop to the face alone. People tend to miss certain spots when applying sunscreen. When you’re going to be spending time outdoors, apply sunscreen to your entire body, and remember to cover often-missed spots like the tops of the ears, hands, and back of the neck.

What are your preferred methods for assessing a patient’s risk of skin cancer and determining the appropriate sunscreen regimen for their individual needs?

While it’s important for everyone to protect their skin against the sun’s damaging rays, some people are at a higher risk of skin cancer than others. In cases like this, products with very high SPF values, even up to 100, can offer extra protection for people with a history of skin cancer and those with certain genetic or immune disorders that increase sensitivity to the sun. It’s important not to be lulled into a false sense of security because you used a high SPF product, however. If you forget to reapply or cover up with clothing, you can still sustain a lot of sun damage — defeating the purpose of choosing a high SPF.

What resources do you provide to your patients to reinforce the importance of sunscreen use and empower them to make informed decisions about sun protection?

For more information about the prevention, detection, and treatment of skin cancer, I recommend patients visit SkinCancer.org. There they can learn to understand the risks of skin cancer, what they can do to avoid the disease, and how to spot potential skin cancers at an early stage, when they are usually curable with treatment by a dermatologist.

Can you share any notable patient success stories or experiences where consistent sunscreen use played a significant role in preventing skin cancer or minimizing sun damage?

There are patients who have experienced prior skin cancer and became diligent about sunscreen use and staying out of the sun, and their incidence of skin cancer was reduced. But it is important to note that it isn’t possible to prove that any one behavior prevented a skin cancer.

How can dermatologists stay updated on the latest research and recommendations regarding sunscreen efficacy and its role in cancer prevention?

Dermatologists can stay updated by continuing medical education through reading the latest relevant journal articles and attending dermatology meetings.