Throughout its history, human race have changed its attitude towards the sun dozens of times. First people on Earth worshipped it as the only source of life; they brought lambs, fruit, bread and everything that was dear to them to the altar of the Sun God to beg him to grant them his mercy. They knew nothing about sunscreens and photoaging and lived all the 35 years of their lives caring more about how to survive than about the number of wrinkles on their face.
As the progress moved on, if we take a look back at the XVII-XIX century, in the times of ladies and gentlemen, horses and carriages, first manufactures etc. we can see that suntan was considered to be the “privilege” of a working class. It is very unlikely that on a picture depicting, say, a party at Mr&Mrs N’s mansion, you can find a sun-tanned person. Those were the days when ladies would take a lazy stroll shielding themselves from the sun under elaborate laced umbrellas, wearing gloves and applying different concoctions afterwards to avoid freckles on their face and decollete area. When men said: “Her skin is as white as sugar”, it was meant to be a compliment.
Nowadays everything seems to have turned upside down. Suntan has become an indispensable part of being considered beautiful. We even devised tanning beds and literally brought the sun to our homes to make the process of sunbathing easier and more convenient. Although everyone these days at some point of their lives have heard about the damaging effect of sun rays, beaches are as crowded as they used to be and the number of women who prefer to sunbathe topless is no less either. We know that there is a price to pay but the Sun inevitably lures us and we readily accept the credit hoping that the day when we would have to pay our debts to our skin will never come. However, the amount of people who die from skin cancers caused by the continued sun exposure is still staggering: 5 mln. of Americans die annually from cancers caused by sun exposure. In fact, one doesn’t have to die to be a negative role-model for keeping away from the sun: there are many other “presents” that sun-lovers can “enjoy”. 
In a situation like this the question is: is there a way to safely enjoy sun or are we doomed to lead a vampire lifestyle? If you take a close look at the people spending their leisure time on a beach, you will be able to spot two categories of holiday-makers – those with perfectly sun-tanned bodies, enjoying themselves in everyway they can, and those who sit under large sun umbrellas or in sun tents wearing wide-rimmed hats, huge sunglasses  with a bottle of SPF 30-60 sunscreen. The first ones apply tan intensifiers that literally magnet sunrays to their skin, the latter ones reapply a sunblock to keep away from them.
The battle against aging is in full swing now. Physicians, estheticians and dermatologists worldwide have come up with myriads of controversial approaches but they are unanimous as for the main cause of the aging process – photodamage. This factor is the most important and comprises the greatest percentage of what is called aging. In fact, our skin becomes more sun-damaged than aged. To see how much the sun affects the skin, look at the backs of the hands and the tops of the feet. Or consider the cheeks of the face and those of the buttocks. They are the same age, but they sure don’t look alike, and the difference is the sun. The treacherous thing about the sun is that its harmful effects are long-term – one might start to rip the “benefits” only 20-30 years later. That is if in your twenties you were fond of going to the beach, in your 40-ties you might be wondering why your cheeks have sagged or where these brown spots on your body came from while those would be the results of previous sun exposure. The interesting fact about it is that we get the most part of sun exposure before our twenties. Since ultra-violet rays gradually make their way into the skin destroying collagen inside it, we see what we get years later.
Lots of people like the “healthy” glow of a tan. But a tan is far from healthy. If sun exposure is moderate, the skin will thicken and form melanin in order to protect itself. Melanin is the enzyme that gives the skin a sun-tanned look and the bane of people with dark complexion. The sun activates the process of melanin production causing  melasma – one of the most difficult to treat skin diseases. This is precisely the reason why lots of Colombian skin type ladies walk about with umbrellas in their hands  - to shield themselves from the sun. The thing is that their skin contains an inherited gene which is extremely reactive to the sun, so if the sun rays manage to find an unprotected spot on their face the skin immediately tries to protect itself and that’s how they get hyperpigmentation.
If people tan deeply over a period of several years, the skin may become permanently thickened and discolored. These skin changes can cause premature wrinkling and skin lesions.
The sun produces fine and coarse lines over the face, changes in texture and color (age spots), broken blood vessels and a sallow tint to the skin.
“There is no getting around it, the sun damages and prematurely ages the skin,”- saysJames E. Fulton MD, Ph. D., founder of Vivant Skin Care, co-developer of Retin A®.

   Excessive sun exposure leads to the acceleration of skin aging, primarily by causing wrinkles, age spots, and fine lines; however, of greater concern is the risk of skin caner. 

   What are ultraviolet light rays (UVA and UVB)?

  The sunlight that reaches the earth has ultraviolet UVA and ultraviolet UVB rays.  These ultraviolet rays are the main causes of damage to the skin from the sun.  UVA and UVB rays affect the skin’s sensitivity to sun exposure in different ways.

UVA

• Can pass through window glass.
• Is not affected as much by a change in altitude or weather.
• Is present all day and every day of the year.
• Penetrates deep into skin layers.
• Is 5% of the sun’s rays.
• Is 20 times more abundant than UVB rays.
• Results in long-term skin damage.

UVB

• Cannot pass through window glass.
• Causes sunburn.
• Causes tanning.
• Helps the body with normal Vitamin D production.
• Varies with weather conditions.
• Is more intense at midday than in than in the morning or late afternoon.
• Is more intense at high altitudes and near the equator.
• Is 0.5% of the sun’s rays.
• Is protected against by the sun protector factor (SPF) in sunscreens.
• Is related to more than 90% of nonmelanoma skin cancer.
• Is related to cataracts.

The Damaging Effect of UVA and UVB Rays
Photoaging
Sunlight destroys the collagen and elastic network of the skin, and produces elastosis, or clumping of the damaged elastin fibers in the skin.  The tissue is no longer functional and the skin begins to sag.
A word about tanning beds. The tanning bed industry states that these devices are safe because the “burning rays” are filtered out. Although it’s true there is no UVB in tanning beds, these devices emit pure UVA, which causes the problems below, as well as cataracts. UVA also kills Langerhans cells, which are the first line of defence in the immune system.
Among the problems caused by sun exposure are:

   Actinic Keratoses
Actinic Keratoses are red, irritated spots in sun-exposed areas like the forehead and temples.  They are sharply outlined, red-colored scaly lesions; these lesions may eventually degenerate into skin cancers.

   Freckles
Freckles, medically known as lentigos, are the clumping of damaged melanocytes.  This type of sun damage can be seen on Fitzpatrick I, II and III skin types.  As some freckles get larger and darker over the years they become lentigo malignas, which in turn can develop into melanomas, the most serious type of skin cancer.

    Skin Cancers
There are three common kinds of skin cancer.  The least malignant and most common is called Basal Cell Carcinoma.  This type of cancer is characterized by a slowly developing nodule, which has a “pearly” elevated border and visible blood vessels.  It may ulcerate in the middle and become a “rotent ulcer”. 

  Squamous  Cell Carcinoma
Is different in appearance, it is more scaly and blood vessels are not so visible.  This cancer is more serious than the Basal Cell Carcinoma.  It may rapidly move to the lymph nodes.

   Malignant Melanoma
The most serious skin cancer.  This cancer is a growth of the pigment cells, the melanocytes, and is characterized by dark brown, black, or discolored nodules on the skin often in a previous mole or nevi.  Check these moles for the ABCD’s
Asymmetry, irregular Borders, uneven Color and Diameter.

   Sun Damage Prevention:
  A cumulative effect
Over and over, we hear that, for sunscreen to be most effective, it should be applied at least an hour before sun exposure to let its ingredients fully activate, and than reapplied every couple of hours during exposure.  Dr. Fulton takes this advice a step further.

   By consistently using sunscreen, one builds up a reservoir of protection in the epidermal level of the skin (the stratum corneum), Dr. Fulton recommends applying sunscreen the night before exposure to sun, followed by a second application an hour before exposure, preferably while skin is moist.  In fact, if Dr. Fulton has a patient who is going to the beach on Saturday, he’ll often have them apply sunscreen on Thursday night, Friday night, and then again on Saturday morning to build up an optimal layer of protective sunscreen in the stratum corneum.  Once this protective reservoir is built up, it takes approximately three days for it to dissipate, so if the patient forgets to reapply sunscreen once during the day of exposure, the consequences aren’t dramatic.

   Apply while skin is freshly hydrated
As with all skin treatments, sunscreen’s active ingredients penetrate the skin more effectively when applied immediately following a bath or a shower, when skin is still moist.  This same principle applies to subsequent applications throughout the day.  Reapply when skin is still damp from swimming.  And remember, even waterproof sunscreen claiming to last throughout the day requires frequent re-application, because waterproof doesn’t necessarily mean “towel-proof.”

   Alcohol vs. cream based sunscreen
Sunscreen with an alcohol base provide longer lasting waterproof protection.  Why?  The alcohol base provides a more effective “delivery vehicle” for the sunscreen’s active ingredients because, when the alcohol evaporates off the skin, the heat of the evaporation helps the ingredients penetrate the skin and bind to its top layer.  This results in a more effective barrier to the sun’s damaging rays, with notably more staying power. 

   Quantity counts
Most people do not use enough sunscreen.  For all-over body protection, anything less than 1 oz. (a shot glass-full) won’t do it, and will lessen the effectiveness of a high SPF.  The average 8 oz. bottle of sunscreen contains no more than 8-10 applications.  Does this mean greater expense at the pharmacy?  Yes. And, it’s well worth it.

Regarding SPFs (sun protection factors)
Most people think that high SPF numbers will double or triple the more common SPF 15 sunscreen.  SPF 50 blocks about 97% of these rays.  Therefore, increasing the SPF from 15 to 50 only gives 2% more sun protection, while exposing the skin to a much higher concentration of potentially irritating ingredients.  For enhanced sun protection for sensitive skin, one is better off sticking to a repeated application of SPF 30 and donning a cover-up and wide-rimmed hat.

   Other ways to protect your skin:
Avoid the sun between the peak hours of 11:00 am and 3:00 pm when rays are the strongest.  Wear protective hats and look for certified protective clothing with special sun-filtering weaves, now more widely available. Otherwise, use clothing effectively in the form of long pants, long sleeves, scarves, hats and umbrellas as photoprotection.

    How to develop a healthy anti-photodamage routine

• Develop habits for good hygiene during childhood (i.e., brush teeth, wash face, apply sunscreen)
• Select sunscreen formulations that are appropriate for the application site
• Use a sunscreen-containing lip balm or lipstick
• Men should use a gel sunscreen as an aftershave
• Develop a routine of applying sunscreen to the face, front of the neck, back of the neck, ears, behind the ears, and central chest

   Dermatologists should emphasize to patients that if they want to keep their skin, they use sunscreen in combination with protective clothing. I am reminded of a young child who asked which teeth he had to brush, and the dentist replied: “Only the ones you want to keep”. People often ask where they should apply sunscreen. The proper answer should be: “Only on the skin you want to be beautiful for the rest of your life”.
The sun is the biggest star of the universe and it should be treated with appropriate respect. If you can find the balance between enjoying its rays and shielding from them, you are almost guaranteed healthy youthful skin. And remember: age is not the most important aging factor, it’s the way we take care about our skin that matters.



Lana Vorobyeva
lanavivantskincare.com

Special thanks to
Dr James E. Fulton Jr.,M.D., PhD