When in Doubt, Reapply: How to Protect your Skin from Damage This Summer

Summer may not be here officially, but the disappearance of bluebonnets and increasingly warmer temperatures are a clear indication that the mild days of spring are behind us. Active Austinites are typically not ones to let a little hot weather intimidate them from being outside—on any given 100-degree day, they can be seen running around Lady Bird Lake, doing brick workouts by the veloway, or swimming at Barton Springs. And although many of them remember to bring an extra water bottle to their workouts, fewer remember to take sufficient precautions against sun damage. With one in five Americans likely to be diagnosed with skin cancer in their lifetime, that is a risk that few athletes can afford to take.

Just a Nosebleed

Running coach Mixon Henry knows all too well the risks of sun exposure. More than 15 years ago, after experiencing regular nosebleeds upon removing his breathing strip after runs, one of his teammates approached him and asked if she could take a look. “I was like, ‘Whatever,’” Henry said. “I didn’t know what she did for a living. I knew her as a runner.” As luck would have it, Henry’s teammate also happened to be a dermatologist. Upon examining his nose, she determined that Henry had skin cancer, necessitating an extensive cutting procedure and plastic surgery to completely eradicate the cancerous growth.

Unfortunately, Henry’s encounters with skin cancer have continued over the years. The battle between his health and his love for exercising outdoors has left him no choice but to take serious measures to protect himself from the sun. Long gone are the running tanks and racing shorts; in their place are clothes that cover more surface area of the skin. Henry uses a special type of sunscreen, is careful to reapply during long workouts, and has also adjusted his exercise regimen: “You can, to a degree, realign some of your training—you can tailor some of it to be inside; for example, you can ride the spin bike. If I want to be on the open road for a ride, I’m still going to ride, but I may get up earlier.” Henry admitted that many athletes neglect the importance of sun protection. “Putting sunscreen on is an effort, one more thing to think about,” he said. “I hear a lot of athletes say, ‘I should wear it more often.’”

An Essential Part of Gear

TriZones Training co-founder and coach Tracy Nelson agreed with Henry that the easier sunscreen is to use, the more likely one will be to use it. She makes sure to keep tubes of sunscreen in multiple places so that she’ll never be without it. “I keep a tube in my tote bag. I’ve got some upstairs. I have some in my bathroom. I have some in the bag that goes to the pool with us. I have some in my workout bag, and I have some in my coaching bag,” she laughed.

Nelson attempts to instill good habits in her athletes from the get-go by grinding home the message that sunscreen is an essential part of training gear, and that remembering to take care of your skin is just as important as wearing a bike helmet. “When we talk about everything you need to swim, bike, and run, that’s on our list [of things to talk about]. We try to educate athletes on what they should look for in a sunscreen; we include it as part of our race day checklist. We see it as part of the gear you need,” she said.

Be a Label Reader

Deciphering the meanings behind terms such as SPF, UVA, UVB, sweat-proof, waterproof, and water resistant can leave consumers feeling frustrated and uncertain about what options are right for them. Dermatologist Roopal Bhatt, M.D., of Four Points Dermatology in Austin, says that all athletes—from the occasional runner to the Ironman triathlete—should follow a few simple guidelines when looking for the right kind of sunscreen. “Be a label reader,” she advised. “Choose a broad spectrum sunscreen of SPF 30 or higher.” According to Dr. Bhatt, broad spectrum coverage is essential, because it offers protection from both UVB and UVA rays, shielding the skin from sunburn, skin cancer, and premature aging.

Application is Key

Just as important as reading the labels, said Dr. Bhatt, is using sunscreen effectively—something that both athletes and non-athletes often fail to do. “The key to sunscreen is proper application,” she explained. Proper application begins with ensuring that enough sunscreen is being applied— a full ounce, according to most dermatologists. Dr. Bhatt also reminds her patients about the often-forgotten areas such as lips, hairlines, and ears. “That’s where we see a lot of burns and cancers develop,” she said. When it comes to choosing between sprays versus creams versus gels versus sticks, Dr. Bhatt said that all of these options can be effective, but some may require different application: “With the sprays and lighter formulations, apply two coats, and try to let it dry in-between.” Also essential, she clarified, is applying sunscreen 20–30 minutes before heading outside, since the protective qualities of the sunscreen’s chemistry require that much time to kick in.

Reapply, Reapply, Reapply

Athletes—especially those who spend multiple hours training in the sun—must be vigilant about reapplying sunscreen. Dr. Bhatt emphasized that it is all too easy for sunscreen wearers to be lulled into a false sense of security by high SPF numbers; she asserted that an SPF above 50 does not provide much more of a difference in protection. Furthermore, athletes typically need to reapply sunscreen more frequently than other wearers: “You’ve got a two-to-three-hour window for which it is pretty effective, but that [SPF] number really represents a fresh application and doesn’t account for it coming off. Athletes tend to sweat off their sunscreen much faster.”

Dr. Bhatt counsels athletes to take several factors into consideration when deciding how frequently to reapply: how long and at what time of day they will be outside, how much they typically sweat, and the type of activity they will be doing (e.g., swimming). She says that a safe guideline is to reapply every one to two hours, but when in doubt—reapply.

Protective Clothing

For those who want to take extra precaution in the sun, Dr. Bhatt recommends wearing UV protective clothing, or using a special detergent called RIT SunGuard, which adds UV protection to clothes. Although most Texans might balk at the idea of covering up during a bike ride in July, there are plenty of lightweight fabric options to choose from, and most of them are specifically designed to cool the skin. Ironman triathlete Sandra Spicher swears by such clothing as her first line of defense against the sun. “My favorite item for those long, hot summer bike rides is a pair of DeSoto Cool Wings,” she said. “Not only do they protect against sun, they feel colder than bare skin in the wind, especially when they're wet.” According to Spicher, because many of these cover-ups fit tightly against the skin, wind resistance is minimal, and the garment is comfortable. Investing in a few pieces of protective clothing could also be cheaper in the long run: “Spending $30 on an article that you can wear over and over is cheaper than buying bottle after bottle of [sun] cream that gets used up,” Spicher explained.

New FDA Regulations

Fortunately for consumers, this June the FDA will enact new regulations for sunscreen labeling, in an effort to facilitate better purchasing choices. Among these changes will be the requirement that a sunscreen claiming to protect against skin cancer, sunburn, and premature aging must provide UVA and UVB coverage, as well as a minimum SPF of 15.

The FDA is also proposing to limit the listed SPF rating to 50, since there is no substantial evidence to show that levels higher than 50 are any more effective.

Although there is no single method of sun protection that completely eliminates the risk of skin damage and/or cancer, athletes can take steps to more thoroughly protect themselves by following dermatologists’ recommendations when selecting and applying sunscreen. Other preventative measures, such as wearing protective clothing, working out in shaded areas, and choosing times of day to exercise when the sun is less intense can also be quite effective. Ultimately, making skin protection a natural part of your workout regime will help reinforce good habits. Coach Henry summed it up well: “I just think people need to be aware that you will do a lot of damage if you don’t take care of your skin. We’re only good athletes for a very short time of our lives—you’ve got to think long term for everything.”

For more information, visit:

The American Academy of Dermatology
www.aad.org

The Skin Cancer Foundation
www.skincancer.org

Follow Dr. Bhatt's guidelines to maximize skin protection:
• Wear sunglasses and a hat when out in the sun.
• Use broad Spectrum (UVA and UVB protection) sunscreen with an SPF of 30 and above.
• Apply a full ounce of sunscreen to your body; don't forget about lips, ears and hairline!
• Reapply, Reapply, Reapply!