Dear Dr Garner,
My best friend lives in a beautiful building with a pool and sun tanning area. She is a teacher and has off much of the summer. The problem is, her addiction to sun tanning. She is at the pool from morning till evening, almost never applying sun tan lotion, and if so, only an oil with a low SPF. Her skin is already getting leathery (she is only 42). Could you please tell which is the best sun tan lotion to use, and also discuss the risk she is taking? I know she reads your column and maybe she will listen to you.
Best Friend of Bay Club Gal in Bayside

Dear Best Friend,
Before I address your question, I want to let our readers know, that on Sunday May 23, at 1PM, we will have a special session of ‘Ask the Doctor’, at the Virgin Mary Church, on 8th Avenue and 2nd street in Brooklyn (718-788-5454). My good friend and colleague, from New York Methodist Hospital, Dr Emile Baccash, organize a yearly health fare and blood drive and he will be joining me for the session. I look forward to meeting many of our viewers and readers and answering your health questions during the course of the program.
Your question deals with a very important topic, as there is much confusion over what sun tan lotion can and cannot do. In addition, as in the case of your friend, there are people who use no protection at all. Many are actually addicted to tanning, and get a “high” out of being in the sun. It is very similar to the addiction to shopping I wrote about last week. The addiction to sun tanning, also requires professional attention for treatment
I urge your friend to seek help from her family doctor.
Unfortunately, it seems as though there has already been skin damage to your friend, but it is never too late to start protection.
Up until the recent past, people chose sun tan lotion based upon the SPF (sunscreen protection factor) of a sun tanning lotion and not much more. We have learned that the sun’s rays that cause harm are known as ultraviolet rays. There are two types of waveforms we have to worry about, Ultraviolet A and Ultraviolet B. The Ultraviolet B waves is what the SPF (Sunscreen Protection Factor) protects against. The B waves are very short and don’t go deep into the skin. These are the rays responsible for sunburn. The A waves penetrate the skin much more deeply and are responsible for causing wrinkling of the skin, by causing damage to the collagen or connective tissue. Both waves cause cancer.
Sun tan lotion is no good unless it protects against both types of waves.
The B wave protection can be evaluated by looking at the SPF. The SPF needs to be 30, which blocks at least 97% of the harmful rays. It is not necessary to use a higher SPF, which adds no significant protection and bumps up the price. SPF actually is a measure of how long it takes the skin to redden with lotion compared to without lotion. For example, an SPF 30 means that it takes thirty times as long to redden with its use than without it. This would mean that instead of burning at 15 minutes, one with burn at 450 minutes or about 7 hours with an SPF of 30.
For A waves protection, there is no scale available yet. It is currently being developed and might be out within a month. For now you should read the label and look for the products titanium dioxide and zinc oxide. I also advise getting these in the “nano particle” size. You can read this on the label. The nanoparticle size is more aesthetic as there is no thick white cream to smear over the body and face.
The lotion should be applied throughout the day. The most dangerous rays are emitted between ten in the morning and four in the afternoon. This is a good period to avoid exposure to the sun when possible.

A myth is that the sun’s rays are not harmful on a cloudy day. Unfortunately these rays are present and go right through the clouds. Much damage has been caused because of this misconception.
In addition, the A waves are present all year round and actually can go right through the windshield of a car. A new study has found that men, who drive trucks, are more likely to develop skin cancer or melanoma on their left hand and arm from the sun going through the glass of the car.
Another myth is that there are some sun tan products that are water and sweat proof and do not need to be applied after each swim or vigorous exercise. There just is no such thing, and the manufacturers were recently sued due to false advertising claims. Sun tan lotion should be applied every 2 – 3 hours no matter what your activity, and after each swim or vigorous exercise.
Babies, particularly under the age of 1, are very susceptible to burns, and just one burn as a baby leads to a much greater risk for developing melanoma later in life.
For babies less than 6 months, make sure to ask your doctor before applying sun tan lotion. Most people associate sun tanning with health. In fact, the suntan is a sign that your skin is trying to protect itself against the sun’s damage. The tan will fade, but the damage to your cells remains and adds up over the years.
In addition, too much sunlight can damage the eyes, leading to cataracts. It is important to wear glasses with UV protection. It is important for everyone, regardless of skin color (African- Americans are also at risk for melanoma and skin cancer) to use protection daily.
Sunburn may not appear for a few hours, and the full effect may not be obvious for 24 hours. “Sun Poisoning” may include fever, chills, nausea or rash.

It is important for every one to have a skin check up each year, particularly in view of the fact that many people thought they were safe because they were using protection against UVB­. This is not true, as the UVA waves were not being protected against.
One should apply at least 2 tablespoons of sunscreen to the entire body 30 minutes before going outside and reapply it every two hours immediately after swimming or vigorous exercise.

I hope that your friend reads this column as she is causing herself much harm. As I pointed out earlier, I hope she sets up an appointment with her family doctor, as she will need help in fighting this addiction.
I urge all our readers to use protection with a product that helps protect against type A and B waves and use common sense when dealing with the sun. Until next week, be well.

* Reprinted with permission of The Tablet