Talking summer skin health with U of M
MINNEAPOLIS/ST. PAUL (07/12/2023) — The seasonal weather changes that come with summer are out in full force. With an increase in heat, sun and humidity comes new needs for maintaining skin health, as well as potential health consequences that go far beyond the cosmetic.
Dr. David Pearson with the University of Minnesota Medical School and M Health Fairview talks about how to keep your skin healthy during the summer months.
Q: How do our skincare needs change in the summer?
Dr. Pearson: Our skin is in direct contact with our environment, which means external factors can have a big influence on our skin’s health. Summertime in Minnesota usually means a lot more sun exposure in terms of duration, frequency and the amount of our body’s surface area that is exposed to the sun. In the short term, sun protection is important to prevent sunburns and dyspigmentation during the increased exposure in the summer months. In the long term, sun protection is critical in skin cancer prevention and preventing premature aging of the skin. More outdoor activities combined with higher humidity may result in more sweating, which can be associated with skin irritation in body folds, heat rash, athlete’s foot and other skin reactions. Dry skin is usually less of a problem, but it’s dependent on the person and the activities they participate in.
Q: What are some of the biggest skin health concerns that arise in the summer?
Dr. Pearson: Most summer skin concerns are related to sun and outdoor exposure. Sunburns, poison ivy and bug bites are all very common. Lyme disease is endemic in Minnesota and we see it frequently in its early, skin-localized form. This is a ring-shaped, red rash centered around a tick bite. Most of the time, it can be treated with a relatively short course of oral antibiotics. I encourage people to thoroughly look over their skin, including their scalp, after they’ve been in areas known to harbor ticks, particularly in the woods or around tall grasses. In the clinic, we find a tick or two every week that people didn’t know were attached.
People with autoimmune diseases may be very sensitive to sun exposure, so they have to be extra cautious. Sun exposure can even trigger systemic flares of disease in conditions like lupus erythematosus and dermatomyositis. Pigmentary disorders, like melasma, are also highly sensitive to sun exposure, and we can see exacerbations of this during the summer months.
Q: What tips do you have for avoiding and treating sunburns?
Dr. Pearson: In principle, avoidance sounds straightforward. Wear sunblock, sun protective clothing and a broad-brimmed hat. Reapply sunblock every few hours and try to avoid prolonged exposure, especially during peak sunlight hours of 10 a.m. to 5 p.m. In practice, this isn’t always easy, as anyone who has experienced a sunburn knows! Working sunblock into your daily skin care routine can reduce the risk of forgetting to apply it. I tell patients that I don’t want reapplication to be a barrier to initial application—putting sunblock on once is better than not putting it on at all. We don’t want people to hide out in a dark basement, but it’s important to find a balance between sun protection and enjoying the summer.
Sunburns can be treated with cool water. A cold shower is great, but a cold washcloth may be easier to tolerate if your skin is too sensitive. Over-the-counter treatments, like aloe and cooling creams, hydrocortisone and ibuprofen or other non-steroidal antiinflammatories, can be symptomatically helpful. Don’t forget to stay hydrated. When the skin barrier is compromised by a sunburn, there is more water loss through the skin and people can become dehydrated easily.
Q: What should I look for in sunscreen? Does a higher SPF mean better coverage?
Dr. Pearson: I recommend a sunblock with an SPF of 30 or greater that contains zinc oxide, titanium dioxide or both. SPF stands for sun protective factor, and a higher SPF generally provides better protection. With an SPF 30 sunblock applied sufficiently, only 3% of the ultraviolet B (UVB) light reaches the skin. SPF 50 results in 2%, SPF 100 results in 1%, and so on. In one sense, there are diminishing returns with really high SPFs. On the other hand, we could also say that twice as many UVB photons hit the skin with SPF 50 versus SPF 100. In actuality, people tend to apply much less sunblock than what the SPF rating indicates—usually half or even less. This means that, in practice, SPF 30 can perform more like SPF 10-15.
It’s important to note SPF only indicates protection against UVB, which is the primary driver of skin cancer and sunburns. Ultraviolet A (UVA) light causes skin aging and eye damage, and can lower your body’s ability to fight off illness. UVA coverage is important for sun sensitive conditions, pigmentary disorders, and as a lesser—but still important—driver of skin cancer. Mineral sunblocks like zinc oxide and titanium dioxide generally provide superior coverage against UVA rays compared to chemical filters.
Q: How does your research at the University support your clinical work?
Dr. Pearson: Much of my clinical work focuses on the overlap between dermatology and rheumatology, which encompasses a spectrum of skin-related conditions and multi-system autoimmune connective tissue disorders including dermatomyositis, lupus erythematosus and vasculitis. My research is based on clinical questions and challenges that clinicians and patients see in everyday life. I am particularly interested in learning how environmental triggers of disease may influence cutaneous and systemic outcomes. For example, many of these conditions demonstrate photosensitivity—the onset or exacerbation of symptoms upon exposure to UV or visible light. But the complex interactions between varying wavelengths and irradiances under environmental conditions are not fully understood. Through cross-disciplinary translational work with the Department of Mechanical Engineering, we are developing personalized detection systems to study this in the real world. Hopefully this will lead to individualized strategies to avoid symptomatic flares.
Dr. David Pearson is an assistant professor of dermatology at the University of Minnesota Medical School and a dermatologist with M Health Fairview. He is also the director of the Autoimmune Connective Tissue Diseases Specialty Clinic at the M Health Fairview Clinics and Surgery Center in Minneapolis. His research interests include environmental triggers of autoimmune connective tissue diseases, effects on quality of life and development of novel therapies for these conditions.
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