Sep 3, 2014 — New clothing and swimwear advertise their “UV protection” technology, but does this really work? Dr. Doug Grossman from Huntsman Cancer Institute talks about varying levels of protection you can adopt to reduce your risk of skin cancer, especially in Utah, where the high altitude intensifies the UV rays. Swimming with clothes on or mowing the lawn after sunset may appear extreme, but all that sun damage adds up. He suggests some simple strategies to lessen the cumulative effects of sunshine.

Interview

Interviewer: You may have seen in stores swimwear or other types of clothing with UV protection built in. Is that a legit thing, or is it just a gimmick? We're going to find out right now.

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Interviewer: We're with Dr. Doug Grossman. He's an expert in early diagnosis and treatment of skin cancers at Huntsman Cancer Institute. Let's talk about clothing with built-in UV protection. What do you know about that stuff? What gives it UV protection in the first place?

Dr. Grossman: Well I think anything that can block the UV rays from the sun is going to protect your skin and so I think it's important to try to cover up as much as you can and still be comfortable to protect these large areas of skin.

Interviewer: So let's talk about clothing that says that they have UV protection in them. What exactly does that mean, do you know?

Dr. Grossman: I think you have to look for a particular type of clothing for the type of activity you're going to be doing. If you're going to be on the beach or you're going to be in a pool, you want what I call sun-protected swimwear. It's basically something that you can wear in the water and you can also wear before you get in the water. It's going to essentially block all the UV rays. If you're getting any redness or tanning you know that some is getting through.

Interviewer: What blocks the rays in this type of clothing?

Dr. Grossman: Just the fabric.

Interviewer: It's the fabric? Just a tighter weave that just doesn't let light in?

Dr. Grossman: Right.

Interviewer: So does that mean that any clothing that has a tight weave would be just as effective?

Dr. Grossman: Just about. I tell patients that if they can hold the material up to the light in the room and still see through that, the pattern of the light bulbs for instance, then too much is getting through. Most clothing would be sufficient, but you want something, again, that is appropriate for the activity you're doing. So if you're going to be biking, then a biking jersey. Again, for in the water, materials that are made to get wet and be comfortable in the water. There are a number of companies that make these.

Interviewer: I would imagine, though, it could be a little misleading. Sure, I've got a shirt and some trunks on that are protecting me from UV rays, but I still have exposed skin. That's not necessarily a good thing, is it?

Dr. Grossman: No. So the idea is to protect as much skin as you can with clothing and be comfortable and that minimizes the areas that you then need to apply sunscreen to.

Interviewer: What type of sunscreen are we looking at?

Dr. Grossman: In general, there are two different classes that I think of with sunscreens. The best products are those that are mineral containing, that have either zinc oxide or titanium dioxide. What these chemicals do is they reflect all the UV rays. They stay on the skin and the UV rays just bounce off, and you get very long lasting protection. They're very difficult, actually, to wash off.
The other class of products, which tend to be much more popular, are the chemical based sunscreens. These work by absorbing the UV rays, particularly the higher energy rays that will cause sunburn. However, some of the longer wavelengths will still get through that can cause some tanning. In addition, these products, because they are absorbing the UV rays, they can quickly saturate and then a lot will get through. They break down quickly and you have to keep reapplying.

Interviewer: The mineral type, is that the type I find in the grocery store? Is that more expensive? It sounds more robust.

Dr. Grossman: They tend to be a little bit more expensive, but they work much better and you don't have to reapply as often. You get what you pay for. I think if it's just brief, short exposures outside, almost any product will be fine, but if you've got fair skin, if you're at high risk, and if you're outside for any period of time, I'd recommend the best protection.

Interviewer: If it comes down to, all right, I wear a long sleeved shirt when I go out hiking or I wear a short sleeve and sunscreen, in your eyes, is there a difference in the amount of protection I'm getting? Is there one better than the other.

Dr. Grossman: It just depends on what sunscreen you're using and how well you apply it. I would think of it as several levels of protection. The first and easiest thing to do is avoid the middle part of the day. If you can do a particular activity, gardening, hiking, or whatever you're doing in the morning or early evening, that's going to be best. The next level would be the clothing, protect as much as you can and still be comfortable. Then whatever is left exposed to apply the sunscreen. Usually it's just face, neck, hands, that kind of thing.

Interviewer: Does time of year make a difference? Is the sun in June worse than the sun in August?

Dr. Grossman: Here in Utah, really you need to protect your skin year round. Because of the altitude, the sun is much stronger than it would be at sea level. Even on a cloudy day, one could get sunburned.

Interviewer: We hear this message a lot, that you should wear appropriate clothing. You should wear a hat. You should wear sunscreen. What happens if somebody doesn't? How bad does it really get?

Dr. Grossman: You get sunburned, which can be uncomfortable but resolves fairly quickly. Any exposure we know causes damage to the skin. If you get a tan then the skin is telling you that the DNA in the cells have been damaged. The tanning response is a DNA damage response, and when the DNA in the cells is damaged this results in mutations that can potentially give rise to skin cancer.

Interviewer: So you, yourself, your family, I bet you're very adamant about dressing appropriately.

Dr. Grossman: We try to.

Interviewer: Any final thoughts?

Dr. Grossman: Just protect your skin as best you can. The other thing I would mention is that the longer-term effects of UV exposure, the damage to the skin, skin cancer, and all the changes that occur with chronic sun exposure that make you look older, take many years and are cumulative over time. Young people don't appreciate it. They go out, get a sunburn, get tan, and then they think their skin looks fine a week later but they're actually incurring that damage that accumulates over many years. It's usually not until 20 or 30 years after these long periods of exposure that one starts to see the signs of sun damage and ultimately skin cancer.

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