With summer temperatures climbing and more Albertans spending time outside, dermatologists are reminding people that protecting their skin goes beyond simply applying sunscreen before heading out. Dr. Vimal Prajapati, a clinical associate professor at the University of Calgary and dermatologist (co-founder and co-director) of the Skin Health & Wellness Centre, Dermatology Research Institute, Dermphi Centre and Dermphi Shop, says there are several key steps people can take to reduce the risk of sun damage and protect their skin during the summer months. “One of the main key aspects of sun safety with one of the most important being the use of sunscreen and you want to use a sunscreen with at least SPF 60 or higher,” Prajapati said. He says one of the biggest mistakes people make is not applying enough sunscreen to actually achieve the protection listed on the label and not applying a thick enough layer to ensure better protection. Another important step is reapplying sunscreen regularly, especially when spending time in the water. “Most sunscreens only last two hours,” he said. “If you’re entering and exiting water, you’re probably only going to get 80 minutes with the very water resistant sunscreens, and you’re getting 40 minutes with the water resistant sunscreens.” Shade and clothing are part of sun protection While sunscreen is an important tool, Prajapati says it should not be the only method people rely on. “The second most important thing is sun avoidance, which most of us will not do, right? But it’s important to stay in the shade if you are going to be in the midday sun,” he said. He says the strongest sun exposure typically happens between late morning and early afternoon. “Roughly between 11 a.m. and 3 p.m. you’ll want to try to stay in the shade, if you can or limit your time,” Prajapati said. He also recommends using clothing as another layer of protection, including broad-brimmed hats, long sleeves and other sun-protective clothing. “Even just wearing long sleeve shirts and wearing pants helps.” Prajapati says there are also now sun-protective clothing options available that are designed with built-in ultraviolet protection. He adds that people do not necessarily need to spend a lot of money to protect their skin. “Pick something that is convenient and affordable to you, but those types of clothing do work.” Prajapati says the areas most commonly affected by sun damage in dermatology clinics include the head, neck, scalp, ears, hands and forearms so it’s important to always pay attention to covering up those areas and reapplying sunscreen when possible. Summer can bring added challenges for people with skin conditions For people living with chronic skin conditions, the summer months can bring additional concerns. Prajapati says vitiligo, an autoimmune condition that causes the loss of pigment-producing cells and visible white patches on the skin, is often misunderstood. “Vitiligo is a chronic autoimmune disease and it is often mistaken as a cosmetic issue, but it is not a cosmetic issue. This is a medical issue.” The condition can affect people’s confidence, mental health and quality of life. “Of course this can have significant impact including anxiety, depression, and suicidal ideation behavior, as well as self-confidence,” Prajapati said. He noted that summer can be particularly difficult for some people with vitiligo because more skin is often exposed. “Summertime rolls around and most individuals are in short sleeves for tops, and they’re in shorts.” “Patients with vitiligo however often will cover up, and the reason is it’s the fact that they’re very self-conscious about their skin condition.” New treatment provides hope for vitiligo patients Prajapati says a newer treatment option has changed the outlook for some people living with non-segmental vitiligo. Health Canada approved ruxolitinib cream, sold under the brand name Opzelura, for non-segmental vitiligo in adults and children 12 years and older. “For the first time in the history, they have this topical therapy and it’s a 1.5 per cent cream approved down to 12 years of age for non-segmental vitiligo,” he said. Prajapati says the treatment has been a major development for both patients and dermatologists. “It’s been an absolute game changer.” The company that makes Opzelura had an online survey and 105 people with non-segmental vitiligo using it for at least three months responded. “What was amazing is that 90 per cent of patients who used Opzelura for regimentation agreed that it was worth their time and effort, and that’s important, because pretty much until this medication came out, we have had no effective treatments.” Beyond treatment options, Prajapati says education and understanding from the public can also make a major difference for people living with visible skin conditions. He says Albertans can help by avoiding assumptions, asking questions respectfully and recognizing that conditions like vitiligo are medical issues — not something contagious or something that should lead to stigma. “Just because somebody has a skin condition doesn’t mean they should be judged, they should be treated fairly, just like everybody else.” Prajapati also points to support networks, including the Canadian Skin Patient Alliance, as resources that can help connect people living with skin conditions to information and support. Understanding skin cancer risks Prajapati says protecting skin from the sun is also critical because repeated exposure can increase the risk of skin cancer. “Melanoma is the most dangerous skin cancer.” He says even small melanomas can become serious, and early detection is important. “It can be difficult to diagnose because sometimes it looks just like mole and we all have moles.” Prajapati recommends people monitor changes to their skin and seek medical advice if something appears unusual. “We should be doing regular skin checks in individuals who are high risk, so every six months or so. If people are low risk, every one to two years is fine,” he said. Prajapati also noted that new technology is helping dermatologists detect potential skin cancers earlier. At the Skin Health and Wellness Center in Calgary, he says an artificial intelligence-powered mole mapping system is being used to help identify concerning changes. He says the technology has helped identify melanomas in patients who came in for full-body scans, even if they were not initially seeking care for a known skin concern.
