SPF is not the only thing that will protect your skin from the sun

For normal Indian skin, SPF of about 15-30 is enough for sun protection. Doctors say eating green leafy vegetables and drinking plenty of water can help prevent photodamage as well. Antioxidant supplements are also helpful, especially those containing beta carotene.

• Tell us about Indian skin and photosensitivity
• How can we protect ourselves from the sun?
• How long should you use sunscreen for? Do you need to reapply it during the day?
• What are the foods that protect your skin from photodamage?
• Can photodamage be reversed?
• When do we need to see a doctor for sun damage?
• What about actinic keratosis?

The one piece of advice you will always get for your skin, no matter who you ask, is—wear sunscreen. Our skin has an intense relationship with the sun; being the best source of vitamin D, soaking in some sunlight everyday can help the skin stay young, but too much exposure can lead to photodamage and accelerate skin aging. In fact, research says that UV exposure may be responsible for as much as 80% of visible signs of aging including wrinkles.

In a tropical country like India, with an abundance of sunshine, it is important to keep your skin protected. However, what is the right kind of sunscreen you should wear? Does Indian skin need sunscreen at all? Should you see a doctor for the sun spots on your skin? Is photodamage reversible? To answer these and more questions about sun exposure, Femoai spoke to Dr Dhrubojyoti Sengupta, a dermatologist with three decades of experience. Here are edited excerpts from a very interesting conversation:

Our skin has an intense relationship with the sun; being the best source of vitamin D, soaking in some sunlight everyday can help the skin stay young, but too much exposure can lead to photodamage and accelerate skin aging.

Tell us about Indian skin and photosensitivity, and how is it different from other skin types. How much is Indian skin prone to sun damage?

We are brown colour individuals. Skin colour is determined by the number of melanocytes in the skin, which produce the pigment melanin. So, very broadly, Europeans have caucasoid skin, we (Indians) have brown skin/Asian skin and Africans have darker skin. In Europeans with white skin, there are lesser melanocytes, in Indians/Asians, the melanocytes are somewhere in-between, and in Africans, there are the maximum number of melanocytes. In terms of evolution, this was determined by geography and weather.

The equator passes through Africa, they experience maximum sun exposure, and they need maximum sun protection (Melanin is a protective pigment in skin, it protects the skin from ultraviolet rays).

Indian skin is somewhere in between. It needs some protection from the sun; in India, however, there are many variations in terms of skin. North Indians largely have fairer skin, whereas south Indians have comparatively darker skin tones, they can adapt to sunlight more. Since our country is tropical and humid, there are some specific kind of  problems. For example sweating leads to more bacterial and fungal infections.

However, there are more variations. In terms of women, those who are more domestic or stay indoors have different skin problems than women who spend more time outdoors. In women in villages, for example, who are doing farm work, they naturally have more  problems related to sun damage. But women who are less exposed to the sun and are in air conditioning at homes and in cars, they have  different acclimatisation problems.

Tell me more about sun damage, what are some of the symptoms, how can we protect ourselves from the sun?

People tend to think that the higher the SPF, the higher the protection but that is not necessary. For Indian skin, we don’t need SPF more than 15-30. Now, companies promote and sell SPF 50, but that isn’t needed for normal skin, that is only for post peeling procedures, which are done for pigmentation.  Secondly, SPF is not the only thing that will protect your skin, there are other factors. An ideal sunscreen should have a combination of physical and chemical sunscreens, which will protect against UVB and UVA (long wave ultraviolet A (UVA) and short wave ultraviolet B) and broad spectrum (protection from both UVA and UVB). An ideal sunscreen should be user-friendly; for summer  we recommend a matte finish which is more powdery, like vanishing cream. It doesn’t make you sweat. Gel sunscreen is also ideal for summer, because it is water-based. For winter, lotion is better.

People tend to think that the higher the SPF, the higher the protection but that is not necessary. For Indian skin, we don’t need SPF more than 15-30. Now, companies promote and sell SPF 50, but that isn’t needed for normal skin, that is only for post peeling procedures, which are done for pigmentation.  Secondly, SPF is not the only thing that will protect your skin, there are other factors.

How long should you use sunscreen for? Do you need to reapply it during the day?

Practically for as long as you are exposed to the sun for. For office going people, if they step out in the sun during mid-day, they should apply sunscreen. But if you are stepping out early in the morning in winter, then it is not necessary.

The other thing to remember is that Indians may not need a heavy moisturiser throughout the year. During the monsoon, it will only aggravate the problem of sweat. Sunscreen for outgoing people in the afternoon, and perhaps an aloe vera-based gel in the evening works well.

An ideal sunscreen should have a combination of physical and chemical sunscreens, which will protect against UVB and UVA (long wave ultraviolet A (UVA) and short wave ultraviolet B) and broad spectrum (protection from both UVA and UVB). An ideal sunscreen should be user-friendly; for summer  we recommend a matte finish which is more powdery, like vanishing cream. It doesn’t make you sweat. Gel sunscreen is also ideal for summer, because it is water-based. For winter, lotion is better.

What are the foods that protect your skin from photodamage?

You should have plenty of green leafy vegetables, and water. Antioxidant supplements are also very helpful, especially those containing beta carotene. Antioxidant preparations are like internal sun-protection agents.

Theoretically, there are some drugs which can increase your photosensitivity or phototoxicity, like tetracycline, which can make your skin more photosensitive. If you are taking some of these drugs, make sure they don’t increase your photosensitivity. Always read about the side effects of the drugs you are taking.

Can photodamage be reversed?

If there is too much sun exposure it can produce pigmentation and conditions like melasma and chloasma (skin discolouration). There are two factors  involved in this; one is pregnancy and the other is sun exposure. Pigmentation due to sun exposure is not completely reversible but it can be minimised by some preparations like hydroquinone and steroids.

If you have a burning sensation from sun exposure, something like calamine lotion can really help. It can, to an extent, reduce pigmentation as well, but not that much.

When do we need to see a doctor for sun damage?

If you get intense itching, redness, burning and too much pigmentation, too much oiliness from sunscreen, then you should see a doctor. However, there are some conditions where you get scaly patches, then you should definitely see a doctor, you may need oral medication for it, like chloroquine and hydroxychloroquine and other drugs which reduce photo toxicity. But  these conditions are not very common.  We do see it in the OPD (outpatient department) sometimes, but it is not very common.

What about actinic keratosis?

There are also conditions like keratosis, which is an overgrowth of skin, but that is caused by viruses. However actinic keratosis is caused by the sun. There is also solar keratosis, which is caused by solar radiation. These are specific conditions, if you find too many dots and spots on your skin, or if you have cosmetic disfiguring, then you should definitely see a doctor.

Sources:

1. Ultraviolet Radiation, Aging and the Skin: Prevention of Damage by Topical cAMP Manipulation. Alexandra Amaro-Ortiz, Betty Yan, and John A. D’Orazio.

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