Getting Under Your Skin: Why Sunscreen Matters, Even In the Winter

Dermatologist Dr. Beth Goldstein shares what sun protection products to use and when

Sunscreen isn’t just for the beach. In fact, says Dr. Beth Goldstein, Adjunct Clinical Associate Professor in the Department of Dermatology at University of North Carolina at Chapel Hill, year-round sun protection can reduce your skin-cancer risk by 40%, so it’s crucial during the winter months, too.

In our new series, Getting Under Your Skin, Dr. Goldstein answers our questions about skin and sun-protection. First up, we’re tackling skin cancer and why applying sunscreen daily is every bit as important as brushing your teeth.

Do you have a question for Dr. Goldstein? Email us here.

Katie Couric Media: Why is it still so important to wear sunscreen in the winter?

Dr. Goldstein: Most people know they’re at risk of sunburn and skin damage in bright sunshine and warm weather, but they don’t always realize that harmful UVA (ultraviolet) rays are present all year long. Although UVA rays don’t cause sunburns nearly at the rate of UVB rays, they’re potentially even more dangerous, because they penetrate more deeply into the skin, which may result in skin cancer, damaged collagen, wrinkles, and the irregular pigmentation we see as brown spots. Over time, UVA rays cause cumulative damage to the skin.

This type of UVA ray comes through most window glass, so even when you’re inside — or in your car — your skin can be damaged. And don’t even think about a tanning bed, which uses UVA rays in incredibly high dosages.

Every day, year round, even in winter — put your sunscreen next to your toothpaste, make it easy to have that daily habit that can make sure an important impact in your skin health. 

Skin cancer is the most common cancer in the U.S. At least one in five Americans will develop skin cancer in their lifetime. Why is this?

Think about cavities. If you only brushed your teeth during the summer months, would you be shocked to see cavities and gum disease? No. Like oral care, skin cancer prevention is not a seasonal thing. It requires daily year-round care.

The majority of skin cancer — 90% of the 5 million cases diagnosed in the U.S. each year — are caused by artificial or natural sun exposure over a lifetime. We get significant sun exposure before age 18 and, as adults, each time a sunburn or tan fades away, the damage to the DNA of the skin continues to accumulate.

What are some signs of skin cancer that people can look for at home?

It is helpful to know what spots you have on your skin to begin with, so you can recognize new ones, spots that are changing, or not healing. The American Academy of Dermatology provides a guide for monthly skin self-checks. Ask someone to help you check areas like your back, that are difficult to see. Ask your hairdresser to check your scalp. 

  • Basal cell carcinomas often look like  a pimple, scratch, or dry spot. What’s different about them is that, after 4 weeks, the lesion just won’t heal. These growths can also look like waxy or scar-like growths that get larger or change in shape.  
  • Squamous cell carcinomas often look like basal cell carcinomas, but they can appear suddenly as a red or scaly patch, pimple, or a bump that will not heal.  
  • Melanomas can be any color, texture or size but the common characteristic is a spot that is evolving or changing. Classically if a spot (flat or raised) is asymmetrical, variable in color (ranging from light brown to pink), has irregular borders, or is enlarging in diameter it should be checked out.  Don’t wait until it’s bleeding or painful to see a dermatologist. Early detection and treatment are what lead to high cure rates.

When buying sunscreen, what should people look for on the label? What sun protection products do you recommend?

You’ll hear this time and again, but the best sunscreen is the one you’ll actually use. There are two main sunscreen formulations, mineral and chemical. The active ingredients provide protection but their protection mechanisms are different: Chemical sunscreen is absorbed into the skin while mineral sunscreens (also known as physical sunscreens) remain on the surface to block harmful rays.  

I always recommended the mineral based blocks to my patients alongside a comprehensive skin protection program., which includes annual skin-checks by a dermatologist. 

Below is a list of quality SPF-only mineral  products I recommend for patients. 

1. For young babies/ infants: Avoid going into the direct sun and use loose fitting clothing, hat and the shade

2. For babies and children: Aveeno Baby Continuous Protection Zinc Oxide Mineral Sunscreen SPF 50 lotion or COOLA Mineral Baby SPF 50 Unscented Sunscreen Stick. These two are all mineral based which is a must for babies and children due to the real risk of absorption due to the increased body:surface ratio in young ones.

3. For winter sports : Dermatone’s No-Touch Sunscreen Stick SPF 50. Great for touch ups when skiing, hiking. You won’t need to pull off your gloves or worry about it getting sticky.

4. Men with oily or normal skin The Daily by GETMr. offers a 3 in 1 lotion, SPF 30, and soothing aftershave. Usually, all mineral sunscreens show up in men’s beards and are often only used when outside. This product provides that easy, one step approach to keep it simple and safe every day. 

5. On the go:  Colorescience Sunforgettable Total Protection Brush-On SPF 50 is a great product to touch up your face, neck and hands without making a mess. It works well with many skin types with several available shades. This also works well for oily skin types and darker skin tones. It is not easy to use all mineral sunscreens with oily skin, but this powder (there is a transparent version) can be a great option. Isdinceutics Mineral Brush is another similar product available is well

6. For sensitive, post procedure or dry skin: After a procedure or for sensitive skin in general, Elta MD UV Elements Tinted Face Moisturizer SPF 44 is my favorite. It is all mineral and the tint makes it a great option also for a foundation and defense against stubborn pigment issues such as melasma. 

7. Lips:  Vanicream Lip Protectant/Sunscreen SPF 30 is one of the few SPF 30 all mineral sunblocks for lips. It is hard to find lip products with only minerals and no flavoring. 

8. Allergies: Vanicream Sunscreen Sport SPF 35. Vanicream is the go to for individuals with difficulty tolerating pretty much anything. This company stands by its credo by being dye free, fragrance free, lanolin free, parabens free, formaldehyde free. 

9. Darker complexions: Supergoop! CC Screen 100% Mineral CC Cream SPF 50 has a shade flexible formula, for all skin types and is all mineral. 

10. Skin cancer frequent flyers: Eryfotona Actinica by ISDIN has been shown to reduce the number of precancerous lesions in patients with many precancers at baseline when used twice daily. Not only does the product have an all mineral SPF 50 but also has DNA repair ingredients. This is a treatment and a sunscreen all in one. 

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Dr. Beth G. Goldstein is an Adjunct Clinical Associate Professor in the Department of Dermatology at University of North Carolina at Chapel Hill. She performs Mohs (skin cancer surgery) in her private practice located across the Research Triangle in North Carolina. She is an editor on several topics in UpToDate, a leading evidence-based clinical decision support resource used by clinicians worldwide, is a Fellow of the American Academy of Dermatology and the American Society for Mohs Surgery and most recently launched a skin protection product to help more men wear sunscreen on a daily basis.