Health recently asked if it’s ever OK to go outside without sunscreen. The article highlighted the American Academy of Dermatology’s approach of always wearing sunscreen when going outside as well as recent discussion in the U.S. and Australia that questions the strict guidance, especially in light of vitamin D.
For an expert’s take, I reached out to Heather Woolery-Lloyd, MD, director of the Skin of Color Division at the University of Miami Miller School of Medicine’s Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery.
There has been some pushback on social media about the message that sunscreen is always necessary when going outside. What do you hear from your patients?
I have not heard any pushback from my patients regarding sunscreen. I practice in South Florida, a location with a very high UV index. Many of my patients complain of dark spots and uneven skin tone so wearing sunscreen is really important. Patients who are concerned about hyperpigmentation are eager to do anything that will help improve their condition including wearing sunscreen.
Is it ever safe to go outside without sunscreen?
From my perspective, it really depends on what the patient’s concern is. If they are concerned about hyperpigmentation and uneven skin tone, then daily sunscreen is really important. If hyperpigmentation and uneven skin tone are not a concern, and a patient with a darker skin type is going outside for a short period of time in an area with a very low UV index, the risk of sunburn or sun damage is likely low in that case. Sunscreen use depends on what the patient’s skin concerns are and the level of exposure. As I mentioned above, I live in a very sunny climate so here, most people do need to wear sunscreen most of the time, and this is especially true if they plan to spend longer periods of time outside.
It is important to note that Australia has updated its new sun safety guidelines. These new guidelines recommend sunscreen use based on skin type, UV index and duration of exposure. The guidelines have not changed in the U.S., but other regions are considering updating their guidelines on sunscreen use.
Should people be more concerned about a day at the beach with sunscreen or brief exposures without sunscreen, such as a walk to the car or around the block?
Both types of exposure are important. A day at the beach can lead to a sunburn if sunscreen is not used. We do know that sunburns increase the risk of melanoma. Daily incidental exposure to the sun contributes to photoaging and photo damage. Although a casual walk outside may not immediately damage the skin, decades of incidental sun exposure will lead to accelerated photoaging.
How best should dermatology clinicians counsel their patients on when to use sunscreen?
Most people who come to see a dermatologist are concerned about their skin. In patients with lighter skin tones, daily sunscreen use helps reduce the risk of sunburn and skin cancer. In patients with darker skin tones, daily sunscreen use can reduce the risk of hyperpigmentation and uneven skin tone. For this reason, I think it is helpful to recommend a broad-spectrum sunscreen for daily use.
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