The skin is the largest organ of the body and it is important that we take care of it. It is the most visible of all of the organs and it acts as a protective coating to ward off germs and guard against injury. The skin is a complex organ and is therefore susceptible to many types of diseases.

One type of serious injury to the skin is a sunburn ( a sudden injury ) or excessive sun exposure ( long term injury ) in general. The skin can be damaged by natural ultraviolet light exposure or by artificial ultraviolet light exposure. Natural ultraviolet exposure obviously comes from the sun whereas, artificial ultraviolet light exposure comes from bulbs or sunlamps such as you get in a suntan parlor. Whether natural or artificial, excessive ultraviolet light exposure is very dangerous. The skin can be damaged just as seriously in an indoor artificial unit as well as outdoors.

It is important to try to minimize the amount of ultraviolet light exposure. If we are the type of individual who works outdoors or participates in many outdoor activities such as baseball there are many ways to protect ourselves.

Children are especially at risk for sunburns and excess sun exposure because they spend so much time outdoors playing sports. Medical studies have shown that most of all the sun damage we receive in life occurs before the age of 20. Little League baseball players and children who play travel baseball are constantly out in the sun. Sometimes these young ballplayers play multiple games in a weekend and the amount of sun exposure can be excessive. Baseball caps do a very poor job of covering their young faces and sensitive skin. The proper use of sunscreen is extremely important.

The reason the word proper is used is because many individuals use sunscreen but do not use it correctly. Medical studies have shown that most individuals who do use sunscreen use 1/3 to 1/2 the required amount. When they use less than the recommended amount they receive protection which is suboptimal. When sunscreen of SPF number 30 is used in amounts that are less than recommended, an individual may be getting the protection that one would receive from sunblock of SPF number 10. This would not be sufficient to protect an individual.

We tell our patients to roast a chicken not their skin. General advice when using sunscreen would be the following:

  1. Use a sunscreen with the minimum SPF number of 30.
  2. Apply a heavy coating of sunscreen and do not skimp.
  3. Have someone help you apply the sunscreen so you can reach hard-to-reach places such as the back.
  4. Don't forget to put sunscreen on the lips using an SPF lip balm of number 30 or more. The lips have little melanin pigment to protect them. The lips burn very easily and are a common site for skin cancer.
  5. Sunscreen needs to be re-applied frequently. After swimming, sweating, or exercising it should be re-applied immediately.
  6. The exact brand of the sunscreen does not matter. It is best if the product is water resistant and blocks UVA rays as well as UVB rays. Check the label!

Other things that are important to protect oneself include wearing a large broad-brimmed hat. UV protective glasses are important to protect the eyes and the skin around the eyes. Many companies sell excellent sun protective clothing which can be easily purchased online.

Whenever possible, an individual should try to sit in the shade. If you are a spectator at a Little League game come prepared. This would include bringing sunscreens, umbrellas, and hats.

An individual should try to plan their outdoor day accordingly. Trying to avoid outdoor activities between the hours of 10 AM and 4 PM is helpful. If possible, play tennis at 5 PM instead of 1 PM in the afternoon. We call this sensible sun protection. We can also all get burned on cloudy days since ultraviolet light penetrates the clouds. Sometimes cloudy days are even more dangerous for sunburn since many of us do not even think of protecting ourselves when the weather is not nice. Accordingly, one can also get burned in the winter time especially when there is reflection of sun from the ice and snow. Skiers and individuals at high altitudes need to be especially careful.

With a little bit of careful planning we can all enjoy the outdoors without the risks of excess of sun exposure. Play ball!

Kenneth Wasserman, M.D.
Clinical Assistant Professor, Drexel University Hospital
Advisory Board, American Academy of Dermatology
Founder, Major League Baseball Skin Cancer Program
Team Dermatologist, Baltimore Orioles

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