Riverbend Awareness Project

For UV Safety Awareness Month, local Dermatologist Stetson Albertson shares with us the importance of looking after your skin while enjoying the outdoors.

What is Riverbend Awareness Project?

The Riverbend Awareness Project brings you a new conversation each month about important causes and issues in our community. Every month of 2024 we will sit down and have a conversation with a professional from our community about significant issues like heart health, Alzheimer’s, literacy, and more. We’ll then share that conversation with you on the Riverbend Awareness Project Podcast, with the goal of sharing resources, and information that will help you have a better understanding of the particular problems, and solutions, associated with each topic.

Disclaimer: Views and opinions expressed in this podcast episode are solely those of the individuals participating and do not necessarily reflect the views or opinions of Riverbend Media Group or the Riverbend Awareness Project, its affiliates, or its employees. It is important to note that the discussion presented is for informational purposes only and should not be construed as medical advice. Listeners are encouraged to consult with qualified health care professionals for any medical concerns or decisions. The Riverbend Awareness Project is a product of Riverbend Media Group.

Melissa: Hey, this is Melissa.

Emma: And this is Emma.

Melissa: Welcome to the Riverbend Awareness Project. Each month, we learn about important nationwide topics that also affect our community.

Emma: This month, we're learning about UV awareness. And today, we have Dr. Stetson Albertson, a local dermatologist joining us.

Melissa: Dr. Albertson, could you give us a brief introduction of yourself and how your experience and education has qualified you to talk about UV awareness?

Dr. Albertson: Yeah, definitely. So basically, as a board-certified dermatologist, you know, we deal with the adverse effects of the sun on a daily basis. So this kinda gives us a little bit of, you know, I guess, qualification to talk on the subject. Not only does, you know, the UV affect your skin, you know, in terms of, like, skin cancer and things like that, but also there's other skin conditions where the sun affects it and causes issues with the skin.

So on a daily basis, you know, we're dealing with that. Patients coming in, dealing with questions or concerns about the sun and the effects and sunscreen; all these different questions pop up on a daily basis. So not that I'm, you know, an expert on UV, but, I mean, we deal with it enough that we can hopefully help some of the people out there to learn a little bit about more about UV awareness.

Melissa: Thank you. And I feel like too, like you said, when I hear UV awareness, my brain thinks, "oh, protecting against skin cancer." So it's interesting already to hear that there's other things that it does to the skin. So that's exciting. I'm excited to dive deeper into the the topic.

Dr. Albertson: Yep. Perfect.

Emma: Our first question is a two-parter. Why is it called ultraviolet light, and what different types of UV rays are there? Well, I guess it's a three-part— and how can these different rays affect people?

Dr. Albertson: Yeah, so when we look at ultraviolet light, also known as UV light or ultraviolet radiation (there's lots of different names that kinda goes by. Sometimes UVR, people call it), but this is part of the electromagnetic spectrum of radiation. So, as you look at the spectrum, it goes kind of on the far left from radio waves all the way up to X-rays and gamma rays. So UV radiation is sort of in the middle of that spectrum, and they call it "ultra" because ultra meaning beyond, and then violet, of course, you know, part of the visible spectrum of light, which also falls on this UV or electromagnetic spectrum.

So ultraviolet light is right after violet, which is the last light you can see visibly. So right after that, you get to the UV radiation or ultraviolet light, however you want to put it. And that's why they call it ultraviolet, because you can't see UV radiation, and it falls on the spectrum right after violet. So kinda beyond violet or right after violet. So that's kinda how it got its name.

UV light is broken down into kinda three different sectors. So there's UVA, UVB, and UVC. So that's how it's broken up. And these are just kinda based on the length of the waves. So it's all about kinda like... I'm not a physicist, but, you know, it's based on, like, the length of the wave and then the frequency.

So high frequency, this is like your gamma rays. These are much more dangerous, you know, to people and to the skin and even, like, you know, internal parts of the body. But basically, it's kinda how it's broken down. So UVA, UVB, and UVC, these are the ones that we know the most about.

Melissa: Cool. Thank you. That's cool to know that there are different types of UV radiation. Did you have other— sorry.

Emma: Oh, I was just kind of wondering about, so— so if there's UVA and then UVB and UVC, are those... Do those have different effects on your skin? Or what's kind of the most— the range of how those affect you?

Yeah. Good question. That's... yeah. I didn't get the third part of your question there, so I'm glad you circled back on that. So UVA, we think about more aging in the skin, causing, like, your photoaging.

And we kinda remember that by the "A" in that portion of the UV range. And then B, we think more of like "B" for sunburn. So the UVB range causes more of like our sunburn effects. And really, you know, everybody who gets sun is affected in some way by it. And at the molecular level, you know, UV radiation affects the DNA in your skin, and that's where you start getting the, you know, the adverse or the bad effects of the UV radiation.

So basically, you know, we think of A for aging, B for burning. UVC is actually filtered out by the ozone, so UVC does not reach the surface of the earth. So UVC, while it's in the spectrum, it's not something that we really have to deal with. So mostly UVA and UVB that we deal with here on Earth. So kind of interesting to note that.

Melissa: Thank you, ozone layer, for—

Dr. Albertson: Yeah.

Melissa: taking out the other—

Dr. Albertson: Exactly.

Melissa: other layers of radiation.

Dr. Albertson: Yep. 100%. Yep.

Melissa: So we know the sun, obviously, is a source of of UV radiation. What are, I guess, the most harmful sources of UV light?

Dr. Albertson: Yeah. Good question. So yeah, you're exactly right. So the sun is our primary source of UV.

And the sun, actually, we consider that solar radiation, and so 50% of that is visible light. I mean, obviously, when the sun's out, we can see better, so we know that's visible. 40% is infrared, which is another part of that electromagnetic spectrum that I talked about, and then 9% is your UV radiation. So the sun is our primary source.

In terms of, like, you start talking about harmful sources, I mean, the sun can be a source of harmful, and obviously the most, you know, present in our daily lives. And so it's kinda hard to say what is the most harmful, but I would say, you know, tanning beds, you know, is gonna be very high on that list of harmful sources of UV radiation. I know a lot of people out there will, you know, argue that or... You know what I mean? Like, not agree with what I'm saying on that. But we know that having a history of tanning bed use, you know, highly increases your risk for skin cancer down the road. So I mean, that's gonna be on there.

But we also have medical devices where we use UV radiation, because there are certain skin conditions that we treat with UV radiation. So it's kinda like any other medication, right? So, if used appropriately in the right doses, at the right time, in the right setting, it can actually be beneficial, for psoriasis or itching or eczema, you know, these are treatments that we use in a controlled, you know, method for treating certain skin conditions. So, it's all about, you know, kinda moderation and understanding what you're dealing with. But those are kind of the main sources: the sun, tanning beds, and medical devices. But really, you know, tanning beds would probably take the cake on that one in terms of the most, you know, harmful, despite a lot of people really enjoy doing that.

But just looking down the road, it can cause, you know, it can cause you some problems down the road. So just something to consider, you know.

Emma: Wow. That is fascinating. I did not know that UV light was used in medical devices. That's really cool.

Dr. Albertson: Yeah. Yeah, it's been, you know, it's been really good. I mean, there's a lot of things, like I said, that we use it to treat with.

So, but at that— also, if you go too far on that, you can burn people's skin, you know, like doing treatments and stuff. So like I said, it's just a controlled dosing, because we need the sun to live. Right? So, you know, you take away the sun and pretty soon we're not gonna be here, you know, when we run out of different ways to make food or we burn up whatever food we have. So it's a balance, right? You know, it's not like we just have to live in the basement. You know what I mean? It's a balance, you know, that I like to tell my patients about.

Melissa: We love the sun.

Dr. Albertson: Yeah.

Melissa: It does lots of good things.

Dr. Albertson: Yeah.

Melissa: We're not against the sun on this podcast at all, so...

Dr. Albertson: Nope. Definitely not.

Melissa: We're just letting us learn more about—

Emma: (laughs) Support the sun. And support UV awareness.

Melissa: how we interact with the radiation and the rays that come from it. So...

Dr. Albertson: Exactly. Yep.

Emma: What are some of the short-term and long-term health effects of UV exposure?

Dr. Albertson: So in the short term, you know, we're looking at sunburn. Right? So that's the one that most people are gonna see, you know?

Sometimes later that day, sometimes mostly the next day, you're gonna see the sunburn. Blistering, you know, blistering can be a cause of really severe sunburn. So those are the short term, right? So those are the things we can see.

And those are the things that are easier for us to understand. You know, I was out in the sun too long. Now I have a sunburn. Maybe you have some blistering. You know, there's a lot of pain, you know, tenderness associated with sunburns.

We've all been there. Right? We kinda know what that's all about. But in the long term, we're looking at increased what we call, you know, photoaging. So the more you're in the sun, you know, you tend to age a little more.

And I'm not saying that's a bad thing. You know? Like, some people are more worried about that than others— what their skin looks like— and I don't think there's a right or wrong way.

And then, you know, the one long term, down the road, after years of exposure, you get into your skin cancers. And those don't pop up a day later, or two days later, or three days later, weeks, or even months later. Sometimes that can be years down the road when you start popping up with skin cancers. And those are related to sun exposure over years. So it's not something that's an immediate effect.

And so I do like that question, you know, short-term versus long-term, you know, because sometimes it's easy to see, "oh, man. I got burnt. That stinks. You know, I'm not gonna do that again." But then it's like, well, what are the long term effects?

And that's where we start getting into your skin cancers and things like that.

Melissa: Random follow-up question. Sorry. When you said that sometimes it doesn't come, like, a sunburn doesn't come until the next day, why is that? It's probably a simple answer, and I'm just unaware of it. But...

Dr. Albertson: No. Yeah, no— it's a good question. So, I mean, most of the time, it's gonna be, like, within a few hours.

But basically, it just takes time for that inflammation to set in, you know, for your skin to really start manifesting those effects. I mean, as soon as the sun hits, your body kinda starts defending itself with the immune system in the skin. But your immune system has lots of different effects from the sun. Some things are upregulated, some things are downregulated. So eventually, you know, things are upregulated, and you start getting all that, you know, increased blood flow.

That's the erythema or the redness that you get from the sunburn. So yeah. So, really, you'll start feeling it pretty soon after, but the next day is usually when you're like, oh, man. That was... you know, you don't wanna lay on your back or, you know, whatever.

Melissa: Yeah, you're like, "that was a bad one."

Dr. Albertson: Yeah.

Melissa: You need some aloe vera.

Dr. Albertson: Exactly. Yep. Yep. Yeah, we've all been there.

Melissa: But yeah. Sorry. That was a side note, but I was just curious.

Dr. Albertson: Yep. Good question.

Melissa: This is a complicated one. Let's say, like, someone looks outside, and they're like, "wow. It's not that sunny today. It's kind of overcast." Or maybe it's fall, so it's not as sunny for long, or the sun doesn't feel as warm. How much sun or... not how much sun, I guess, how much UV rays are we actually getting in that moment even though we can't necessarily see it as much?

Dr. Albertson: Yeah, so we do know that on an overcast day, where it might even be a tiny bit rainy or overcast, we do know that the clouds do block out some of the UV radiation, but we do know that UVA has more access through clouds and through the rain and things like that. It's not quite as filtered out to where UVB tends to be a little bit more blocked. Now there's a lot of overlap, you know, sometimes in like UVA and UVB, but we do know that it does still get through. So even on an overcast day, you can still get, you know, sun damage or sun exposure.

Just it'll be a lot less. The numbers are not perfect, but they say, oh, the clouds can block out up to 30% of the UV rays. That being said, like, how cloudy is it? You know what I mean? Like, are you on the top of the mountain where the sun exposure is more?

Are you down at, you know, sea level where you're a little bit farther away from the sun? How far are you from the equator? I mean, there's lots of factors that come into it. But on a sunny day, you know, on a hot sunny day, I mean, the more you can see, the more you're gonna get. Right?

So I think that's easier for people to remember. But when we're looking at a cloudy day, if you're out there all day without protection, you can still get a pretty good sunburn or pretty good exposure. So just something to keep in mind. You still have to cover up, but it's not quite as strong, right?

So... But it is still there and something you need to be to be aware of, you know. On a cloudy day, you can still get a pretty good sunburn.

Melissa: So... Trying to see if there's anything else, because there's a lot there.

Dr. Albertson: Yeah. And we can talk a little bit too about, you know, we talk like on car windows and things like that.

Melissa: Oh yes. What's the difference between direct sunlight and indirect sunlight?

Dr. Albertson: Yeah, so obviously you know direct sunlight is gonna be much more intense, you know, if there's nothing in between you and the sun. So windows, they have to have a special kinda coating or filter put on them to block out UVA and UVB.

All windows block out UVB, so we do know that just by the fact that it's a window, it's gonna block out UVB. If you want UVA protection, then you need to have a special coating. The windshield does have that coating for UVA and UVB. So the windshield does, but the side windows and sunroofs would not have that special coating typically. You can have these things put in your vehicles, but you have to special order them from the manufacturer.

So this is something that has to be done during the process of making the window. I know there's been a push to get some of this more prevalent, but, obviously, you know, expense and things like this have been a little bit limiting. But just realizing you're getting UVA through your window— we always say A for aging, but also A for access. So A has more access, you know, through the window.

So what you're gonna get— there was a picture that I saw recently of a lady who worked, and she had a glass window on the one side of her, and so she would catch a lot of sun just as she was working. And she wasn't getting a sunburn, so she was not really thinking, "oh, this is gonna be an issue." But what they showed, like, fifteen years later, like, you know, her left face and her right face were significantly different in terms of not only the color, but, you know, the wrinkles and some of the stuff that we associate with photoaging. So, just kinda shows, you know, and not saying one way is bad or not bad, but we do know that it is showing the sun is still doing something through the windows. Something to keep in mind.

I don't know if you've ever seen, like, the truck drivers and people who drive in the car a lot. Their left side gets significantly more sun damage. And so just something to keep in mind. I like that question, but it is a little bit challenging. But just understanding, like, even if you're in your car, you're still getting some of that indirect sun exposure, so...

Melissa: Yeah. I never would have thought about that. Like, I remember my mom saying she used to always ride with her arm out the window, which, I mean, obviously, the glass is down at that point. So,

Dr. Albertson: Mhmm.

Melissa: it's not completely related, but the idea of you may be getting UV sources that you're not completely aware of. So kinda look around and be like, oh, yeah. There's still sunlight coming through or reaching me.

Dr. Albertson: Yeah. Exactly. Yep. You're exactly right. So, yep. It's a good point to to make on that.

Emma: Yeah. Just sitting here, I'm thinking this is so... I don't know. It's kinda funny to me because we're talking about awareness for this thing, but it's so much like— you can't see these lights and you can't... you know, you don't even know they're there. And you might get a sunburn, but you can still have the damage. So it's kind of funny that it's all... I don't know. It's kind of like a... I don't know, it made me think of secret agents and stuff.

It's like the..

Melissa: Secret agent UV UVA.

Emma: (laughs) UVA.

Dr. Albertson: Yep. Yep.

Melissa: Which it's good that it's less harmful. Is that— I don't know if that's correct in saying. Because you said it does, like, aging, but is... UVA might not be as much related to the skin cancer?

Dr. Albertson: So that's a good question. So it still does cause a lot of the DNA damage.

Melissa: Okay.

Dr. Albertson: Yep.

Melissa: So it can still be harmful.

Dr. Albertson: Yep. And there's still a lot of, like I said, ongoing research on this.

It's a really... you know, still a lot going on, like, you know, can we really divide this into UVA and UVB? I mean, we do that to help us understand it. But as— like I said, the spectrum is still there. And so both of them have been linked to skin cancers, you know, and stuff. So not 100%.

So, like, we kinda break it down that way to help us understand it, but there is still a lot of research going on in the area of how much, you know, does this play a role in skin cancers. And we know it does, but still, there's still a lot of research in that area. So yeah.

Melissa: Thank you for clarifying that.

Dr. Albertson: Yeah, that's a really good question.

Emma: So another thing we were wondering about was what factor age plays in UV skin damage?

Dr. Albertson: Yep. So the thing is, you know, the longer you live, the more sun exposure we get, and it really adds up over time. So a lot of the stuff that we are treating, you know, like, if you get a skin cancer, say, in, like, your thirties or forties, you know, that's probably something that happened to you, you know, ten, fifteen years ago.

So just the longer you live, the more sun exposure you have, and then the higher risk you are for getting skin cancer. So it's kinda hard. I mean, it's a little bit of a tricky question. But basically, it it adds up over the years.

So a little here, a little there. And then every time you get, you know, sun on your skin, you get some changes in the DNA, some damage to DNA. Your body is very good at repairing those. But when you get so much and maybe your body can't repair it, then that's when you get some of the cells that turn into skin cancer.

So that's kind of what we have to watch out for. Everybody's body is different. Somebody's body might be a little better at defending itself against the sun, and we don't really know who those are gonna be per se. We just know if you're lighter complected, you know, or if you're darker complected, you know, the lighter you are, you're a little more risk for skin cancer based on your genetics. So, I'd say age really is just like, you know, the more time you have, the more exposure you get, and then you have a little more risk of getting some of the adverse effects of the the sun or the UV radiation.

Melissa: Sorry, I was just thinking about when you said lighter complexion. I'm a redhead and I have very fair skin. But I do know— so, like, my brother is also... we're similar in our complexion, but he'll get a sunburn, and then it'll peel, and then he'll be pale again. I'll get a sunburn, it'll peel, and then I'll be slightly tanner.

So that just made me think, like, the difference— like, we're siblings, so our DNA is not, like, super diff— I mean, we still have different DNA, obviously. But, like, even in just siblings our skin reacts differently to the sun. So that's... sorry. I don't know why. I was like, is there more that you could speak to that and, like, the way different people's DNA responds or why that would be?

If not, that's fine. I was just curious.

Dr. Albertson: Yeah. No, that's a good question.

So really, like I said, it really gets down tothe cellular level, and we don't really know maybe why one person might be better at repairing that DNA than another person. But we do know if you don't tan at all, then you're just gonna be more susceptible to getting skin cancer. Some people, they have a little more, like, they say, like, kinda like an olive tone or maybe they tan more. I'm the same way. If I go out in the sun, I burn.

You know what I mean? So I just, you know, I'm lighter-complected, so I look at the sun and I burn. You know what I mean? So, like, I just know that I'm gonna be a higher risk. But in terms of, like, the molecular level, it can be hard to say, but it all comes down to genetics, right?

I have patients who, you know, lived in the sun their whole lives, you know, and then they come in and they're just— they look great. You know what I mean? I have other patients, you know, who live in the sun, and they come in and we're working on them frequently, right? We're taking off a skin cancer here. We're treating, you know, precancerous spots.

So really, at the genetic level, it's hard to say, you know, just some people are able to withstand it more. There are genetic conditions where patients are not able to repair their DNA. There's one called xeroderma pigmentosum, where these patients genetically lack the ability to repair their DNA following sun damage.

So these patients, after one day in the sun, could very easily develop a skin cancer in the next, you know, weeks or months, just because, you know, if you can't fix the damage, then, I mean, what are you gonna do? So these patients have to live a life not being in the sun or just always covering up. I mean, they don't... they... even one day outside can be very bad for these patients. So it's really like a genetic level, you know, at the DNA level, and one person to the other, we don't know.

People respond differently to medications, you know, it's kind of the same thing. One medication works for this person, but not the other. And it's like, well, why? Well, it's gotta be something at the genetic level. And so medicine is kinda going this way of, you know, what is the genetics of the patient and how will they respond to a medication?

Not to get off in the weeds, but at the genetic level, sometimes we can't really know without very, very extensive studies, and those things are going on, you know, as we speak.

Melissa: I think that's fascinating.

Dr. Albertson: Yeah.

Melissa: Like, and it's also... I feel like, gives the idea, like, you should know— be aware of your body and, like, how it interacts in response to things in general, also to the sun. So...

Dr. Albertson: Yeah. No, exactly. I mean, yeah, in life in general, you should, you know, start to figure out, maybe you can't do certain things or eat certain things or do certain stuff because that, you know, affects you negatively, and maybe your friend can do that, and they don't have a problem. But it's all, like I said, yeah, learning about yourself and how your body interacts and responds to environmental factors. So, yeah, that's a really good point.

Emma: What are some of the skin cancers that are caused by UV exposure?

Dr. Albertson: Okay, so there's three big ones that we think about when we start thinking about skin cancers as their relation to not only UV radiation, but, you know, just our health in general. So the most common is basal cell carcinoma. This is the number one skin cancer that we see.

Second is squamous cell carcinoma. That's number two, our second most common.

And then the third is melanoma. So that is the more dangerous out of the three. Luckily, not as common as the other two, but, you know, much more aggressive, and worrisome.

They've all three been linked to UV radiation. So we do know that there is a role for UV radiation in those three. Not every one of those every time will be related to UV radiation, but they have shown a lot of direct correlations between your sun exposure, your UV exposure, whether that's, you know, from the sun or tanning beds or whatever it might be. Even like I said, the medical devices, overdoing it or doing too much or having to do it for too long, you know, these can lead to skin cancer. So nothing is really immune, right?

So... but those are the top three that we think about when we think about UV exposure. And these are the top three that I see in the clinic that we treat daily, weekly, monthly. Right? There's always, you know, patients coming in with these things.

The incidence of all these is increasing. I don't know why. I don't know if it's more people are coming in and there's more awareness and we're catching them earlier, you know, or if it's just, you know, there's just more going on. That's a big area of research right now in our field of dermatology; why is the incidence of these skin cancers going up over time, even when we have more awareness of the stuff. So it'll be interesting to see over the next ten years where the trends go.

Melissa: We talked about, like, the different types of skin cancers. Are there different treatments for the different types of skin cancer? And then this is kind of an obvious question, but, like, what are the benefits of going in for maybe a less severe type of skin cancer, getting, like, early diagnosis?

Dr. Albertson: Yeah, good question. So there are multiple treatments for the different skin cancers. So it all depends on, you know, if you have a spot you're worried about, you get a biopsy typically. On the biopsy, it tells you what type it is. And then based on the type, and there's other things they look at within that biopsy to tell you maybe how aggressive it might be. Is it a little more aggressive? Is it a little less aggressive? How deep is it in the skin? That plays a big role, particularly in melanoma. We do know that the vertical depth of a melanoma, the deeper it is, the more aggressive it tends to be.

So really based on the biopsy that tells us how to treat it.. Surgical removal is still probably at the top for most skin cancers. Just having it surgically removed with a safety margin, I like to call it. So you have the... maybe it's the size of a nickel or whatever it might be. Based on what type of skin cancer it is, you take a recommended safety margin and that usually treats it. If it's a melanoma, there might be follow-up, you know, treatments for that.

Sometimes there's imaging related, if it's a really aggressive one or a really deep one, you might have to get maybe like a CAT scan or an X-ray or some follow-up labs to kinda see, like, how has this gone to other places.

Occasionally, we do a lymph node biopsy. You know, we check the lymph nodes because we know that it typically will spread to the lymph node before it goes, you know, anywhere else. There's also, you know, you can do radiation treatments. I know we're talking about radiation today, but this would be like, you know, in the X-ray range where we can use very local, very focalized treatments for skin cancers, if maybe a patient's not a good candidate for surgery, or whatever it might be. We have the Mohs micrographic surgery for the head and neck area or areas where we need to preserve a lot of the extra skin.

So there's lots of different treatments out there.

And you're exactly right. Catching them early is always better. If it's smaller, not as deep, it's gonna be much easier to treat. So I think that's why we kinda advocate in dermatology for regular skin checks, you know, coming in once a year, you know, if you have a mole that's changing or whatever it might be, like, getting a check, because we do have patients that, unfortunately, sometimes wait a long time. And then what could have been probably a pretty straightforward procedure is now a very involved, you know, larger procedure. So you're exactly right. You know, catching them early in any type of cancer, it doesn't matter what type cancer, catching it early is always gonna be in your favor.

Melissa: What are the best cautions to protect against UV damage?

Dr. Albertson: Okay, so I think, like you said, you know, this podcast, you know, just the awareness is really number one.

So I think the biggest thing to understand is that the UV rays are gonna be the strongest from 10 AM to 4 PM. So this is when the sun is more directly above you. So at noon, you know, at noonday, that's when the sun's gonna be the strongest. So, really, like, before 10 AM, you're probably not really gonna need much, you know, coverage. After 4 PM, depending on the day, things will start to dwindle in terms of the strength of the UV rays, but also, like, on a really hot, hot day, you know, it can still be even after 4 o'clock. But between 10 and 4 is when I like patients to think about it the most.

Sunscreen's really good. You know, sunscreen's good. It is very helpful in one of the newer, you know, in the last 10 years, you know, sunscreens have come a long ways. But also just, you know, covering up. You know what I mean?

So understanding that, you know, hats and shades and long sleeve shirts can be good, you know, gloves. But really just covering up and giving yourself another layer of protection is the best thing you can do.

But I think just understanding when the sun is the strongest, you know, for sure, during those times, be a little extra careful. You know, if you're out in the lake all day trying to maybe take a little break from the sun. I know that can be hard to do, and nobody really wants to do that. But, you know, if you're having lunch, maybe just try to shade up for a little bit. Try to get out of the sun.

But those are kind of the biggest things that we recommend, you know, covering up, putting on sunscreen. And just like I said, being aware that it is there, and you gotta kinda, you know, protect yourself a little bit.

Emma: Speaking of sunscreen, how does sunscreen work, and what should you look for when you're buying sunscreen?

Dr. Albertson: Yeah, so that's a really good question. So they make, you know, multiple different ingredients in the sunscreens. And what you want to look for, the number one thing is the rating. So, you know, they call them the SPF that they all have. And there's like 15, 30, you know, there's 50.

There's all sorts of different ones, but I recommend SPF of 30 and above. So you wanna look for 30 and above, and you wanna look for broad spectrum. So we talked about UVA and UVB— so broad spectrum does both. So you want coverage for both of those.

I would say most sunscreens now are probably gonna be broad spectrum. They want people to buy them, right, and so there's a lot more awareness on sunscreens. But, you know, look for your rating 30 and above, and then look for, you know, the... sorry, I lost my train of thought there, the broad spectrum. So, so look for 30 and above and broad spectrum. That's what I would look for for that.

When you're looking at sunscreens, there's two different types. So there's physical sunscreens, the physical blockers, and then the chemical blockers. So physical blockers are zinc and titanium. So zinc and titanium are your physical blockers.

The chemical blockers, there's a whole bunch of them, you know, avobenzone, you know, oxybenzone, all these different names. Those are gonna be your chemical ones.

The way they work is a little bit different— so physical sun blocker is more like what it sounds. It's more of like a physical barrier. So the zinc and titanium, they are basically gonna reflect or scatter. So when that UV ray hits your skin, it gets scattered or reflected off in a different direction.

The chemical sun blockers, these ones are gonna take that high energy UV radiation and basically absorb it and convert it into a lower energy and then dissipate that as heat.

So basically, one is like absorbing and kinda changing it into a lower energy state, and then the physical ones are just kinda reflecting it back. Zinc and titanium are obviously, you know, micro, you know, they're tiny metals, so that's kinda easy to remember.

One thing you'll notice is that zinc and titanium, they go on a little bit thicker. So, like, if you think of your lifeguards, you know, if you see them at the pool or in the movies, they have that big white one on their nose. That's usually like a zinc or a titanium based, you know, sunscreen. They don't rub in as well, but they work really well. So it's kind of a catch. But they both work really good.

So those are kind of the... maybe a few more details than you wanted to know. But, just looking for broad spectrum, SPF 30 and above, those are what you're gonna wanna look for, so.

Melissa: A couple years ago, one of my friends was complaining she had a sun— she'd gotten sunburned. And then we were like, "well, why didn't you put sunscreen on?"

She's like, "well, some of these sunscreens don't like my skin."

And so I was like, "well, I wonder if there's other sunscreens out there." So I think I sent her some zinc sunscreen, and I think that worked better. So, like, knowing your options too, like, maybe you have a reaction to one that wasn't super great, but there's other sunscreens that you can use and still protect your skin. That's good to know.

Dr. Albertson: Yep. No, you're exactly right. So I... For example, so oxybenzone is a very common ingredient in the sunscreen, and that's the number one irritating ingredient in sunscreen. So I have a daughter; she happens to be sensitive to a lot of sunscreens. So I did— you just have to play around with it a little bit and figure out which ones they can use, you know? But it is pretty common to be a little bit sensitive to them. But like I said, there's multiple ingredients, multiple formulations.

So I haven't had anybody yet who couldn't find one that works for them. They might have to eliminate five or six different brands or different ingredients, but luckily we have a lot of options out there. So that's a really good point you bring up.

Emma: We also wanted to ask about how UV light can affect your eyes. And we know you're a dermatologist, not an eye doctor, but is there anything that you... any information you could give us on how UV light affects the eyes and how we can protect our eyes?

Dr. Albertson: Yeah. No, that's a good question. So yeah. So not, you know, my exact area of expertise, but we do know that UV radiation does affect your eyes.

So they do recommend wearing sunglasses when you're out and about to help protect from these UV rays. But it can lead to cataracts, you know, macular degeneration. And then in the short term, people who are doing mountaineering and stuff like that, they end up getting snow blindness and things like that. So that's, you know, a lot of it just not from the sun above, but also from the reflections. So we do know in the short term, it can cause, you know, like, basically a corneal sunburn. So you can kinda get sunburn in your eyes, which is also known as keratitis.

And I— like I said, I'm not an ophthalmologist, they would be able to speak a little better to that. But we do know that the UV radiation does affect your eyes as well, so something to keep in mind. And that's why if you see these mountain climbing shows, like, they are pretty good about wearing their sun protection, you know, not on their face, but on their eyes because they know that snow blindness is a real thing, and that's caused by the UV radiation.

So, yeah, like I said, I don't deal with that as much, you know, in my clinic, but it definitely does affect the eyes. So it's something you wanna keep in mind.

Melissa: Stay protected on all parts of your body.

Dr. Albertson: Exactly.

Melissa: Is there any specific advice or guidance you'd give to someone who maybe works outside, or in the summer, they're doing all the sports? Because I know Emma and I were talking about this. You were a lifeguard. Right?

Emma: Yes.

Melissa: For multiple summers?

Emma: Yeah, for three summers.

Melissa: And then for three summers, I was a flagger, so a stop sign holder. So those are jobs where you're, like, out in the sun all day, and during the peak times, you said from like 10 to 4. So what can those people do? I don't know, there might not be any different advice, but just... encouragement for them.

D. Albertson: Yeah. I would say you can do your sunscreens and then, you know, covering up. I think if you're gonna be out there all day, you know, wide brim hats are good, and maybe depending on your style. It might not be that, you know, stylish, but wide brim hats are good.

Like I said, just long sleeve shirts, gloves. I know when it's hot out there, that's not always the best option for you. But just getting your sunscreen on if you don't like to cover up in that way. But just remembering you have to reapply sunscreen every two hours.

So this is where a lot of people go wrong. They say, "oh, yeah. We went to the beach and, you know, got sunburned. I put on sunscreen," you know, it's like, "well, did you put it on, like, at 10?" If you're swimming, depending on which sunscreen, it only lasts 80 minutes, and some only last 40 minutes.

So if you're sweating a lot or if you're in and out of the water, I mean, you're reapplying every 80 minutes, you know, based on your sunscreen. And also, you wanna look at your sunscreen. That's one other thing I should have mentioned before to look at is, like, is it water-resistant? They're not allowed to say water-proof because there is no such thing for a sunscreen. But the water resistance will be either 40 or 80 minutes.

Most of them are 80 now because they want, you know, people are gonna look for that longer duration, but you have to reapply. And so I think that's one thing that people forget. Like, yeah, I put it on the morning, but then I still got sunburned. It's like, well, you gotta get it on there, you know, more than just once. Once is good, but if you're out all day, you're looking at, you know, two, three, maybe four applications of it.

So I noticed... I know a lot of places, they do provide, you know, shelters depending on the work and stuff. I know, like you said, in construction, I've seen...

Melissa: The umbrellas?

Dr. Albertson: Yeah.

Melissa: Yep. I have had an umbrella with me. It was my own umbrella, and I did use it frequently. So, you know, I have my little shade parasol out there.

Dr. Albertson: Yeah. Yeah. So, I mean, yeah, like I said, just being aware of it and covering up as best you can.

And you're still gonna catch some sun. Even if you're wearing sunscreen all day, you're gonna get a little bit. But you just wanna try to avoid getting those really bad, deep sunburns and for sure, you know, blistering if you can. So yeah.

Emma: So we know it's important to protect ourselves from the UV rays, but there's also a lot of good things that can come from being out in the sun. You know, it's like... I don't know. I think it's... it's nice. It makes us feel happier, sometimes, being in the sun.

I don't know, sometimes I think the sun feels kind of unnatural, but that's just me. I'm kinda weird that way. My mom's like, "what's more natural than the sun?" I'm like, "I don't know. It's too bright and I just don't..."

Anyway, but in general, you know, the sun can be really good. It can make you happier. I know it's a good source of, like, vitamin D. So what are maybe some ways that we can still enjoy the sun and get a good amount of vitamin D while still being cautious, I guess, and aware of the UV rays?

Dr. Albertson: Yeah. So this is one of the big arguments for, you know, that we need a lot of a lot of sun exposure. So we do know that in the skin, there is a conversion that takes place with the UVB, you know, specifically conversion where the vitamin D has to be converted into an active form, and then in the liver and kidney, convert it again to the active form that your body can use.

So we do know the sun does play a role in this, and that is important. We do know also that it doesn't take that much. So maybe, like, a few minutes a day just on your face and even arms. So probably your incidental or indirect, you know, even sun exposure is probably gonna be enough to get your vitamin D for the day. If you are super-duper strict on your sun control, then you probably should just take a vitamin D supplement.

So that's what we do recommend, because some patients, they just don't go out, not necessarily because they're afraid of the sun, they just don't go out or they don't get it. And so in Idaho, in the wintertime, we don't get as much sun just because it's cold. We're indoors. You know? Some places where it's really overcast all the time, you just don't get as much sun. So you probably just wanna do a little bit of a supplement. We do get some of our vitamin D through our food as well. But we have shown that really it doesn't take much sun exposure to get enough vitamin D.

But I agree in general. I mean, the sun is good. I mean, it provides life, you know, to the earth, and humans are a part of that. And so I don't tell any of my patients, like, "hey, don't go outside." You know what I mean?

Like, I get patients that get one skin cancer, and they're like, "oh, I'm never— I'm done. I'm done going outside. I'm done being in the sun." I tell them, "well, don't be done, you know, just, like, cover up a little bit, you know, just take a few more precautions," but, like, I like being outside. I don't wanna live my whole life inside. And so if we catch some sun, I mean, we have to be careful about it, but we can you can do it safely. You know what I mean?

I don't want anybody to live inside. If it was, you know, the option was live inside and never have any problems or live outside and have a few problems, I'd pick living outside. Right?

But you can do them both. You can find that good happy medium between, because the sun does make us feel better, you know? It makes us happy.

The sun's out. I mean, compared to when it's cloudy for ten days straight and the sun pops out, you just automatically feel better, and so it's a balance, right? So... but it's like anything in life. We have to balance a lot of things, right?

Not just our sun exposure, you know, what are we doing on a daily basis. It's all about the balance. So good question. I like that question.

Melissa: So we kinda touched on this. You talked a little bit about advancements in understanding UV damage and our skin. Are there other advancements for UV protection or skin damage treatment that we haven't talked about?

Dr. Albertson: So, I think really what has changed is the sunscreens have gotten better. They have gotten more user-friendly because nobody likes to be greased up and your face is all chalky white or whatever it might be. So the formulations have gotten a lot better, and this has helped people want to use that more.

If it rubs in real nice and you can't hardly tell it's on and it's doing what it's supposed to do, then people are more likely to use it. So I just think in general, the sunscreens have gotten better. We've gotten better ingredients in the sunscreens that are safer for long term use.

And where that's been, you know, the real advancement, but also they are coming out with UV ratings for clothes. So this is probably something that's a little bit newer in the last, I would say, I don't know, five to ten or maybe even last five years. So they're doing UV ratings on clothes. So I think this is also helpful, you know, for people who are out there all day. You can get, you know, like, they call them the rash guards or whatever those, like, long sleeve, you know, swimming suits or even shirts or whatever. So that's been something that's been a little bit newer.

They are working on some, just to kinda touch on it a little bit, some oral-type stuff that can help protect your skin from the sun. So that's a little more of the... I'd say a little more cutting edge. That's some stuff that's coming out that they're working on. I don't know. I mean, it'd be great if we had an oral sunscreen. You know, if you could take 2 pills in the morning and be protected all day. I mean, I don't think anybody would be mad about that. You know what I mean?

So that being said, I don't know if we would ever get there, but also there's a lot of things going on now that people thought would never be here. So, but there are some supplements that they are working on, and even some out there that are saying can help protect your skin from the sun.

So I think it's all good. You know? It's all going in the right direction. Those are some of the newer things I would say that are out there in terms of UV protection, so.

Melissa: Thank you. That's really cool.

Dr. Albertson: Yeah, no. It's cool. Yeah. It's good stuff. Yeah.

Emma: Could you please tell us about UV index ratings and how people can use them to plan for their outdoor activities?

Dr. Albertson: Okay, perfect. Yep. So the UV index is sort of on the newer side of things.

So this is basically an international standard measurement of the strength of the sunburn-producing UV radiation. So it goes basically from 0 to 11+, depending on which scale you look at. So 0, obviously: nothing. So this is nighttime. You know, probably, there's no UV radiation going on specifically.

And then all the way up to 11+, sometimes 12, but usually it just caps out around 11 or 12 from what I've seen. So basically, if you pull up your app on your phone, or you can look it up on the Internet— so this is based on basically every area. So every city on a particular day will have a UV index, you know, the UV rating for the day, and it'll change throughout the day. So, like, if you look at it at 8 AM, it's probably gonna be 0 or 1 depending on where you're at.

As you watch it throughout the day at noon, it's gonna be at its highest, you know, noon or 1 PM when the sun is straight up in the sky. And so at 3 and above is when we recommend having protection on. I will tell you that's probably gonna be most of the day. So, like, if you watch it around 10 AM, usually, a lot of times in this area, it'll pop up to 3 or around 4 or 5 depending on the day, how hot it is, or what's going on. It'll probably still be around 3.

So, basically, you have 3 and above you wanna have protection on. It's been a good tool. I've used it a lot. You know? I think it is helpful to know kinda where you're at because it might be 8 or 9 around noon, and that's high, you know? I mean, that means you're gonna burn pretty quickly. So, basically, it's from a 3 to a 6, it's kinda like double, right? You're twice as likely— you're gonna burn in, like, half the amount of time, you know, so it kinda goes up that way. Like a 6 to a 12. You know what I mean? You're gonna burn really easily. So I think it is a good tool to have.

It's basically on all your weather apps. If you pull it up, you can find a UV index. And I think it has been a really helpful tool to kind of see, well, where are we at? You know, you like, pull it up and it's 9 or 10, you're like, well, we need to be a little more careful. So, yeah, it's a good tool that's out there and I'm a big fan of it.

Melissa: Are there any questions or topics we didn't bring up that you would like to talk about?

Dr. Albertson: You know, I think we pretty well—we covered it all. I don't— I can't think of anything, you know, outside of what we've gone over, just being aware. I think that's, you know, I think you guys are doing a great thing by even just doing the podcast and maybe nobody listens or maybe a lot of people listen or maybe one person listens and they change what they're doing. And, you know, like, for me, that's still very significant.

If it's just one person makes a change based on our discussion today, then I think it would have been a success. I think maybe even us three probably maybe got some benefit. I think about myself, you know, and my kids and things I need to do better when we start talking about it. So I think if nothing else, you know, we— somebody's gonna maybe make a little change for the better, you know, on protection from UV.

What I would say is, I mean, don't be afraid to go outside. I don't want anybody to live a life inside. I grew up outside: hunting, fishing, camping, rodeoing, whatever it might be. Like, all of my activities that I want to do are outside. So I don't advocate for anybody to live a life inside just because they're scared of going out. Like, just figure out a way to do it safely and in moderation.

And, you know, I mean, it happens to everybody. Right? Something happens, you end up getting a little more sun than maybe you anticipated. I mean, even dermatologists, you know, have this where they end up... And maybe you didn't get as much sunscreen on as you should have or whatever, and you got a little sun. But, I mean, just do better next time.

You know what I mean? Don't run away from it because it gives life to the earth and makes us feel better. But you just have to— like anything else, you just have to understand it and figure out how to live with it like you were kind of saying, and you'll be fine. Don't be afraid of it. You know?

Don't be afraid of going outside. So just do your best to do a little protection.

Emma: Thank you. I was going to say I've been changed because I... just most of the time, I just clean forget to wear sunblock. So now I'm like, oh, yeah. That sounds like a good idea, so.

Melissa: Definitely.

Dr. Albertson: Perfect.

Melissa: Thank you so much for coming in today and sharing your knowledge and your time with us.

Dr. Albertson: Yep. No, thanks for having me coming in. I appreciate the invite. And, yeah. Happy to do it. And hopefully, we can all learn a little something together. So I appreciate it.

Emma: If you enjoyed today's episode, please remember to share, subscribe, and rate the Riverbend Awareness Project.

Melissa: If you'd like to send us an email, you can reach us via podcast at riverbendmediagroup.com. Thanks for listening, and join us next time on the Riverbend Awareness Project.