The Australian Sun: Vital Tips for Skin Care and Sunscreen Knowledge Throughout the Year

As a General Practitioner based in Australia, most of my conversations with patients centre on a mole or spot on their skin. Then we discuss the patient's exposure to the Australian Sun and weather, taking into account the local climate. The place is impressive and genuinely one of the nicest parts of the world, but there is always a downside. Australia is known for having some of the highest levels of UV (Ultraviolet) radiation in the atmosphere.

During our childhood, many of us were raised with the mantra "Slip, Slop, Slap"; however, the message has changed today. It's not a last-ditch effort only when a heatwave strikes in January. In almost every corner of Australia, it is essential to protect yourself from the sun's rays, which can contribute to skin damage over time.

Sunscreen plays an important role in sun protection throughout the year

Many people believe that if the day is not hot, there is little chance of sunburn. This idea is totally wrong. The heat we feel is caused by infrared radiation, whereas skin damage results from UV radiation. UV radiation is invisible and cannot be felt.

In Australia, UV rays may still reach the skin and contribute to sun exposure even on cold or cloudy days.

What Are UVA and UVB?

To shield ourselves effectively, we must comprehend the enemy:

• UVA (aging). These rays penetrate deeply into the dermis, causing premature skin aging and wrinkles. They are also responsible for the long-term harmful effects on the skin. Additionally, they can pass through glass (such as car windows).
• UVB (burning) rays, which cause the red, painful, and inflamed skin of sunburn, are a significant factor in skin cancer development.

Both UVA and UVB exposure have been associated with an increased risk of skin cancer. For this reason, broad-spectrum sunscreen is generally recommended as a "Broad Spectrum" sunscreen since it protects you against both UVA and UVB rays.

The UV Index

I always advise my patients to check the UV Index daily, as it helps them choose appropriate clothing. They can get the UV index information by downloading the Bureau of Meteorology (BOM) app.

• A UV Index of 3 or higher: It is imperative to take sun protection measures. This level is achieved almost every day of the year in most of Australia.
• UV Index is less than 3: There is usually no need to take sun safety measures unless you work most of the time outdoors or are in areas with highly reflective surfaces, such as snow or water.

Research shows that one way to help reduce long-term skin changes associated with sun exposure is to get regular sun protection.

Looking for the Perfect Sunscreen that Fits Your Skin Needs

When we enter any personal care aisle, we are confronted with numerous products. There are gel bunches, cream packs, spray containers, and stick tubes. What is really the finest one? My simple advice as a GP is: the "best" sunscreen is the one that you are most determined to use correctly and consistently.

Nevertheless, here are a few tips to help you select one that meets your skin needs.

Recommendations by Skin Type

• Oily or Acne Prone Skin: Select sunscreens that contain 'non-comedogenic ' ingredients. Typically, these products are lighter in texture, often gel-based, and formulated to prevent pore clogging. This approach may suit people who are mindful of both sun protection and skin sensitivity.
• Dry Skin: Cream & milk-type sunblocks that contain moisturisers (e.g., aloe or vitamin E) are beneficial for Skin Barrier Health.
• Sensitive Skin: Sun protection products which are "physical" or "mineral" in nature, such as those which use zinc oxide and/or titanium dioxide, are characterised by these ingredients sitting on top of the skin, which sit on the skin surface and help reduce UV exposure, where chemical filters would typically cause more irritation.

Handling Photo Sensitivity and Sunlight Exposure

Many people experience sunburn after prolonged sun exposure, and it can also cause rashes, itching, or skin irritation. Photosensitivity is one of such situations.

Ways to Avoid "Sun Rash"

Polymorphic light eruption is the most common cause of redness and itching that may begin after only 5 minutes outdoors or after sun exposure in individuals with very sensitive skin.

• Cover Up: When it comes to sun-related skin problems, the first line of defence is clothing. It can be a physical UV barrier if long sleeves, high collars, and tightly woven fabric are used.
• Patch Test: Before using a new facial sunscreen, apply a drop to a small area of your inner arm and test for a couple of days.
• Check Your Meds: Some medications, such as certain antibiotics and acne products, may increase your skin's susceptibility to sunburn. Therefore, you should check with your doctor whether this applies to you.

Since sun exposure may aggravate eczema or dermatitis symptoms in some individuals, it is better to stay covered and cool to avoid them.

Step-by-Step Guide on Sunscreen Application

One of the primary reasons people get sunburn is insufficient sunscreen application. Recent surveys have revealed that most Australians apply only half of the required amount.

The "Teaspoon Rule"

The person needs to apply a thick layer of sunscreen to get the claimed SPF 50+ protection. We suggest following the 'Teaspoon Rule' for simplicity:

• 1 teaspoon for the face and neck.
• 1 teaspoon for each limb (arms and legs).
• 1 teaspoon for the front of the torso.
• 1 teaspoon for the back.
• Typically, seven teaspoons (35ml) are used for the entire body.

Apply well in Advance.

Sunscreen will not immediately protect you if you apply it and then go outdoors instantly. In fact, sunscreen needs time to bind properly to the skin to provide effective coverage. Therefore, you should apply sunscreen at least 20 minutes before going outside or being exposed to the sun. If you only put on sunscreen when you get to the beach, the 20-minute sun exposure will have already occurred by the time your skin is fully protected.

Tips for Reapplying Sunscreen During the Day

If you apply sunscreen once and then neglect it, it will not keep your skin protected. Additionally, it degrades over time, is wiped off by clothing, and is removed by water.

Two-hour rule

Dermatology experts recommend reapplying sunscreen every 2 hours, regardless of any label claiming 4 hours of water resistance.

• Swimming/Sweating:
• Sport:

Some outdoor activities tips

Going out for the entire day? Just set a timer on your phone. When you're totally absorbed in having fun, it's so easy to lose track of time.

• Don't forget the ears, sides of the neck, tops of the feet, and lips, as these are common areas often overlooked and are commonly exposed areas that are often overlooked.
• Do you have hay fever when you go outside? Check the sunscreen label for the "hypoallergenic" claim by running your finger over it. A hypoallergenic sunscreen can be used if you want to avoid skin irritation. You can find more information in our Outdoor Allergy Tips.

Supporting Your Skin Health Beyond Sunscreen

Sunscreen is one way to implement a sun safety plan. In addition to sunscreen, the Cancer Council recommends five sun protection measures: Slip, Slop, Slap, Seek, and Slide.

1. Protective Clothing (Slip)

Clothing is the most dependable physical barrier. Look for clothes made of fabric with a 50+ UPF (Ultraviolet Protection Factor) rating. Usually, darker colours and fabrics with a tighter weave provide better protection than lighter, looser ones.

2. Hats and Sunglasses (Slap and Slide)

A broad-brimmed hat can provide good protection to the face, neck, and ears from the sun's rays. A baseball cap, on the other hand, not only exposes the neck but also the ears, which are the most vulnerable part of the body to skin cancer. Sunglasses should be certified to Australian Standards (AS/NZS 1067), support the skin barrier after sun exposure.

3. Seek Shade

Avoid direct exposure to sunlight during the middle of the day, i.e., from around 11 am to 3 pm, when UV levels are at their highest.

Unscrewing Your Concern about the Skin through Professional Help

Being aware of your skin condition is recommended for all Australians. Make it a regular habit to scan your skin for any new spots or changes in your freckles or moles.

The ABCDE Rule

A quick method that can be used to distinguish between normal and suspicious moles is by applying the ABCDEs:

• A (asymmetry): Half of a normal mole is basically the same as the other half. this pattern may be seen in some melanomas, which can have one half quite different from the other.
• B (border): The borders of a melanoma are usually not sharp and are often very irregular.
• C (colour): In most cases, you will find a variety of colours in one single mole in the case of melanomas.
• D (diameter): A mole with a suspicious appearance likely has a maximum diameter of more than 6mm; however, some very small melanomas exist.
• E (evolving): If your mole keeps on changing its size, shape or colour, then you should be concerned.

If you notice any of these signs or if a sore on your skin is not healing, see your doctor as soon as possible.

You can obtain an initial assessment from a GP via telehealth consultations, and, if necessary, the GP will help you refer you to a dermatologist. Specific procedures, such as biopsies, cannot be performed via video call. Nevertheless, the problem can be assessed, and the next step in the patient journey clarified.

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References:

• Cancer Council Australia. (2024). Sun Safety.
• Healthdirect Australia. (2023). Sun safety and sun protection.