Dr. Kevin Welch is a board-certified dermatologist who offers a variety of cosmetic dermatological services at the Welch Skin Care Center at the Medical Center Clinic. Though he specializes in treating cosmetic issues (like premature wrinkling and hyperpigmentation), Welch also sees patients and screens for skin cancer as part of his work.
IN: Does SPF 100 really protect better than SPF 50? Is there a certain number at which the SPF factor doesn’t really matter?
WELCH: Anything higher than SPF 30 probably provides very little incremental benefit. Certainly SPF 30 is better than SPF 15, which is better than SPF 8, et cetera, but above SPF 30 the benefit is small. Instead of worrying about getting SPF 1000, folks should apply an adequate amount of sunscreen (always more than you think) and reapply often.
IN: Is sitting under an umbrella or wearing sheer fabrics adequate sun protection for a day on the beach, or is sunscreen still necessary?
WELCH: Wearing clothing, even sheer fabrics, is helpful in sun protection. However, those wearing sheer fabrics still require sunscreen to afford adequate protection. Umbrellas are certainly helpful, but there is a tremendous amount of indirect and reflected light. Sunscreen is absolutely needed, even under an umbrella.
IN: How high does skin cancer rank as a cause of death among women? Does it occur more frequently in women than men?
WELCH: Skin cancer deaths are mostly attributable to metastatic melanoma. It is the fastest increasing cancer in the United States. More than 7,500 deaths per year are due to melanoma. Men and women are roughly equivalent. It is the sixth leading cause of cancer death for men and seventh for women. However, it is the second most common cause of cancer death for women ages 20 to 35, and the leading cause for women ages 25 to 30.
IN: How dangerous are tanning beds when it comes to skin cancer? How does their use contribute (or not) to the development of skin cancer?
WELCH: Tanning beds have been shown to significantly increase the risk of skin cancers, including basal cell carcinoma, squamous cell carcinoma and melanoma. The UV rays from tanning beds penetrate deep into the dermis of the skin, causing damage to all layers. If the cancer risk does not scare you, tanning beds use exactly the type of UV most linked to making the skin look old and saggy.
IN: For those who get gel manicures and sit under the drying lamps that are popular now, is ultraviolet radiation from the lamps a concern?
WELCH: UV exposure from manicures is negligible. A recent report in the April 2014 Journal of the American Medical Association found little risk. If a client is worried, sunscreen can be applied to the exposed skin. Alternatively, cotton gloves with the tips cut out could be utilized.
IN: Some sources say to avoid being outdoors between 10 a.m. and 2 p.m. to avoid the strongest UV rays of the day; others say 10 a.m. to 4 p.m. What’s your guidance as far as times to minimize exposure?
WELCH: The exact time to avoid or limit direct sun exposure is somewhat of a common sense issue. I think the beach is most beautiful at midnight, and you can expose as much of your skin as you would like. Mid-day sun is obviously more damaging than sun exposure in early morning or late afternoon—I like the 10 a.m. to 4 p.m. parameters.
IN: Does skin tone really have anything to do with the likelihood of developing skin cancer?
WELCH: Fair-skinned, blue-eyed people are at a higher risk of all skin cancers, including melanoma, squamous cell carcinoma and basal cell carcinoma. Melanin in the skin protects against the damaging effects of UV radiation (sunlight). Light-skinned people have less pigment, so less protection.
Dr. Kevin Welch
Medical Center Clinic Welch Skin Care Center
8333 N. Davis Highway