Podcast: An Expert’s Guide to Healthy Summer Skin

Dr. Victoria Perez: Sunburns can actually double your risk of skin cancer. Only about 11% of people are wearing sunscreen every day. It is the personal mission of every dermatologist to change those numbers.

Courtney: Welcome to Health Matters, your weekly dose of the latest in health and wellness from NewYork-Presbyterian. I’m Courtney Allison.

Whether you’re hitting the beach or hiking the trails, summer is a great time to enjoy the outdoors. It’s also an important time to protect our skin. This week, I’m joined by Dr. Victoria Perez, a dermatologist at Columbia and NewYork-Presbyterian The One, a new center for advanced care in Westchester. From the best sunscreen to use, to how to treat bug bites, and when to see a doctor for poison ivy—we discuss everything about summer skin health.

Courtney: Hello, Dr. Perez. Welcome to Health Matters.

Dr. Victoria Perez: Pleased to be here.

Courtney: We’re so excited to talk to you today about how to keep our skin healthy, especially since during the summer months we may be more exposed to sun and bug bites. What are the types of conditions you most often treat in the summer?

Dr. Victoria Perez: You know, in the summer sometimes we can see folks spending a little bit more time outdoors. It’s a good time to take precautions when in the sun. So, using your sunscreen daily. Skin cancer is actually one of the most common malignancies in the United States. About one in five Americans will actually develop skin cancer during their lifetime.

Using sunscreen on a daily basis can actually reduce the risk of skin cancer by 50%. And that’s just a huge, huge, huge number.

Courtney: Do you have any advice to help people prioritize it?

Dr. Victoria Perez: Absolutely. So I think in terms of routine building, just those really small little steps that you take every day to start making it a habit. So maybe leaving your sunscreen right next to your toothbrush, making that part of your morning, you rinse off your face, you brush your teeth, and then you put on your sunscreen.

So I think small changes like that, leaving your sunscreen out. You know, finding a sunscreen that you like and will use. We so often get asked about recommendations for sunscreen and I will, by far, say the sunscreen that you wear is the one that you should get. And so if there’s a certain brand or a certain combination that you really enjoy and the way that it feels on your skin, I would say that would be the one to do. Because only about 11% of people are wearing sunscreen every day. It is the personal mission of every dermatologist to change those numbers.

Courtney: Right, absolutely.

Dr. Victoria Perez: Sunburns can actually double your risk of skin cancer. And then, additionally, a lot of the aging concerns that folks come in with, 90% of those concerns are probably sun related. And so not only are you protecting your skin health in terms of preventing skin cancer, but you can also contain that lovely glow without the sun.

Courtney: I like that. And I’m actually really surprised about those numbers you mentioned, so I see why it’s so important to get the message out for sunscreen. You said that the sunscreen that you should choose is the one that you’ll wear, but are there any ingredients you should look for?

Dr. Victoria Perez: So I like to think about a physical as more like a block and a chemical sunscreen as more of like a sponge you’re absorbing versus a block you’re shielding against. An example of what would be a, you know, a mineral would be like a zinc oxide versus a chemical, which would be like an avobenzone. But those are just two examples of types of both chemical and mineral sunscreens and it’s really up to the patient to decide which is their preference.

They both work and so, as long as you’re getting good coverage in terms of broad spectrum, it’s really a patient preference.

If you’re using a chemical sunscreen, you’re gonna have to wait about 15 minutes before it activates. And so making sure you have enough time before you’re actually in the sun. So that’s why it’s even more important to put it on when you’re brushing your teeth or it’s part of the morning routine. And then if you’re going to be out and about, making sure that you reapply throughout the day, I think that’s also super important.

Things to keep in mind would be like, are you using it for the face or the body? Do you need it to be water resistant? Are you gonna be in the water? You know, if you have a particular skin concern. Some folks with rosacea or acne may have some other skin issues that they want to make sure that’s compatible with the sunscreen that they’re using. And then tinted versus untinted.

I like to mention that all skin types should be wearing sunscreen. So, darker skin is in fact more prone to hyperpigmentation induced by UVA invisible light. And so for our darker skin patients, we often will advise actually using a tinted sunscreen containing pigments. All skin types should be wearing sunscreen.

Courtney: This might sound silly, but what exactly is a sunburn?

Dr. Victoria Perez: There are a lot of sun-related injuries and sunburn falls within that category. When the sun gets that top layer of the epidermis, you can cause injury and that’s where you get that sunburn.

Sunburn oftentimes is very uncomfortable and patients will ask, how can I treat it? Something to help cool the skin is our go-to. Sometimes you can use aloe, cold compresses, things like that. Really staying out of the sun. Usually if you’ve had sunburn, it means you’ve been in the sun a little bit too long. And so that goes with being dehydrated. And again, prevention is the best medicine. So we’re gonna always be saying, you know, use your SPF, use your Sun Protective clothing. If you do unfortunately blister, try to not pop those blisters. Of course, if there’s a very large blister, then seek some medical attention.

Courtney: And what about a heat rash? What’s a heat rash and how common is it for kids and adults?

Dr. Victoria Perez: I would say that it’s definitely something that we see often in kids, but by no means is exclusive to children. Anytime there’s friction or heat in an area, you can definitely, it can definitely need to lead to rash. And again, that’s just gonna be secondary to some irritation to the skin. It comes and goes. So it’s not gonna stick around too long. So as soon as you kind of cool down a little bit and again, you want to just keep the skin cool and dry to prevent further irritation from what’s oftentimes sweat. Cooling measures, baths and showers, using fans and air conditionings, again, trying to avoid excess sweating, wearing loose, breathable clothing. I think those are all, you know, very helpful when you have this heat rash.

Courtney: What are some other things that you treat most often in the summer?

Dr. Victoria Perez: A very common complaint that comes in is poison ivy, which is where you get this irritation to the skin from an oil from the plant. And it sometimes can be taken care of at home. And so if it’s mild, meaning that you’re not having any overly skin blistering, you notice that it’s a little bit red and itchy, but it’s very localized, you may be able to take care of that at home with some over-the-counter hydrocortisone.

But there are some times when you need to go see the dermatologist and when you saw if it’s kind of, spreading, if it’s starting to get blisters or weepy or looks wet, those are all signs that it’s time to go see the dermatologist because you may need something either topically a little bit stronger or even an oral medication to help with some of that inflammation.

Courtney: Is the most important thing to do if you suspect that you’ve hit some poison ivy, do you wash it with soap and water?

Dr. Victoria Perez: First and foremost, yeah, definitely want to get the soap and water out.

But prevention is probably the most important. So making sure you’re wearing protective clothing when you’re out and about. And if you think you may be in a place that has poison ivy, so if you’re gonna be gardening, wearing long sleeves, wearing gloves, if you’re gonna be hiking, making sure you have the high socks on. You know, prevention is the best medicine.

But If you think you have a known or a suspected exposure, it’s so, so, so important to clean the skin as soon as possible. Because by 30 minutes up to 75% of the resin is absorbed, and then at, in about an hour, basically it’s all absorbed. So the faster you can kind of clean it off the more that’s gonna help your skin.

So once the oil has been washed off, there isn’t any risk of spreading it to other parts of the body. That being said, you don’t only want to wash your skin, you want to wash all of your garments. Putting those right into the wash and that will also help prevent it from spreading to any pets ‘cause they can also carry it on their coats. If everybody was on the hike together, you might want, it might be bath time for everyone including our little furry friends.

So the other thing, you know, would be a reason to visit the dermatologist, if you suspect there might be some super lying or secondary infection. So if anything looks yellow or crusted, always a good time to see your dermatologist.

Courtney: Another skin condition that comes to mind when I think about summer is bug bites.

Dr. Victoria Perez: So, if you know, you have a really robust reaction when you do get a mosquito or a bug bite, then it’s even more in your favor to try to protect yourself from even getting that bug bite by using protective clothing, using, you know, bug sprays, things like that. If you know you’re going to be in an area that may have some increased risks. But even, despite our best efforts, we can get bit and again, initially the soap and water is a great idea.

We as dermatologists are very comfortable using different kinds and types of anti-inflammatory and also an anti-itch medication that we can prescribe to patients. But you can also purchase it over the counter as a hydrocortisone and, you know, if you’re having an itch, using a cream to help with that itch is always better than scratching.

Courtney: Yeah.

Dr. Victoria Perez: Scratching starts a very, very tough itch scratch cycle. Once, like, that cycle starts, it’s really hard to break. And so doing our best to try to stop the cycle before it starts either by using a cold compress, by using medicated ointments or creams, doing our best to keep the area covered. Anything that we can do, because of that itch scratch cycle, and then also just to prevent, again, that secondary infection.

Courtney: So how can someone tell if they’re dealing with a bug bite or some other kind of contact rash?

Dr. Victoria Perez: That’s a good question. If it’s a bug bite, it tends to be a little bit more localized, you may see, kind of, like a central mark, a punctum — the crime scene where it all happened — and then some surrounding redness and swelling. But again, you know, redness can look a lot different in different skin colors, so it can be a little bit more subtle and darker skin types.

Courtney: And so for something like a bee or a wasp sting, what can you do at home if that happens?

Dr. Victoria Perez: So, I think, again, washing with soap and water. You know, keeping the area clean. And sometimes a bee may have a stinger, so if there’s a stinger still there, you want to make sure you remove it and then wash the area with soap and water. Using a cold compress, that’s always a good idea to kind of help reduce pain or swelling. And again, if you’re having more itching, we have our over-the-counter topical corticosteroids or even oral antihistamines to help with that.

Courtney: Which bug bites or stings are just annoying or which should we actually try to prevent or be nervous about? Like whether it’s horse flies being worse than bees or wasps. So anything you want to elaborate on, on that?

Dr. Victoria Perez: People can have allergies to bee stings. And so if you have swelling anywhere else other than the site. So if you have any difficulty breathing, shortness of breath, lip swelling, throat swelling, eye swelling around the eye, any tongue swelling, difficulty swallowing, those are all do not pass go, do not collect 200, go straight to the emergency room. And so that’s more signs of systemic type of reaction that you may be having and not a localized type.

Courtney: Thank you so much. This is all so helpful. I feel so much more prepared for summer.

Dr. Victoria Perez: Yeah, absolutely. I’m happy to help.

Courtney: Our many thanks to Dr. Victoria Perez. I’m Courtney Allison.

Health Matters is a production of NewYork-Presbyterian.

The views shared on this podcast solely reflect the expertise and experience of our guests. To learn more about the care we provide at NewYork-Presbyterian The One, a new center for advanced care in Westchester, and how to make an appointment check out the show notes.

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