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Sunscreen: the spots you miss

With summer in full swing, many of us will slap on some sunscreen to protect our skin from harmful UV rays. But what about the areas which are commonly missed? And does it matter if you don’t get to the back of your ears? Here are some tops from Dr Anjali Mahto, consultant dermatologist and spokesperson of the British Skin Foundation.

The sun’s rays can damage the eyes and surrounding skin over time. The skin of the upper and lower eyelids is thin and fragile, requiring protection. Eyelid cancers account for about 5-10% of all skin cancers and occur most frequently on the lower eyelid. The best defence against this is to wear sunglasses that offer adequate protection against UVA and UVB which cover as much skin as possible.

Back of knees:
The legs are the commonest anatomical site for melanoma in females. It is important to reapply sunscreen regularly to achieve the SPF on the bottle, particularly if you are in and out of the water or sweating excessively.

The ears are a high-risk area, particularly for non-melanoma skin cancers such as basal cell carcinoma and squamous cell carcinoma. These occur as a result of UV exposure from sunlight. Skin cancer on the ears is commoner in men than women. The ears are the third most common place on the body to develop basal cell carcinomas.

Tops of feet; sides of face; hands; underarms:
The same principles apply for all these areas of the body. Any areas of skin that are exposed to UV sunlight should ideally be protected by sunscreen. This should be broad spectrum, containing UVA and UVB protection, with an SPF of at least 30. Try not to miss any areas and leave your skin vulnerable to sunburn.

Scalp & hair:
Skin cancers can develop on the scalp. Men, with reduced or thinning scalp hair may be particularly vulnerable to sun damage in this area and should ideally wear a hat. For women, ensure that sunscreen is applied adequately to the margin of the hairline.

The lips are often an overlooked site for non-melanoma skin cancer. These most commonly affect men over the age of 50 years with fair skin types. The lower lip tends to get more sunlight than the upper lip, and is therefore more likely to be affected by skin cancer. Don’t forget to use a photoprotective lip block or lip balm to block UV rays.

The V (chest):
Dermatologists advise that sunscreens should be applied at least 30 minutes before going outdoors and then regularly reapplied every 2 hours. One way to avoid missing areas may be to apply sunscreen before getting dressed.

· Ensuring you get the right sunscreen for your skin type; many are greasy and unsuitable for oily or acne prone skin which require lighter formulations.

· Those with olive or pigmented skin often think they don’t need sunscreen. Skin of colour is also sensitive to damage caused by UV and requires protection.

· Not using enough sunscreen – the average-sized adult should apply more than half a teaspoon of sunscreen (about 3ml) to each arm and the face/neck, and just over one teaspoon (6ml) to each leg, the front of the body and the back of the body. Use about a quarter of a teaspoon for the face.

· Incorrect layering of products on the face – moisturise first, then apply sunscreen afterwards followed by make-up if you choose.

· Check expiry dates as sunscreens lose their potency over time.

It’s safe to go out in the sun when wearing sunscreen. When choosing a sunscreen look for a high protection SPF (SPF 30 or more) to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA. Ensure you apply plenty of sunscreen 15 to 30 minutes before going out in the sun, and reapply every two hours and straight after swimming and towel-drying.
Protect your skin with clothing, and don’t forget to wear a hat that protects your face, neck and ears. Make sure you spend time in the shade between 11am and 3pm when it’s sunny. Always keep babies and young children out of direct sunlight.

Dr Anjali Mahto
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