Staying Safe in the Sun

Throughout a lot of childhoods, kids were encouraged to play outside during summer. While the reasons are all good — fun, exercise, fresh air — all that time in the sun can take a toll on skin, and problems might pop up several years later.

Dr. Megan Neill, a board-certified dermatologist at Strother Dermatology in Kirkland, spent her childhood summers under the blazing hot sun in Texas.

Neill was a fourth-year medical student with plans to go into radiology when a small dark spot on her hand caught her eye. It took four months to get an appointment with a dermatologist. After having her concerns dismissed by a couple of doctors, Neill fought for a biopsy with one, and 10 days later learned she had a melanoma with several aggressive prognostic features.

“I decided that dermatology needed someone like me, and I completely switched career paths. I continuously strive to practice the way I wish I had been treated,” Neill said.

We reached out to Neill to learn more about what precautions people should take to take care of their skin.

Courtesy of Strother Dermatology

What are some common misconceptions/myths about sunscreen?

I think the biggest issue I encounter is that patients tend not to reapply as often as needed. Sunscreen needs to be applied 20-30 minutes prior to going outside and reapplied every two hours.

What sunscreen should you choose?

There is a lot of controversy surrounding sunscreen use, specifically the chemical ingredients that allow for broader protection, so I personally stick with mineral (zinc or titanium) products labeled as “broad spectrum.”

In addition to sunscreen, what are other ways people can keep safe from sun damage?

I am a huge proponent of sun-protective clothing, which includes wide-brimmed hats, sun shirts, and pants. This limits the exposed body surface area significantly and minimizes the need for sunscreen. It is also beneficial to limit exposure during the midday hours, when the UV radiation is strongest. Also remember to apply sunscreen to the back of the neck, ears, and lower face.

What do you wish people knew about skin cancer?

There are different types of skin cancers. The most common ones are squamous cell and basal cell, and these often present as rough, raised areas, or pimple-like bumps or sores that don’t heal. Melanoma is more difficult and doesn’t always follow the textbook descriptions. Most commonly, it develops as a new pigmented lesion; it will grow and change over time, but there is a rare variant that is not pigmented. Many are familiar with the ABCDEs (Asymmetry, Border, Color Variegation, Diameter, and Evolution). The “C” and “E” have remained the most important indicators, in my experience. And of great importance is the “ugly duckling sign,” which is a mole that doesn’t fit with a patient’s typical mole pattern.

When looking for a dermatologist, what should people be looking for?

As with any health care provider, realize that we’re all humans with distinct personalities and approaches to our jobs. Find one who really listens to and respects your concerns. As with any healthcare provider, realize that we are all humans with distinct personalities and approaches to our jobs. You must find one who really listens to and respects your concerns.

Dr. Neill’s Favorite Skin Care Products

AN A.M. ANTIOXIDANT: I currently use CE Ferulic by Skinceuticals.

DAILY SUNSCREEN: Sunbetter sheer mineral sunscreen lotion on workdays, or my Zinka stick when hiking/camping.

A TOPICAL RETINOID AT BEDTIME: I use prescription Tretinoin. However, there are over-the-counter options that tend to be less irritating, such as skinbetter AlphaRet. I use plain Vaseline as a nightly moisturizer (too gross and greasy for most), so I often recommend CeraVe cream.

I am always covered head-to-toe in my sun-protective clothing. I like Koofin Gear fishing shirts, or Coolibar sun shirts and Mountain Hardware hiking pants.

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