3D Animations of Skin Procedures

Botulinum Toxin

Introduction

Botulinum toxin type A injections are one of the most popular minimally-invasive cosmetic procedures performed to treat facial lines and wrinkles, called frown lines, on the forehead. Botulinum toxin is produced by the bacterium clostridium botulinum, which is normally responsible for causing the illness known as botulism. However, in small doses, botulinum toxin type A can be used safely to reduce the appearance of facial lines and wrinkles. The toxin is purified and the formulations are marketed by different companies with names such as onabotulinumtoxin A and abobotulinumtoxin A, etc. In this animation, they will all be referred to generically as botulinum toxin type A. With little downtime and almost immediate results, botulinum toxin type A can help you restore a smoother, more youthful appearance to the face.

Anatomy

Two sets of muscles, called the corrugators and procerus muscles, lie beneath the skin between your eyebrows. These muscles allow you to squint and to furrow your brow when you frown. Contracting these muscles causes vertical frown lines, called glabellar lines, to appear.

How Frown Lines Form

In addition to factors such as age, sun exposure, and heredity, one of the primary causes of facial lines and wrinkles is repetitive muscle contraction. Nerves release neurotransmitters, which are chemicals that send signals, or impulses to other nerves, muscles, or the brain. Nerve impulses are what trigger muscles to contract or move. Under normal conditions, a neurotransmitter known as acetylcholine is released by nerve cells. The acetylcholine is encased in fluid-filled sacs that bind to the nerve cell membranes. Once bound, the acetylcholine is released and transmits a signal to the muscle, causing it to contract. When this happens in the muscles between your eyebrows, you squint and frown lines are formed. Repeated muscle contraction over many years may cause deep facial lines and wrinkles to form on the skin overlying the muscles.

How Botulinum Toxin Prevents Frown Lines

When botulinum toxin type A is injected into the treatment area, the toxin enters nerve cells and splits a special protein along the nerve membrane that is necessary for the sacs containing acetylcholine to bind properly. As a result, acetylcholine cannot bind to the nerve membrane and is not released. Without the release of acetylcholine, facial muscles have such a greatly reduced ability to contract that any motion they do have is not noticeable. Consequently, the brow region has a smooth, less wrinkled appearance.

Procedure

Based on your pain sensitivity, your physician may apply a topical anesthetic prior to the procedure to keep you comfortable, however, this is often unnecessary. Before administering the injections, your physician will ask you to contract your facial muscles in the desired treatment area in order to determine precise injection sites. Using an ultra-fine needle, your physician will inject small amounts of botulinum toxin type A into the facial muscles along the treatment areas. If an anesthetic has not been administered, you may feel a slight stinging or burning sensation during the procedure. The entire procedure typically takes about 10 minutes.

Recovery

Your physician may advise precautions or restrict strenuous activity for a couple hours after your procedure to lessen your bruising risk, but most normal activities can be resumed immediately. You may notice some redness, minor swelling or bruising, or numbness around the injection sites. However, these and other symptoms are generally minor and should resolve within a few days following the procedure. Although rare, botulinum toxin may spread from an injection site to other areas of the body and cause side-effects, and it may not be appropriate for all patients. When administered correctly, botulinum toxin type A is considered safe for use. Talk to your caregiver or visit the website of the US FDA or your country’s regulatory agency for more information.

Results

After your procedure, it may take a week before you notice results. As the muscles in the treatment area are limited in their ability to contract, the appearance of facial lines and wrinkles will decrease. The results from a single procedure last approximately three to four months, after which you can receive subsequent injections to maintain the desired results. Although the results are temporary, botulinum toxin type A can safely and effectively help to restore the smooth, youthful, and well-rested appearance you desire.

Hyaluronic Acid Injection

Introduction

Injectable fillers are one of the most popular facial rejuvenation techniques. As we age, the underlying tissues that keep our skin looking youthful and firm begin to break down due to the effects of gravity, sun exposure, diet, genetic factors, and years of facial muscle movement. Over time these factors contribute to the development of lines, wrinkles, and folds in the face.

Where Do Wrinkles Form?

Your skin consists of two layers known as the epidermis and the dermis. The epidermis, or outer layer of the skin, acts as the skin’s primary defense against the environment. The dermis, or innermost layer of the skin, is composed primarily of connective tissue and provides the skin with a support network. Most facial wrinkles and deeper folds occur within the dermal layer of the skin.

What Causes Wrinkles?

Within the connective tissue of the dermis, collagen and elastin fibers form a network that provides the skin with structure, support, and elasticity. Furthermore, fat cells and other molecules, such as hyaluronic acid, help to create volume beneath facial skin. With time, this network of collagen and elastin fibers breaks down, and hyaluronic acid molecules and fat cells that create volume are depleted. Together, breakdown and depletion of these molecules result in wrinkles and other changes to facial skin. When used as standalone treatments or with other procedures, injectable fillers can reduce or eliminate wrinkles and scars, create fuller lips, and treat lipoatrophy, or fat loss beneath the skin. With little downtime and almost immediate results, injectable fillers offer a safe, effective method of restoring a smoother, more youthful appearance.

The Basics of Hyaluronic Acid Fillers

Hyaluronic acid is a naturally occurring complex sugar molecule that forms large matrices in the connective tissue of the body, such as skin and cartilage. Much like a sponge, its primary function is to bind and absorb water molecules, which creates volume in the face. Hyaluronic acid fillers are generally used to treat facial wrinkles and folds and to enhance the appearance of the lips. One of the fastest growing dermal filler treatments available, hyaluronic acid fillers work by replacing the hyaluronic acid in the body that has depleted over time, which restores the volume beneath the skin’s surface.

Types of Hyaluronic Acid Fillers

While there are a variety of hyaluronic acid fillers, some of the most common are Hylaform^®, Restylane^®, and Juvederm^®. Hylaform^®, marketed by INAMED Aesthetics, consists of avian, or bird-derived, hyaluronic acid. Restylane^®, marketed by Medicis, and Juvederm^®, marketed by Allergan, are both non-animal derived forms of hyaluronic acid produced in the laboratory. Hyaluronic acid fillers are generally biocompatible, which means allergy skin testing is not required prior to treatment.

Procedure Preparation

Depending on the extent of treatment, hyaluronic acid injection procedures typically last between fifteen and sixty minutes. Prior to the start of your procedure, the treatment areas will be cleansed, usually using an alcohol-based cleaner. Unlike collagen injections, hyaluronic acid injections do not include an anesthetic agent. Therefore, a local or topical anesthetic may be used to numb the treatment area during the procedure.

Hyaluronic Acid Injection Procedure

Using an ultra fine needle, hyaluronic acid is injected into the dermis at several points along the edge of the treatment area. After approximately two to three injections, the physician will massage the treatment area. The physician will continue injecting the filler along the length of the wrinkle or fold until maximum correction has been achieved. If a local anesthesia has not been used, you may feel some minor stinging from the injections. As the injected hyaluronic acid molecules attract and bind water molecules, the volume beneath the skin will increase, restoring a smoother, more youthful appearance.

Hyaluronic Acid Injection Recovery

Immediately following the injections, you may experience some redness, slight stinging, minor swelling, or bruising in the treatment area. Tiny scabs may also form at the injection sites. These symptoms typically disappear within two to three days. Bandaging is not necessary and most patients are able to resume normal activities immediately following treatment.

Hyaluronic Acid Injection Results

The body will eventually metabolize and absorb the injected hyaluronic acid over time. Therefore, while the effects are immediate, hyaluronic acid injections do not provide the same long-lasting results that may be gained from cosmetic surgery. Although the longevity of results varies by patient, results from hyaluronic acid injections are typically maintained for six to twelve months.

Laser Skin Resurfacing

Introduction

Laser skin resurfacing, also known as laser peel, lasabrasion, or laser vaporization, is an effective treatment that uses concentrated beams of light and energy to improve skin tone and texture while reducing wrinkles, scars, uneven pigmentation, and sun damage.

Skin Anatomy

The skin is composed of three layers known as the epidermis, dermis, and hypodermis. The epidermis, or outer layer of the skin, acts as the skin’s primary defense against the environment. As a result, these layers sustain the most damage. The dermis, or middle layer, is responsible for providing structure and support to the skin. The dermis is composed primarily of connective tissue that provides the skin with a support network made of collagen and elastin fibers. Over time, the dermis also sustains damage and these collagen and elastin fibers break down, resulting in a loss of skin elasticity and the formation of facial wrinkles.

Laser Skin Resurfacing

The lasers utilized for laser skin resurfacing treatments target water in the outer layers of the epidermis in order to remove the damaged skin and allow healthy skin to grow in its place. Resurfacing lasers are categorized as either ablative or non-ablative. Ablative resurfacing can be performed with erbium or CO2 lasers, while non-ablative resurfacing can be performed with many different types of lasers including erbium. While both ablative and non-ablative lasers stimulate collagen production, ablative lasers also remove a significant portion of the damaged outer layers of the epidermis. Ablative lasers are more intense and require more recovery time than non-ablative lasers, but dramatic results can often be seen after just one treatment. While also highly effective, you may need multiple treatments with non-ablative lasers to achieve your desired results. Ablative lasers are best for treating mild to moderate wrinkles, scarring, and uneven pigmentation and are not always recommended for patients with darker skin tones. Non-ablative lasers are best for improving skin texture and tone and pose fewer risks for darker skin types.

Procedure

Laser skin resurfacing will begin with a consultation during which your provider will examine your face, discuss your treatment goals and any medical conditions or current medications that you may be taking, determine the best laser resurfacing technique for your skin, and address any concerns that you may have. Depending upon the type of treatment, laser resurfacing typically lasts from thirty minutes to two hours. Your provider may administer a topical numbing medication for 30-45 minutes. An injectable anesthetic may be used and you may be given a sedative to help you stay relaxed and comfortable during your procedure. The treatment area will be cleansed and you may be given eye protection. Your provider will focus the laser on your skin and you will likely feel a slight to moderate burning sensation. Deeper wrinkles or scars may require multiple passes over the treatment areas. Ablative lasers remove the damaged outer layers of the epidermis and both ablative and non-ablative lasers heat the dermis, stimulating collagen production over time and improving the structure and elasticity of the skin.

Risks

It is uncommon to experience serious complications from laser resurfacing. Potential risks may include redness, swelling, itching, acne, scarring, hyperpigmentation (or skin darkening), hypopigmentation (or skin lightening), and infection.

Recovery and Results

You may experience minor pain, itching, redness, crusting, and swelling for the first few days after laser skin resurfacing. These symptoms typically subside in three to ten days, depending upon whether your resurfacing treatment was non-ablative or ablative. The redness will fade slowly over a few months. The outer layers of the skin will peel away within several days following treatment, and your provider may recommend special ointment to keep your skin moisturized and protected during the initial healing stages. It is important to remember that laser-treated skin can be extra sensitive to the sun for up to a year following your procedure and it is essential that you diligently protect your skin with a broad-spectrum sunscreen and minimize sun exposure whenever possible. You should notice an improvement in your skin in one to two weeks, but your skin will continue to improve for up to one year following your treatment. The results from laser skin resurfacing may last for several years, though your treatment will not stop the natural aging process and you may undergo additional laser skin resurfacing treatments as necessary. Laser skin resurfacing is an effective and minimally invasive method of improving the appearance of your skin.

Lip Augmentation

Introduction

Lip augmentation includes a number of cosmetic procedures performed to enhance the appearance of the lips. Lip augmentation can correct uneven lips, reduce lip lines and wrinkles, define lip shape, and add volume to the lips. There are many different options for lip augmentation, including injectable dermal fillers, fat grafting, and lip implants. Procedures are customized to achieve individual aesthetic goals, and results are either temporary or permanent, depending upon which treatment option is chosen. Consult with your doctor about which procedures they perform. Prior to treatment, you will undergo consultation during which your provider will examine your face and lips and discuss your treatment goals in order to determine the best lip augmentation procedure for you.

Lip Fillers

The most common method of lip augmentation is the injection of dermal fillers. Most lip fillers contain hyaluronic acid, a natural molecule that is found in the connective tissue of the body and that binds to and absorbs water molecules. There are many brands of lip filler products available, and your provider will help you determine which product is most appropriate for you. Lip filler injections typically last from fifteen to thirty minutes. Prior to the procedure, a topical or local anesthetic is used to numb the treatment area. Your provider will use a fine needle to inject a precise amount of filler into your lips. Lip augmentation is an outpatient procedure and you will be able to return home the same day. Lip filler results are temporary and typically last from six to twelve months. If you are dissatisfied with the results, hyaluronic acid lip filler can be dissolved with an enzyme called hyaluronidase, which breaks down hyaluronic acid.

Fat Grafting

Fat grafting (also known as autologous lip augmentation) transfers your own fat to your lips in order to enhance their shape and size. The fat grafting procedure typically lasts from sixty to ninety minutes. A local anesthetic is used to numb the treatment area. Your fat will be harvested from your abdomen, thighs, or buttocks through liposuction. The fat is then purified and carefully injected into your lips. Fat grafting is an outpatient procedure and you will be able to return home the same day. Fat grafting results last approximately five years.

Procedure

The insertion of lip implants is an option for lip augmentation that is less commonly performed due to an increased risk of complications. Lip implants are made of synthetic material and are the most permanent lip augmentation option available. Your provider will determine which size implant is best for your specific anatomy. The lip implant procedure lasts approximately thirty to sixty minutes. Local anesthesia is used to numb the treatment area. Your provider will create small incisions that are hidden in the corners of the mouth. A tunnel is created and the implant is placed inside, underneath the lip fat and above the lip muscles. The incisions are closed with absorbable sutures. Lip implant placement is an outpatient procedure and you will be able to return home the same day. Lip implants are permanent, but can be removed or replaced if necessary.

Recovery & Results

Potential risks from lip augmentation may include redness, swelling, bruising, bleeding, lip asymmetry, and infection. Most patients who receive lip filler injections are able to resume normal activities immediately following treatment, while patients who undergo fat grafting or lip implants may have bruising and/or swelling for up to two weeks. Patients should notice the results of lip augmentation immediately following each procedure.

Microdermabrasion

Introduction

Microdermabrasion is one of the most popular non-invasive cosmetic procedures performed today. Over time, factors such as aging, genetic factors, sun damage, acne, scarring, and enlarged pores can contribute to the formation of facial wrinkles and a rough skin texture on the face. Most commonly used to treat the face and neck, microdermabrasion can successfully reduce the appearance of superficial wrinkles and scars, large pores, acne, and age spots, restoring a smoother, more youthful appearance.

Overview of the Skin

Before you learn how microdermabrasion can rejuvenate your skin, you need to understand what makes up your skin. Your skin consists of two layers known as the epidermis and the dermis. The epidermis, or outer layer of the skin, acts as the skin’s primary defense against the environment and sustains the most damage
from the sun. The effects of sun damage are what cause the skin to have a rough appearance. Beneath the epidermis lies the dermis, or innermost layer of the skin, which provides structure and support.

What Causes Skin Damage?

The dermis is comprised primarily of connective tissue, which is made mostly of collagen and elastin fibers. These fibers form a network that provides the skin with structure, support, and elasticity. Over time, the aging process and sun damage cause a decrease in the amount of collagen and elastin fibers. As this network of fibers breaks down, the skin loses its elasticity and becomes more lax.

How Does Microdermabrasion Work?

During microdermabrasion, fine crystals usually remove the superficial or uppermost layer of the epidermis, known as the stratum corneum. Depending on the extent of skin damage, deeper treatment may be necessary; however, treatment rarely extends beyond the epidermis. As a result, microdermabrasion is not appropriate for the treatment of deeper wrinkles and scars, or extensive discoloration as these conditions likely extend into the dermis. In these instances, chemical peels and laser resurfacing may achieve more desirable results. As microdermabrasion only causes superficial injury to the skin, the risk of scarring and pigmentation anomalies following microdermabrasion is extremely low, when compared with other resurfacing techniques. Therefore, microdermabrasion can be safely and effectively used on individuals of all skin types.

Procedure Preparation

A microdermabrasion procedure may last approximately thirty to forty-five minutes. Unlike certain chemical peels and laser resurfacing, the procedure is relatively painless; therefore, anesthesia is not typically required. Prior to your procedure, your physician may recommend that you treat your skin with products containing alphahydroxy acid or retinoic acid, among others, which may increase the effects and longevity of your treatment. Before the treatment, your face will be thoroughly cleansed, usually using an alcohol-based cleanser. Your physician may also provide you with goggles to protect your eyes during the procedure.

Microdermabrasion Procedure – Part I

During the procedure, the physician uses a device which emits pressurized crystals onto the surface of the skin. Using single strokes, the physician will guide the device over the treatment area to remove damaged skin layers.

Microdermabrasion Procedure – Part II

The handpiece releases fine, pressurized crystals, which much like sandblasting exfoliate the stratum corneum, or the skin’s outermost layer. In areas with more damage, the physician may increase the amount of pressure exerted by the device or the number of passes made in the area. This will cause the treatment, or amount of injury, to extend deeper into the skin. A vacuum sucks the used crystals and exfoliated skin particles back into the device so that they can be removed and discarded.

Microdermabrasion Recovery

Following your microdermabrasion procedure, you may experience some redness for the first few hours, but you will be able to return to your normal routine immediately after your treatment. Your physician may apply a cream or ointment to the treatment areas to keep them moist as they heal. It is important that you continue to use these products as directed by your physician, as your skin may continue to exfoliate following the procedure. Your skin may appear as if you have a minor sunburn for two to three days and will be more sensitive to sunlight. Therefore, it is important that you use sunscreen with SPF 15 or greater as your skin heals.

Microdermabrasion Results

As the new skin cells are revealed, your skin will have an improved texture and overall appearance. It is important to realize that in order to maintain the results from a microdermabrasion procedure, you will likely have to undergo approximately five to ten treatments, depending on the severity of skin damage. Initially, you may receive treatments every one to two weeks. However, over time the frequency of treatment may decrease to once a month, and later to twice a year. Although multiple treatments are required, microdermabrasion is a simple, fast, effective method of reducing superficial skin damage to restore a refreshed and youthful appearance.

Microneedling

What is Microneedling?

Microneedling (also known as collagen induction therapy) is a minimally invasive procedure that uses fine needles to stimulate the skin’s healing process to improve texture and tone. Most often performed on the face, microneedling can also be performed on other parts of the body such as the neck, chest, back, stomach and thighs in order to reduce the appearance of wrinkles, scars, enlarged pores, uneven pigmentation, and stretch marks.

Skin Anatomy

The skin is composed of three layers known as the epidermis, dermis, and hypodermis. The epidermis, or outer layer of the skin, acts as the skin’s primary defense against the environment. As a result, these layers sustain the most damage. The dermis, or middle layer, is responsible for providing structure and support to the skin. The dermis is composed primarily of connective tissue that provides the skin with a support network made of collagen and elastin fibers. Over time, the dermis also sustains damage and these collagen and elastin fibers break down, resulting in a loss of skin elasticity and the formation of facial wrinkles. Microneedling uses fine needles to create controlled micropunctures in the skin without damaging the epidermis. These microinjuries stimulate the skin’s healing process, promoting collagen production within the dermis, encouraging new skin growth, and improving the tone and texture of the skin.

Microneedling Procedure

Microneedling will begin with a consultation during which your provider will examine your face, discuss your treatment goals, and address any concerns that you may have. The procedure typically lasts from ten to thirty minutes, depending upon the area to be treated. Your provider may administer a topical numbing medication thirty minutes prior to treatment. The microneedling device may be a handheld roller or an electric tool that pulses up and down. Your provider will guide the device over the treatment area, making micropunctures in the skin. Needle length can range from 0.5 millimeters to 2 millimeters, and may be changed as needed, depending upon the extent of the damage to the skin. The skin’s natural healing response to the micropunctures stimulates the production of collagen within the dermis, improving the structure and elasticity of the skin. Microneedling may be combined with additional treatments such as platelet rich plasma (PRP), radiofrequency, and laser therapy in order to enhance the results of the procedure.

Microneedling Risks

It is uncommon to experience serious complications from microneedling. Potential risks may include redness, swelling, scarring, flaky skin, and infection.

Microneedling Recovery and Results

You may experience minor discomfort, redness, and swelling for the first few hours after microneedling, but there is no recovery period following the treatment. Your provider may recommend an aftercare routine to improve your results after the procedure. Your skin will be more sensitive to sun exposure as it heals, and it is essential that you protect your skin from the sun with broad-spectrum sunscreen following microneedling. You should notice an improvement in your skin three to four weeks following microneedling, and full results may take several months to appear. Depending upon the severity of skin damage, many patients require regular treatments to achieve and maintain their desired results. While your skin will continue to change and age after your treatment, microneedling is a safe and effective method of reducing superficial damage and rejuvenating your skin.

Skin Self Exam

Introduction

Skin cancer is the most common form of cancer, affecting millions of people worldwide each year. Skin cancer can be deadly, but in most cases, when detected early it can be treated successfully. Performing a head to toe skin self-examination is an important preventative measure used to identify skin cancer before it becomes life-threatening. A skin self-exam only takes about ten minutes to complete and should be performed once a month. Asking a family member or close friend to help you perform your skin exam will help you identify suspicious patches of skin in areas that are hard to reach or see. In addition to monthly self-exams, it is recommended that you see your physician once a year for a professional skin exam. This animation will explain how to perform a skin self-exam, how to detect possible signs of skin cancer, and how to record your findings to report them to your physician.

What Qualifies as a Suspicious Patch of Skin?

The purpose of a skin self-exam is to identify any patches of skin that may be indicative of skin cancer. Skin cancer reveals itself in various ways, depending on the form of skin cancer a person has. The three most common forms of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma and squamous cell carcinoma typically occur on areas of skin that are most often exposed to sunlight, including the face, ears, scalp, neck, arms, hands, and legs. Basal cell carcinoma often emerges as an open sore that will not heal or as a pearly, abnormal growth. Squamous cell carcinoma can appear as a thick, wart-like sore or as a scaly, red patch with irregular borders. Melanoma often surfaces as an irregularly shaped or multi-colored mole on the head, neck, lower legs, or trunk. To view descriptions of abnormal growths that may indicate skin cancer, click on any of the three forms of skin cancer and roll over the corresponding examples. Move your mouse off of a particular example to select another form of skin cancer and view examples.

Looking for Abnormalities

A practical system used to remember what to look for during your skin self-exam, known as the ABCDEs of melanoma, has been created to help you recognize the indicators of melanoma, the deadliest form of skin cancer. If you notice an abnormal growth that displays any suspicious characteristics, record your findings and notify your physician. The ABCDEs of melanoma stand for asymmetry, border irregularity, color variation, diameter, and evolving. Each characteristic is described as follows:

• Asymmetry – one half of the mole is different from the other half
• Border irregularity – the edges of the mole are irregular or poorly defined
• Color variation – the mole is multicolored
• Diameter – the diameter of the mole is greater than 6mm (about ¼ inch)
• Evolving – the mole looks different from your other moles, or it has changed in shape, color, size, or another trait

The Self Exam

To perform a skin self-exam, look for any abnormal growths by first inspecting your hands, including the tops of your hands, your fingernails, your palms, and the skin between your fingers. Next, stand in front of a full-length mirror and examine your face and ears. Part your hair to ensure you can clearly see your scalp.
Continue by inspecting your neck, chest, and torso; women should check under their breasts as well. Lift your arms to examine your underarms, elbows, and the front and back sides of your arms.
Proceed by turning your back toward the full-length mirror, and use a small handheld mirror to inspect your neck, shoulders, back, buttocks, and the back side of your legs. To complete the exam, sit in a chair and examine your genitals, the front side of your legs, and your feet, including the tops of your feet, your toenails, heels, soles, and the skin between your toes.

Detection and Prevention

Performing a skin self-examination once a month can help you detect skin cancer in its early stages, increasing the chances for it to be treated before it becomes life-threatening. If you notice any suspect moles or abnormal growths, do not hesitate to schedule a professional skin examination with your physician.

Keeping a Record of your Findings

Taking notes during monthly skin self-exams will help you track changes or irregularities in the appearance of your skin. Record the location, size, shape, color and any additional specifics about any moles, abnormal growths, or suspicious patches of skin you detect. Saving these records and bringing them with you during your annual professional skin examination will help you accurately report your findings to your physician.

Sunscreen

Introduction

Most people today are aware of at least some of the damaging effects that sunlight has on the skin. In addition to painful sunburns, excessive exposure to sunlight can cause sun damage that prematurely ages the skin, causes blemishes, and greatly increases the risk of various types of skin cancer. Unfortunately, although we know protecting uncovered skin is important, with a large variety of sunscreens, sunblocks, lotions, gels, sprays, mists, and sticks marketed in different strengths and for different purposes, it can be difficult to determine how to best protect yourself.

The Sun’s Damaging Rays

When it comes to avoiding sunburn and sun damage, the forms of sunlight we’re most concerned with are invisible waves of ultraviolet light classified as UVA and UVB. UVA and UVB pass through air to the Earth’s surface, and they can even pass through clouds, which is why you can sunburn on a cloudy day.
Approximately 95% of the ultraviolet light that penetrates your skin is UVA. This form is responsible for tanning, penetrates more deeply than UVB, and is an important factor in causing sun damage and skin cancers. UVB accounts for about 5% of the UV light that strikes your skin. Although UVB doesn’t penetrate as deeply as UVA, it has more energy and is the primary cause of sunburn. Most sunscreens protect against UVB, and fewer protect against both UVA and UVB. The sun protection factor (SPF) rating is a general measure of how well a sunscreen protects against developing a sunburn from UVB.

SPF

SPF measures the time it takes to produce a sunburn reaction on protected skin compared to unprotected skin. However, avoid believing you can stay in the sun 10 times longer with SPF 10 sunscreen, because there are misconceptions about SPF and sunscreen. SPF only measures protection against UVB, and does not measure UVA protection. Also, an SPF 30 sunscreen is not twice as effective as SPF 15. An SPF 15 sunscreen blocks around 93% of UVB; whereas an SPF 30 sunscreen blocks about 97%. In addition, people generally apply sunscreen more thinly than recommended, which lowers the SPF. Sunscreens claiming to be water-resistant will wash off after about 40 minutes and those claiming to be very water-resistant protect for up to 80 minutes. Certain labels such as waterproof, sunblock, and all-day protection are misleading, and governmental agencies in various parts of the world have recommended banning their use on sunscreen bottles for this reason.

Types of Sunscreen and How They Work

Sunscreens can be classified by how they protect against UV light as well as by the type of UV protection they provide. Sunscreens protect against UV damage by either chemical or physical means, or a combination of both. Chemical sunscreens are absorbed into the skin and are designed to halt UV before it damages skin. When UV light strikes the sunscreen molecules, absorbed energy excites the molecules, which release the energy as heat as they return to their former state. Conversely, physical sunscreens act as a protective film on the surface of the skin. UV light that strikes the sunscreen molecules is either absorbed into the sunscreen, or it is scattered and reflected away before passing into the skin. Most sunscreens protect against UVB, but fewer are what are known as broad-spectrum or full-spectrum sunscreens, which protect against both UVA and UVB. Whether a sunscreen blocks against UVB alone or both UVA and UVB depends on its ingredients.

Sunscreen Ingredients

One of the first ingredients used in modern sunscreens was para- aminobenzoic acid, or PABA. Although PABA protects against UVB, it produces adverse reactions in some people, which is why you will sometimes see PABA-free listed on sunscreen bottles. Today cinnamates are the most frequently used sunscreen ingredient for UVB protection. Two increasingly common UVA protectants are avobenzone and ecamsule. Among physical sunscreen ingredients, metallic compounds such as zinc oxide or titanium dioxide are common and protect against UVA and UVB. These metallic, physical sunscreen ingredients are also sometimes blended into chemical sunscreens along with the other chemical Ingredients.

Sunscreen Additives

As you may notice when looking at the back of a bottle, sunscreens usually contain a variety of ingredients. Some of them work with other chemicals to increase the SPF, stabilize ingredients to prevent them from breaking down after UV exposure, or to reduce the oily feeling. Other additives may also be included such as fragrances, softening agents, antioxidants, moisturizers, and even insect repellents. Keep in mind, however, that although some of these products may be convenient, they are not all intended for the same uses. For example, the insect repellent DEET does not need to be applied as frequently as is recommended for sunscreen. If you are going to be in the sun for a period of time that would require several applications, a separate sunscreen and bug repellent may be the best choice.

The Sunscreen Controversy

There is some controversy over sunscreen use. You produce vitamin D as a result of UV exposure, and some people are concerned that sunscreen use may cause a deficiency. However, people have been found to maintain normal vitamin D levels with proper sunscreen use, and those with a deficiency or minimal sun exposure can obtain additional vitamin D in supplements. Another concern stems from an observation that since sunscreen protects from the UVB rays that cause sunburn, people stay in the sun longer, potentially increasing the chance of developing melanoma skin cancers from UVA exposure. To reduce this risk, use a sunscreen with UVA protection.

Proper Sunscreen Application and Use

Dermatologists recommend using a broad-spectrum sunscreen of SPF 15 or greater. Apply the amount recommended on the sunscreen bottle fifteen to thirty minutes before sun exposure. Shake the bottle well and remember to apply sunscreen to frequently forgotten areas such as the ears, back of the neck, bridge of the nose, scalp, hands, and feet. Reapply sunscreen every two hours or when done toweling off after swimming. Sunscreen is just one way to protect yourself from the sun. In addition, try to avoid sun exposure between the hours of 10:00 A.M. and 2:00 P.M. when the sun is most intense. When possible, wear long-sleeved shirts and pants, and wear a wide-brimmed hat to protect your head and neck. Infants under 6 months of age have particularly thin, sensitive skin and should be shielded from the sun. Since children often receive much more sun exposure than adults but tend to dislike sunscreen, a variety of physical sunscreens now come in exciting colors and packaging to make them more appealing.

Choosing the Right Sunscreen

Always opt for a broad spectrum sunscreen that protects against both UVA and UVB. Physical sunscreens generally offer the best sun protection, but they are often visible on the skin. As a remedy, some sunscreens reduce the size of the zinc oxide and titanium dioxide ingredients to avoid visible residues. Determining the correct SPF to use depends on how susceptible you are to burning and the amount of time you plan to spend in the sun. The effectiveness of your sunscreen will depend both on how well you apply it and the protective ingredients in the sunscreen. If you find that your skin is sensitive to a specific ingredient or sunscreen additive, or if you don’t like the way the sunscreen feels on your skin, you can use what you now know about sunscreens to find a different formulation that will suit your needs.