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Chemical Peels

Chemical Peels NYC Treatment 

chemicalpeelsbeforeafter1.jpg

How do Chemical Peels work?

There are basically four major types of chemical peel solutions:

Alpha Hydroxy (Glycolic Acid - other fruit and sugar based acids)
Beta Hydroxy (Salicylic Acid)
Cosmelan
TCA (Trichloroacetic Acid)


Chemical peels work by "ungluing" the top layer of damaged and discolored skin so it can peel away and reveal the fresh new skin beneath. By forcing the turnover of the cells, the old dull and damaged cells peel off much more quickly.

Lighter superficial peels using Alpha Hydroxy acids such as Glycolic Acid can be very effective in a series of "no downtime" procedures. Your skin will have a light pink look and flaking or peeling may be unnoticeable. Superficial peels are ideal for improving pigmentation problems, fine wrinkles and sun damage. They can be used anywhere on the face and body.

What types of chemical peels are there?
There are several types of chemical peels each suited to different skin problems and types. Chemical peels also vary in strength and are classified as superficial, medium, and deep according to the level of skin they reach.
 
The superficial chemical peels include;
Alpha-hydroxy acid (AHA) peels - glycolic and lactic acid peel. Glycolic acid is derived from sugar cane, and lactic acid is a naturally occuring acid in the body. These peels can be performed at various concentrations to vary the strength of the peel. Their main role is to remove the top layers of the skin and induce new collagen formation. 

Beta-hydroxy acid (BHA) peels  - Salicylic acid is main ingredient found in these peels. These peels are generally used in oilier skins or acne prone skins as they are oil soluble and penetrate deeper in this type of skin environment. Beta-hydroxy acids are generally larger molecules than alpha-hydroxy acids and therefore may not penetrate as deeply in a normal (non-oily) skin environment.

Blueberry smoothie peel  - a very light peel containing AHAs and BHAs as well as some physical exfoliants.

Purity peel  -  A salicylic acid based peel .

Retinoic acid peels . Retinoic acid is the ingredient found in well known skin products such as Retin-A or  (tretinoin), although in much less concentrations that in the retinoic acid peels. Retinoic acid helps to increase the turn-over rate of the skin and make it behave more like a 'younger skin'. They can also help to reduce DNA mutations caused from UV exposure on the skin. 

Benefit peel and Timeless peel  - These are both retinoic acid based peels. The benefit peel is the lighter of the two.

Jessner's peel (a combination peel of salicylic acid, resorcinol, and lactic acid). This combination peel brings together a combination of alpha and beta hydroxy acids (see above) as well as resorcinol, and the effects of each of these ingredients. Resorcinol is a derivative of phenol ( a very deep peeling agent) and is good for resurfacing the skin. The depth of the peel, which in most cases is superficial, is determined by the number of layers placed on the skin. The skin turns a frosty white colour after treatment for a short time.

Trichloroacetic acid (TCA) peel 10-20% - This is a peel that has been performed for many years.  Performed at lower concentrations, TCA peels provide superficial resurfacing of the skin to improve skin texture, wrinkles, and pigmentation.
Deep sea peel   - an natural organic, herb/plant based peel. Can produce deep exfoliation of the skin and significant peeling.

The medium depth chemical peels include;
Trichloroacetic acid (TCA) 35% - at these concentrations, TCA peels can help with skin texture, wrinkles and pigmentation. A cost effective alternative to laser resurfacing.

Phenol 88%* - one of the strongest peeling agents available for severe wrinkling and sun-damaged skin. Can be cardiotoxic (people have died having this peel!) and needs to be done under a general anaesthetic in most cases. There is significant whitening (and sometimes over-whitening) of the skin from this peel.

Which chemical peel is right for me?
Chemical peels induce a controlled wound to the skin, and can replace part or all of the top layers of skin. The key determinants to which chemical peel is right for you are; the degree of the skin problem/ageing/sun-damage, the skin type/colour, the amount of improvement you would like to achieve, and the amount of recovery or downtime that is acceptable by you.
As a rule, the deeper the peel, the more side effects, potential complications, and recovery are needed. Another rule of thumb is that the darker the skin type, the more problems that may be encountered post-peel, especially pigmentation problems such as post inflammatory hyperpigmentation where the treated skin may become darker than the untreated skin. Therefore, deeper peels in darker skin types must be considered with caution and sometimes it may be better to perform a series of more superficial peels rather than one deep peel.

The degree of skin aging will also determine which peel to use. For younger patients with less sun-damage, pigmentation and wrinkles, only superficial peels may be required. The opposite is also true.

Different skin problems also respond to particular peels. Acne, for example, responds well to Jessner' s peel and salicylic (beta-hydroxy acid) peels. Salicylic acid peels and Jessner's peels (which also contains salicylic acid) are very oil soluble and are able to penetrate deeper into pores and remove oil and sebum and are anti-inflammatory. Both alpha-hydroxy acid  and beta-hydroxy acid peels help exfoliate the skin. TCA peels, alpha-hydroxy acid peels, and Jessner's peels are suited to pigmentation problems and sun-damage.

Wrinkles can be best treated with TCA peels, or any medium to deep chemical peel. These peels can be a cost effective alternative to laser resurfacing.

Parts of the body other than the face can be peeled also. For example, you can have chemical peels on the chest and back for acne, or on the neck and decolletage to help reduce sun damage. 

How can I prepare myself for a chemical peel?
Skin priming can be achieved by commencement of a skin care products containing retinoic acid such as Retin-A (available by prescription only), as well as a topical lightening agents such as hydroquinone, kojic acid or arbutin . This needs to be commenced at least 2 weeks prior (preferably more) to peeling to help with uniform penetration of the peel, accelerated healing, and to reduce post-peel complications such as post-inflammatory hyperpigmentation. Use of alpha-hydroxy acid cleansers/exfoliants in the weeks prior to chemical peeling can also help the peeling agent (especially in evenness of penetration), but do not reduce the risk of post-inflammatory hyperpigmentation.

How are chemical peels performed?
In our opinion, chemical peels are best performed by an experienced dermatologist. The skin is thoroughly cleansed with an appropriate cleanser first. Vaseline is sometimes used to protect the peel from entering the eye. A fan may be present to help cool the skin for comfort during the peel. Your eyes should be closed during the procedure. 

The chemical peel solution is then applied to the face. The procedure is timed, and you will be asked about your comfort level. Neutralisation of the peel (generally with sodium bicarbonate) is performed at the end of the peel, or if there is an untoward skin reaction, or if the pain is excessive. 

The peel is completed usually by placing sunscreen and a soothing balm on the face.

Are there any medical problems that your doctor should be aware of prior to having a chemical peel?
Patients with a history of, or a current infection of herpes simplex virus (cold sores) should ensure that their doctor is aware of this before chemical peeling. If there is an active infection present, you may be asked to wait until it has passed prior to having a chemical peel. Also if you have a history of cold sores, you doctor may place you on anti-viral medication as a prophylaxis to an outbreak during your treatment. 

If you have a history of keloid (thick, pigmented scars) you may also be excluded from all but the most superficial of peels. 

Patients with HIV/AIDS or immunosuppression should avoid chemical peels because this may impair wound healing and increase the likelihood of infection and scarring. 

Also those who have recently had a course of oral isotretinoin or accutane should avoid chemical peels for at least 6 months before undergoing medium or deep chemical peels. Similarly, patients who have had a recent face or browlift should wait at least 6 months. 

What are the complications or side effects of chemical peels?
As a rule, the deeper the peel, the higher the rate of complications and the longer the recovery. Most superficial peels are safe and effective, where medium and deep peels require more experience from the operator and more careful pre-peel preparation and post-peel care. 
The deeper the peel, the longer it will take to recover . The downtime can vary from a few hours (in the case of a light glycolic peel) to a week for a 20% TCA peel. 
Swelling - usually lasting up to three days, but it is usually only associated with the deeper peels.

Pain - again, this is only really seen with the deeper peels and may last for a few hours only.

Redness - most superficial peels produce a mild amount of redness that persists for a few days only. Medium to deep peels can cause redness that can persist for up to a month.

Itchiness - This is only common after medium and deep chemical peels.

Ocular injury - Care must be taken during the procedure to avoid the peel from entering the eye.

Allergic reactions - uncommon, although peels such as the Jessner peel have a higher rate of allergy. Anti-histamines may be taken before, if an allergy is known, or after.

Folliculitis /acne - this occurs commonly as a result of the emollient creams used during healing. Antibiotics may be required to heal these eruptions.

Bacterial/fungal infection - is uncommon. It can, however, lead to scarring. This is usually only associated with medium to deep peels.

Herpes simplex recurrence - is common and needs to be treated with anti-viral medication to prevent spread and scarring.

Hyperpigmentation - dark patches over the peeled areas. This usually occurs over the deeper parts of the peel and is a result of inflammation causing release of melanin/pigmentation from the skin (post-inflammatory hyperpigmentation). This is usually temporary, although it can last for up to 2 years. Treatment usually involves a lightening agent such as hydroquinone.

Hypopigmentation - is a loss of pigmentation and usually occurs in darker skin types after peeling. This can be permanent sometimes.

Telangiectasia - are small red vessels under the skin and can become more prominent with peeling. The vessels are easily treated with lasers such as the Gemini laser.

Milia - this are small white cysts that form about 2 to 3 weeks after the skin has re-epitheliased (grown over). It can be due to blockage of the skin due to emoillent creams used after chemical peeling. They can be removed with a needle or lancet.

Demarcation lines - this is usually a result of medium to deeper peels, and the line of where the peel was used and the untouched skin is noticeable even after the skin has healed.

Scarring - a very uncommon complication of chemical peels. This is usually associated with a history of poor healing or keloid scarring. Scarring is more likely the deeper the peel. A early sign of scarring is persistent redness and itchiness. This needs to be treated with a topical steroid.

How can I minimise the complication rate from chemical peels?
Patient selection is a very important part of reducing the rate of complications. By choosing the right peel for each particular skin type, whilst considering the needs of the patient, complications can be minimised. Darker skinned patients in particular, especially those of European, Asian, Indian, Sri Lankan, or African backgrounds are more prone to pigmentation problems (either a gain or loss of pigmentation) after a medium to deep chemical peel. It is possible to prepare the skin beforehand with hydroquinone and tretinoin which help to reduce the rate of post-inflammatory hyperpigmentation (dark areas) post peel. This is particularly important for the medium/deep peels and in darker skinned patients. This regime can be continued after the peel (2 weeks after) to further reduce pigmentation problems. 
Similarly, sun exposure pre and post peel should be avoided or at least minimised. Sun exposure can lead to an increase in pigmentation problems also.

Dear Friends
 
Our goal at NYC Dermatology is to be the Tiffanys of Skin
Care. I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified DermatologistMy goal is, quite simply, to provide the type of dermatologic care which I  would seek for my own family. This is a very important point, since physicans often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results and the best dermatologist. We also support our patients with a very fine medical staff . Please take a moment to explore our top of the line winning website. My philosophy is simple…Experience Counts and Quality Matters. Please allow me to solve your skin problems.  After all, at NYC Dermatology , our philosophy is if you look great you will feel great with gorgeous skin.”
 
Best Regards,
 
Dr. Rothfeld
 

  
 
 

 Dr. Gary Rothfeld possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding  Dermatologist in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist, Dr. Rothfeld  in Manhattan treats the most difficult cases until the problem clears.  Dr. Rothfeld, a Board Certified Dermatologist at NYC Dermatology in Manhattan, New York is caring, detailed, and meticulous and will never give up until the problem is cleared.  Dr. Rothfeld, a board certified dermatologist in nyc who practices Dermatology in Manhattan, New York has treated many patients in the entertainment and music industry is caring, detailed and meticulous and will not give up until the condition resolves.  Dr. Rothfeld is recognized as one of the best Dermatologists in NYC by the entertainment industry.

NYC Dermatology is under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist. 
To enhance every aspect of your skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures..

NYC Dermatology by Board Certified  Dermatologist Dr. Gary Rothfeld  is a board certified NYC  Dermatologist with a  New York City office in Manhattan, New York  providing expert skin care, dermatology, and cosmetic dermatology services.

A board certified dermatologist in NYC specializing in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld  is known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include full body liposuction using the tumescent technique, facial fat transplantation, Botulinum injection into facial lines and laser resurfacing. NYC dermatology  specializes in chemical peels, vein injections, laser, restylane, Perlane, Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.
 
As an expert in the field of dermatology and cosmetic dermatologic surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high profile national magazines.
Our goal at the manhattan office of Board Certified  Derrmatologist , Dr. Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology and Cosmetic Surgery Center in Manhattan, New York.  Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board Certified  Dermatologist at NYC Dermatology who has treated many patients in the  entertainment industry.
   Schedule an appointment at our office which provides top of the line  expert skin care, dermatology, cosmetic dermatology services, and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media  office and   including different offers and many more. We offer a variety of services from Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for a consultation.   Beauty Is Forever!  and Dr. Rothfeld  at NYC Dermatologist has over 20 years of experience with his beauty tips.  
.

During your office consultation  and examination you will be provided with a detailed plan of the treatments that will benefit you most.  NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan,  services including general dermatology, wrinkle fillers such as Restylane®, Captique,  Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®, Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne, rosacea, skin cancer and  surgery.  Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical hair transplants, and lasers in  the country.   Acne Photodynamic Treatment - Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser  - Cosmelan Depigmentation Treatment - Glycolic Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction -  - Surgery - Minimal Scar Technique -  Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy - Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments - Velasmooth Our cosmetic surgeon includes Dermatologist  Dr. Gary Rothfeld Board Certified Dermatologist  at NYC Dermatology.  Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan office in NYC

 

Sun Protection

 

Ultraviolet radiation is the major cause of skin cancer, including melanoma. It is important for everyone to be aware of its damaging effects and take measures to avoid overexposure.

 

Although many people enjoy the appearance of tanned skin and think it looks "healthy," tanned skin is damaged skin. The ultraviolet radiation in sunlight penetrates the deepest layers of the skin where it harms the cells. The body responds by making more pigment (melanin) to try to protect itself, but the damage has already happened and may be permanent. The more exposure you have to the sun, the more likely you are to develop skin problems later in life.

Ultraviolet Radiation

The damaging part of sunlight is called ultraviolet radiation, or UV rays. It is categorized into three types:

  • UVC rays (wavelengths = 200 nm to 290 nm) are the shortest and most powerful of the UV rays. UVC is the most likely to cause cancer if it reaches skin. Fortunately, most of it is absorbed by the ozone layer in our atmosphere. However, there is concern that a thinning of the ozone layer may be causing more UVC to reach the earth's surface.
  • UVB rays (wavelengths = 290 nm to 320 nm) are less damaging than UVC, but more of it penetrates to the earth's surface. It is the most common cause of sunburn and skin cancer. UVB is particularly strong at the equator, at high elevations, and during the summer.
  • UVA rays (wavelengths = 320 nm to 400 nm) are the least powerful of the UV rays, but they are present all year and can penetrate windows and clouds.

Sun Protection

The first and more effective way to avoid sun damage is to stay out of tthe sun as much as possible.

If you cannot avoid being exposed to sunlight, there are five basic defenses that you should keep in mind when you go outdoors:

  • Avoid peak hours of sunlight
  • Sunscreen
  • Clothing
  • Sunglasses
  • Shade

Avoid Peak Hours of Sunlight (UV Index)

In general, UV rays are the greatest between 10 a.m. and 4 p.m. It is best to avoid the outdoors during these hours without protection, particularly during summer, in tropical regions, or at altitude. During this time, you should pay close attention to the appropriate use of sunscreen, clothing, sunglasses, and shade.

You can obtain an accurate measure of the amount of UV rays in your area by looking up the Ultraviolet (UV) Index. The UV Index is like a weather forecast. It provides a report on the amount of damaging UV rays that are expected to affect a region on a particular day. The UV Index changes day to day according to time of year, cloud cover, atmospheric ozone, and other factors.

The following table is a breakdown of the UV Index. A high UV Index number means that you are at greater risk of being exposed to ultraviolet radiation. You should take special care to avoid outdoor exposure to sunlight when the UV Index is moderate or greater.

  • 0 to 2 = Minimal
  • 3 to 4 = Low
  • 5 to 6 = Moderate
  • 7 to 9 = High
  • 10 or more = Very high

The UV Index can be found on our Website or in local papers, usually in the weather section.

Sunscreen

There are several factors to consider when selecting the right sunscreen. (See the Sunscreens handout for more information.)

Sun protection actor (SPF) - Sunscreens are rated by the amount of protection they provide from UVB, measured as the "sun protection factor" or SPF. Sunscreens with higher SPF provide greater protection from the sun. It is best to use sunscreens that offer a minimum SPF of 15.

Broad-spectrum sunscreens - It is best to use a sunscreen that can protect you from both UVA and UVB rays. These are called "broad-spectrum" sunscreens. 
Most of the original sunscreens blocked only UVB, but increased awareness of the damage caused by UVA has lead to the development of ingredients that protect against UVA too. Broad-spectrum sunscreens combine ingredients to provide a product with greater protection.

Common sunscreen ingredients that  provide protection from UVB rays:

  • Cinnamates
  • Octocrylene
  • PABA (para-aminobenzoic acid)
  • Padimate O and Padimate A (Octyl Dimethyl PABA)
  • Salicylates

Common sunscreen ingredients that  provide protection from UVA rays:

  • Avobenzone (Parsol 1789)
  • Benzophenones (oxybenzone, dioxybenzone, sulisobenzone)

Sunblocks - "Physical" sunscreen ingredients lie on top of the skin and work by reflecting or scattering UV radiation. They are particularly useful for people who are sensitive to the ingredients found in other sunscreens. Sunblocks often contain one or more of these ingredients:

  • Zinc oxide
  • Titanium dioxide
  • Iron oxide

Although past formulations were unsightly (often leaving a white film on the skin), newer "microfine" formulations are invisible after being applied. Microfine titanium dioxide is effective at protecting from both UVA and UVB rays.

Water resistance - Sunscreens are classified as "water-resistant" if they maintain their protection after two 20-minute immersions in water. They are classified as "waterproof" if they maintain their protection after four 20-minute immersions. You should seek a water-resistant or waterproof sunscreen if you will be participating in water sports, such as swimming or water skiing, or will be actively sweating.

However, independent testing has shown many products do not perform well in the real world. So it remains a good idea to apply sunscreen every time you leave the water, or frequently if you are actively sweating.

Using a Sunscreen

Sunscreen should be applied evenly and liberally on all sun-exposed skin within 30 minutes before going outside to give sunscreen time to take effect. (Sunblocks are effective immediately after being applied.) Sunscreens should be reapplied every two hours or following swimming or sweating. Apply sunscreen generously and reapply frequently at least every two hours.


The chemicals may lose effectiveness over time, so it is important to throw away sunscreen that is past its expiration date or is over two years old.


No sunscreen is 100% effective; take additional measures to avoid the damaging effects of the sun's rays.

Clothing

Clothing can provide excellent protection from the sun. However, not all clothing is protective. A thin, wet, white t-shirt will provide almost no protection from UV rays. When selecting clothes for sun protection, consider the following:

  • Cover your head, shoulders, arms, legs, and feet.
  • Use a hat that is broad-brimmed (brim should be at least four inches wide).
  • Wear fabrics that are thicker or with a tight weave; these allow less sunlight to penetrate the skin.
  • Wear darker-colored clothes that absorb more UV rays.
  • Wear clothing made from nylon or Dacron because it is more protective than cotton.
  • Avoid remaining in wet clothes because wet fabric may allow more UV rays to penetrate the skin.
  • Wash clothing with chemical absorbers to increase their protectiveness.
  • Some clothing comes with a UPF rating that stands for "Ultraviolet Protection Factor." This measures the ability of the fabric to block UV radiation from penetrating to the skin. A fabric with a UPF 15 allows only 1/15th (6.66%) of the UV radiation to penetrate your skin as compared to uncovered skin.

Garments fall into 3 categories:

  • Good protection: UPF = 15 to 24
  • Very good protection: UPF = 25 to 39
  • Excellent protection: UPF = 40 to 50+

Choose clothing with a UPF rating of at least 15. Keep in mind that the UPF of a garment will decrease over time as the fabric wears.

Sunglasses

Overexposure to sunlight can cause cataracts and macular degeneration, a major cause of blindness. Sunglasses can provide protection. However, not all sunglasses are of value. A darker lens itself does not guarantee protection. Look at the label to ensure that the glasses provide UV protection. Sunglasses should be large enough to shield your eyes from many angles. Look for sunglasses that are described as blocking 99% or 100% of UVA and UVB. The glasses may also be described as providing UV absorption up to 400 nm.

Shade

If possible, remain in the shade when outdoors. Keep in mind that shade does not provide full protection from the sun because UV rays can bounce off reflective surfaces, such as sand, snow, water, concrete, or even porch decks. In addition, some fabrics used as shade devices, such as parasols or umbrellas, may not provide sufficient protection. If you seek shade under a cloth, look for a fabric that is thick, tightly woven, and dark-colored.

Clear window glass provides protection from UVC and UVB, but not UVA rays. If you are frequently exposed to sunlight while driving, the plastic interleaf of your windshield (which prevents it from shattering) can help block the light, but side windows have no such protection. Non-drivers can make use of additional window shade devices. Drivers in some states may be able to use darkly-tinted glass in the side windows, but this is illegal in some states.

Summary

  • Avoid the sun when its UV rays are strongest, between 10 a.m. and 4 p.m.
  • Use a broad-spectrum sunscreen with SPF 15 or greater. Apply it 30 minutes prior to being exposed to the sun and reapply every two hours. Consider using a water-resistant sunscreen if you will be active (sweating) or in the water.
  • Use a sunblock on your lips.
  • Wear a broad-brimmed hat when outdoors.
  • Wear sunglasses.
  • Wear tightly woven, dark clothing to cover your arms, legs, and feet.
  • Stay in the shade when possible.
  • Avoid reflective surfaces, such as water or snow.
  • Avoid sunbathing.
  • Don't be fooled by cloudy days since damaging rays can penetrate clouds.

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