I tuned in for the season premiere of The Real Housewives of Beverly Hills expecting to watch the usual train wreck that precedes this cult-following Bravo reality series. What I didn’t realize was that I’d also receive an education in Sun Damage 101.

The majority of the housewives are in their forties, but you’d never guess it. Despite their efforts to look younger (including overblown lip injections, obvious forehead lifts, extreme Botox and fillers, etc.), most of the women actually look ten years older than their real age—tan skin, neon pink lipstick and all. I found it odd that the housewives put so much emphasis on having cosmetic procedures done on their faces (and that‘s a whole other blog), but yet they make little to no effort to take care of their sun-damaged wrinkly necks and leathery, brown-speckled décolletages. This exemplifies the point that you cannot have it both ways: All the fillers, injections, and lifts available will never look convincing if you continue to damage your skin in the sun.

So all this got me thinking: As diligent as I am about wearing sunscreen, I still sometimes forget certain areas like the neck, chest, and hands. Seeing the leathery-skinned housewives of Beverly Hills taught me to never make that mistake again! Because those areas are constantly exposed to UV light, they blatantly show the telltale signs of sun damage if not adequately protected. Let the sun-drenched skin of the Beverly Hills housewives serve as a reminder for us all: Never neglect your neck, chest, and hands from broad-spectrum sun protection!

I could go on and on about other “lessons” from The Real Housewives of Beverly Hills and the other Housewives series, but let’s hear what you have to say!

Last weekend I visited a local cosmetic dermatologist I hadn’t seen before. My goal was to simply have a consultation to discuss my sun damage concerns, but, since time allowed, I went ahead and had a treatment. You might think this was for my face, but, thanks to almost neurotic sunscreen use since I was 14 years old, my face isn’t too sun damaged. My arms are a different story!

Since returning from vacation I’ve been paying more attention to how sun-damaged my arms are looking. The tiny freckles are part of how my skin responds to sun exposure even with high-SPF products (remember, no sunscreen is 100% effective at blocking the sun’s rays) and aren’t cause for concern. What bothers me are the larger, more mottled brown patches that only seem to be getting worse with age. It was time to do something about it!

After ruling out a series of Fraxel Refine treatments (I didn’t want to pony up $2,000 for a series of five, though from what I understand that’s a reasonable price), I decided to have the Vi Peel done. This peel, which was the only one this particular dermatologist offers, is a blend of trichloroacetic acid (TCA), tretinoin, salicylic acid, phenol, and vitamin C. According to the dermatologist, she no longer offers other types of peels because her patients have been thrilled with this one. I didn’t explore whether that’s true or not, but I was eager to see what the Vi peel could do for my sun-abused arms.

Before the peel commenced, I had to read and sign a consent form—standard practice before doctor-performed cosmetic procedures—but that’s where I paused to ask a question before signing on the dotted line.  

What stuck out was the statement that by signing the consent form for the Vi Peel I was waiving my right to request information about the percentage of active ingredients in the peel. Were they serious? I asked the dermatologist about this and she said yes, this form must be signed or they cannot administer the peel. I asked if she would tell me the percentages off the record and her response was that the company that sells the peel (Kalil Medical Products) won’t tell her, either, citing “proprietary information.” Imagine that!

OK, I understand the proprietary portion, but come on! This is a professional peel that’s only sold to and authorized for use by physicians or nurses. Next I asked what they’d do if a patient had an adverse reaction that required medical attention—would the company divulge the percentages then? She wasn’t sure, but suspected they would, and of course she mentioned that none of her patients had experienced a negative reaction to the peel. I didn’t feel pressured to go on, but I was stuck: either I consent or walk away.

Reluctantly, I signed the form. My logic, and mind you my brain was running low on caffeine and it was early in the morning, was that this is being done on my arms, not my face. Given the company-mandated subterfuge at hand, I probably wouldn’t have gone through with the peel if it was being applied to my face.

As for the procedure itself, it was quick and, true to claim, painless. My arms were cleansed, and then the liquid peel was poured onto disposable gauze pads and stroked in a series of three successive layers over each arm, from my wrist to the bicep area. The odor was, well, it didn’t smell good. I can’t imagine having this applied right beneath my nose, and because the peel is left on skin, you smell it for hours afterward.

Once the peel had been applied, I was given detailed post-care instructions and sent home. The peel needs to be left undisturbed for at least four hours after being applied, so I didn’t shower or apply skin-care products to my arms until later that day. Since then, I’ve either been wearing long sleeves (not the best idea at the height of summer) or slathering on sunscreen so as not to undo the eventual results.

I was told that by day three I’d notice peeling as if my skin was recovering from sunburn. So far that hasn’t happened; my skin feels tighter, has a subtle sheen, and looks a bit tan (that’s common). It has also been itchy, but nightly application of Paula’s Choice Slip Into Silk Body Lotion provides welcome relief.

By day seven I’m supposed to see the full effect, meaning signs of sun damage should be noticeably diminished. That’s exactly what I hope to see but whether or not I’ll go back for another Vi Peel remains to be seen. They’re pricey ($250 per treatment) but if the results are impressive enough I could see having it done again. I’ll comment on my progress soon, so be sure to check back! In the meantime, have you had the Vi Peel? Other peels? Did you like the results? Share your experience with us!

I recently visited my hometown to see my family before the holidays. While there, I met with a high school friend of mine that I hadn’t seen in nearly 15 years (where does the time go?). As we caught up on each other’s lives,  naturally we discussed what’s going on with several of our former classmates. I asked about our friend Joanne, as I had lost touch with her and noticed she wasn’t on Facebook (and these days, who isn’t on Facebook?). My friend paused and then revealed some sobering news: Joanne died in August 2006, at age 32, the victim of melanoma. I was stunned. Joanne was a bright, effervescent woman with a quick wit and sense of sly sarcasm that made many boring yet required high school courses much more bearable. I looked forward to seeing her in class and passing her in the hallway, where we’d often make each other laugh with just a silly glance.

As I took this news in, I realized one thing that didn’t click right away: Joanne was a sun worshipper. In fact, my friend mentioned that on sunny days, the two of them would often skip class and lay out on the beach at Lake Lansing, slathered in suntan oil. Joanne had naturally blonde hair and dark eyes, a combination that, along with her light skin tone, allowed her to tan after she became sufficiently freckled. I recalled her stating that she wanted to stay dark enough so that “all the freckles connected”. I also recalled being jealous of how dark she could get. Being lighter than her, it used to bother me that my attempts at tanning were basically useless (not to mention painful) and, as a lucky result, tanning became practice I quickly abandoned despite the pressure to not be pale.

Unfortunately, Joanne learned the hard way that keeping a tan at all costs can end up costing a person their life. Melanoma is the rarest form of skin cancer, but its numbers are on the rise, especially among young women who continue tanning (whether in the sun or, even worse, in tanning beds). The death rate for melanoma is startlingly high: 79% of those diagnosed will succumb. Melanoma is also the second most common cancer in women between the ages of 25–30, though the median age of diagnosis is 45, a time when it may be too late to stop the spread of this deadly skin disease.

Next summer, when the Seattle clouds clear and the rain dissipates, I’ll be paying extra attention to playing it safe in the sun—and thankful for the knowledge I’ve gained after working so closely with Paula on the topic of how sun exposure damages our skin.

Joanne, wherever you are, I hope you’re still making people laugh. You are missed and your untimely passing will serve as a powerful reminder to all who knew you as they consider how to protect their skin from the sun. Joanne’s family left this as her final message: “Wear your sunscreen, hats, protective clothing. DON’T DIE TO BE TAN! Stay away from tanning booths and beds! It’s not just a little spot you have removed and live on. This is a DEADLY BEAST.” I couldn’t agree more!

I received an email the other day from a woman who wrote to thank us for our advice about using sunscreen and the importance of sun protection. We get complimentary messages like this every so often (and they never fail to delight and motivate us), but this one stood out. The timing of the message coinciding with our latest special report on the best sunscreens plus the fact that it’s summer all coalesced and made this email stand out. Why? Because the dear woman who wrote in included a picture of herself after having had a skin cancer removed from her face. As you will see from the photo below (which she graciously granted us permission to as a powerful visual reminder about the importance of sun protection), removing her skin cancer resulted in a scar in a conspicuous place. Here is the note she sent to us, followed by some additional comments from me:

Paula,
I just read your latest report on sun protection and the guide for the best sunscreens. I wish I had had this information years ago when I was in my early 20′s and thought a tan made me look better. Instead, I believed that using sunscreen just kept me from getting a great tan, so I didn’t bother with it.

Needless to say, here I am at age 57 and am paying the price. Just thought I would send you this picture of what I went through a couple months ago having a tiny basal cell carcinoma removed from my face. Now I’m scarred for life. I NEVER go out without applying sunscreen, but the damage is already done. Hopefully I will not have any more of these skin cancers pop up. I take such good care of my skin now; you can tell from my picture (with no makeup on) that I don’t have any wrinkles thanks to what I learned from you. However, I’m so embarrassed now about the scar down the front of my face.

Please keep up the good work of keeping people informed on the need of using a good sunscreen.

Name withheld by request

This woman’s story of regret and what happened to her after years without sun protection should prompt all of us, whether we want to admit or not, to confront the fact that the sun can cause what no one wants to have: cancer. No matter how good the sun feels on a temperate blue-sky day or how gorgeous you think you look with a deep, dark tan, it’s a sobering fact that the sun can (and does) kill us. Of course, simply applying a well-formulated sunscreen rated SPF 15 or above allows us to enjoy the positive aspects of the sun while severely minimizing its potential to cause damage. Personally, I don’t avoid the sun as much as I enjoy it responsibly, like many other things in life.
I want to thank this woman for sharing her story and photo. I hope it resonates with anyone reading this blog who doesn’t use sun protection or, for whatever reason, continues to tan. Skin cancer isn’t the automatic inevitable outcome of sun damage for everyone, but playing roulette with the health and appearance of your skin is not a bet worth making.

Just when it seems the message about sunscreen’s importance as part of a person’s daily routine has been widely accepted, along comes more scary information that has consumers wondering whether their sunscreens are as bad for skin as the sun itself. The latest article questioning sunscreens appears in the February issue of Allure. To Allure’s credit, the article was balanced. Its summation was that you shouldn’t skip sunscreen: it does far more good than harm, and the harm doesn’t equate to the fear lots of people feel when they don’t know the whole story. Funny, that’s a lot like many things in life isn’t it? Our fears and reactions come from a one-sided piece of information.

The article in Allure centered on a study published in the October 2006 issue of Free Radical Biology & Medicine. The study found that while sunscreens can protect skin from the free-radical damage sunlight causes, in a short amount of time it causes free-radical damage on its own. Of course, the big question is: are we trading free-radical protection for free-radical damage, thus canceling out the importance of applying sunscreen?

Lots of doctors and researchers took issue with the results of the study for several reasons: it wasn’t done double-blind, it wasn’t conducted on people, the results haven’t been duplicated by other studies, and the study didn’t use commercial sunscreen products, just individual active sunscreen ingredients. That last point is important because as any cosmetics chemist will tell you, how a sunscreen is formulated has a significant impact on how the active ingredients function on skin (from spreading and adhering properly to their stability). Testing individual sunscreen ingredients and extrapolating the results to apply to regular sunscreen formulas is like tasting individual ingredients used to make a cake instead of the finished product and then being surprised that the flour doesn’t taste sweet.

On the flipside, other studies have shown the protective effect of certain sunscreen actives against free-radical formation—and a growing body of research is demonstrating that adding antioxidants to sunscreens offsets the negative effect sunscreen can have on skin, especially if it is not reapplied at regular intervals during long periods of sun exposure.

Well-known dermatologist Dr. Leslie Baumann was quoted in the Allure article as agreeing with the questionable study. She stated, “We’ve actually been talking about this for a couple of years.” Dr. Sheldon Pinnell of Skinceuticals fame also weighed in, stating “It’s known that some sunscreens behave in this manner. They get inside the skin and absorb energy, and that energy becomes free radicals…” Lots of dermatologists would disagree with Pinnell’s assertion, and even Pinnell believes that any free-radical damage sunscreen may cause (including by virtue of how the active ingredients work) is counteracted by antioxidants, whether in your sunscreen or in other skin-care products you apply. So as it turns out, there really isn’t cause for concern.

The only thing that is crystal-clear about the Free Radical Biology & Medicine study is that more research is needed to determine whether sunscreen actives as formulated in consumer sunscreens cause measurable free-radical damage on intact human skin. Until conclusive information is available, it is not a wise decision to stop using sunscreen due to fear of free-radical damage. Even if some sunscreen actives do cause free-radical damage, we know it can be offset by antioxidants. We also know that going without sunscreen exposes skin to a long list of problems, the least of those being free-radical damage!

I’ll finish with a quote in the Allure article from Amy Lewis, assistant Clinical Professor of Dermatology at Yale School of Medicine: “Right now we have one small, inconclusive study versus huge amounts of data that show that lack of sun protection causes DNA damage, melanoma, basal-cell and squamous-cell skin cancer, and horrible deformed moles and wrinkles, and there is great evidence for prolonged use of sunscreen to protect against all of those things. If these chemicals cause something, the sun exposure you’re trading it for is going to cause more free radicals.” I couldn’t have said it better myself!