The Importance of Sun Protection
By Harry W. Saperstein, M.D.
It is now the time of the year that we review sun exposure and sun protection. It should be remembered that we have sun virtually full time in Southern California and therefore sun precautions should be existent at all times. Also, although patients with lupus need to be particularly cautious of sun exposure, all of us need to be aware of the dangers of sun exposure. The sun causes skin damage, which is both permanent and cumulative. We have to be particularly careful with our children, as 80% of all sun damage to our skin occurs before the age of 20. 
There are two rules which one needs to follow:
1. It is healthy for our bodies and soul to be outside and to be physically active in the “swim of life.” 
2. Any sun, even a little, is bad for our skin and potentially dangerous for your health if you have lupus.
The trick is to satisfy both issues. This can be done only by using good sun sense, wearing sun protective clothing, and by using sunscreen.
First it is important to note the sun’s UV rays are broken down into three categories.
1. UVC, which does not reach the earth. 
2. UVB, which are the “burning rays,” of which 90% are blocked by the ozone layer (or what is remaining of the ozone layer!)
3. UVA, which are the “tanning rays,” are present throughout the day and are not blocked by the ozone layer. 
We used to feel that only UVB was important for skin damage. However, new evidence is showing UVA to be as important, if not more so, in the development of skin aging and skin cancer. It is the UVB rays which are the most important rays responsible for lupus flares, but some patients react to UVA as well.
So, go out, have fun, be active, but follow the following rules.
1. Avoid sun between 9 am and 3 pm if possible.
2. Wind and high altitude increase your ultraviolet radiation.
3. 80% of ultraviolet rays get through on a cloudy day. It does not have to be sunny or warm to get a sun burn.
4. Snow, concrete, water, and sand reflect an additional 85% of the UV radiation.
5. Glass blocks out only UVB completely. Adding a tinted filter will block out UVA as well.
6. Tanning parlors are dangerous today but even worse for your tomorrows.
Trying to avoid activities between 9 am and 3 pm and still being active may physically limit you. The use of sun block on your back, legs, and arms is much more difficult and less effective than sunscreen on the face. There is now a FDA approved fabric with an SPF 30 + manufactured by Solumbra (1-800-882-7860). They make a line of outdoor clothing and cover-ups using this fabric. The use of pants, top, and three inch brimmed hat will completely protect you outdoors from both UVA and UVB for the entire day without concern of application problems, being waterproof, or sensitivity to the product.  
That leaves you to choose a sunscreen to use for application to the face and hands, and to the whole body when swimming. The factors to consider in choosing a sun block are:
1. Use a broad spectrum sun block that blocks both UVB and UVA.
2. Use a minimum of SPF 15.
3. For the face and chest, use a product which is noncomedogenic (does not block pores) and is hypoallergenic.
4. Always use a water-proof sun block if you are going in the water or are excessively sweating.
5. Apply a sun block 15-30 minutes before going outside, reapply it every two hours, and put it on liberally.
6. Use a PABA-free product if sensitive. Use a chemical free sun block (containing Titanium dioxide) if very sensitive or if one is younger than 6 months of age. 
Remember, have fun and embrace a physical outdoor life, but always use good sun sense, sun protective clothing, and sun block. 
The less sun your lupus and skin get, the healthier you will be.