An Interview with Health’s First Medical Group

Dr. Larry Bishop

SpaceCoast Living: Thank you for meeting with us today. We’re making March our water sports issue and to be a service to our readers, we thought we’d address personal skin care and protection while on or near the water. So, tell our readers a little bit about skin protection and skin care. What people need to know to take care of themselves out there on the water.

A: Well, as both a dermatologist and as a kiteboarder, I have a lot of exposure to the problem from both sides, as a patient and as a doctor.  So let me start from the perspective of being a kiteboarder. You’re out in the sun and you’re having a great day, you have a lot of really great wind, and you’re just having a fantastic time. The thing you have to remember is to be prepared both before you go out and also while you are out there. Otherwise, especially on a bright day, you’ll not only get the direct rays of the sun on your head and scalp, but you will also get it on your ears, on your face, on your arms and on your legs. Something that people don’t fully realize is you can also overexpose your eyes.  Our eyes take a real beating both externally as well as internally and in fact, a colleague of mine, a retina specialist here in Melbourne, told me the biggest risk factor for macular degeneration is ultraviolet exposure.

Q:  That is something that people don’t realize.

A: So take that and engineer it backward. What you want to do is you want to protect your skin and there are multiple ways to do that. The obvious one is if you’re out and you can, wear a rash guard. A rash guard is an elastic suit. It works as a long-sleeved shirt and is an ultraviolet shield. It gives you a much longer time out in the sun without worrying about getting blistered on your back and on your arms, but equally importantly, it also protects you from some of the other things that are out there, like jellyfish stings. So, it has multiple advantages. Next, how to protect your head? Whenever people get wet, their hair gets plastered down and the scalp is more exposed. If you can see more skin, that means you also will get more sun damage to the skin on your scalp. My favorite thing is to get one of those full-brimmed floppy hats.  Floppy hats work like an SPF 1,000 in prevention of ultraviolet exposure.  But the other thing, that’s equally important, is that even if it gets wet, it doesn’t wash off.  So in comparison, if you were to spray sunscreen on your scalp, you would find that over a course of maybe the next hour or two, it can get washed off easily in the water during your activity. But with a hat, the protection is always there. I like the hats that also cover my neck, like a French Foreign Legion hat.

Q: There’s our first pro tip. Get a big hat! What’s next?

A: Next, protect your eyes. The rule for sunglasses is if you look in the mirror and you can see your pupils, then your sunglasses aren’t dark enough, particularly for being on the water.  You also need to have wraparound frames and lenses so you can get side exposure protection as well as direct frontal exposure. 

Q: Let’s talk about sunscreen.

A: You know, sunscreen is not very controversial these days.  There were a lot of people back in the 80s and in the 90s who would challenge the validity of using sunscreen on a regular basis.  But there are so many scientific studies, particularly that have come out of Australia, which gets a lot of sun exposure at a very low latitude, proving sunscreen works.

SCL: How strong is strong enough? SPF 100?

A: Anything that’s SPF 30 or better. If you go to an SPF 100 or something like that, it really doesn’t make any difference. Actually, the American Academy of Dermatology suggests SPF 30 as well.

Apply it every two hours. If you do that, then you’re generally protected; if you don’t, you’re not. So looking at it from kiteboarders’ perspective again, I want to be out there for a long time and enjoy the day, so UV clothing and suncreen are really important.

I have a lot of patients who have had to stop doing the things they love because they have had so many skin cancers. Besides my kiteboarding, I also happen to be a fisherman and if I’m out on the water for any length of time, I have to protect myself for the exact same reasons that we’ve talked about with kiteboarding. The difference is that it’s a lot easier as a fisherman to cover completely both legs and the arms. There is UV-protecting clothing now, and it’s phenomenal.

SCL: That was our next question.

A:  It’s really phenomenal. Columbia Clothing makes a UV blocking clothing line and you can get the shirt and pants. It is so much less expensive than it used to be and it works fantastically. I go fishing with a bunch of friends every year and we all are dressed from top to bottom in this gear, and it works really, really well. It also keeps you cooler than if you’re out there in shorts and sleeveless shirts because it has a reflective property to it. And if it gets wet, it just keeps working.

Last but not t least, and it’s something that’s relatively new here, there are elastic masks that fit over your face and come up to your eyes. You can talk, you can breathe normally, and it works fantastically because if you’re out for a long, long day on the water, you are going to sweat. When you wipe away the sweat, there goes your sunscreen. If you’re wearing one of those masks, you’re not going to rub that off.

You’ll find fishermen down in Central America or the guys that spend a lot of time out on the water or even in our own Mosquito Lagoon wearing those these days because being out there is their job. They have to protect their job.

Q: What about windburn?

A: If you’re skiing or water skiing or wakeboarding or for that matter kiteboarding or anything else, what you find is thicker sunscreens seem to protect you against wind better than the thinner spray-on sunscreens. So if you’re going to be exposed to a lot of sun and a lot of wind, it probably makes sense to use the kind that comes out of a bottle instead of a spray.

SCL: There’s another pro tip: Use sunscreen in the bottle instead of a spray.

Dr. Bishop: Now get out there and do something near or on the water!

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