Skin Talk with Dr. Umesh Nihalani, Specialist Dermatologist, Dubai London Clinic & Speciality Hospital

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Dr. Umesh is a Specialist Dermatologist with more than 15 years of experience in the fields of Clinical Dermatology, Aesthetic Dermatology and Venereology and has had the opportunity to work in both India and the UAE.
He has vast experience in treating patients with all types of skin ailments, such as Acne, Pigmentation disorders, Skin Tags, Eczema, Fungal, Viral & Bacteria infections, Hair Loss (Alopecia), Disease of the Nails, Herpes, Hives (Urticaria), Pre-Cancerous skin growths (Actinic Keratoses), Psoriasis, Rosacea and Warts. He has expertise in the treatment of various Sexually Transmitted Infections such as Gonorrhoea, Syphilis, and Genital Warts. He is skilled in various Aesthetic Treatments such as Botox, Fillers, Thread Lifts, and Laser Treatments. Dr. Umesh has relentlessly pursued opportunities in continuing medical education, participating frequently in meetings and conferences. It is this passion for learning that drives him to understand and care for his patients with extraordinary depth.

Do we need to use sunscreen every day, and why?

Ultraviolet lights that reach earth consists of shorter UVB and longer UVA wavelengths. UVA and UVB suppress the skin immune function. That can lead to sunburns, skin cancers and premature skin aging.

In a country like UAE, what is the best SPF factor to be used daily? And for a day at the beach?

Sun rays are stronger and more damaging near the equator. Ultraviolet rays reflected off of sand, concrete adds to the total UV exposure. Ideally one should use “Broad Spectrum” sunscreens, which protects against UVA and UVB. If properly used in enough required quantity, minimum of SPF30 is recommended for daily use.  Sunscreen should be used at least 30 minutes before the sun exposure, should be reapplied again immediately before sun exposure and then every two hours.  During extra sweating, swimming it should be reapplied more often.

What are the best types of sunscreen to be used? (in terms of formula) What is the difference Mineral and Physical SPF? Which is better?

Sunscreens are of two types physical and chemical. Physical sunscreens scatter and reflects the ultraviolet rays while chemical sunscreens absorb it through chemical reaction. Physical sunscreens are inert for longer duration but they leave a tint on the skin. While chemical sunscreens break down over the time and have (though less than 2%) contact dermatitis potential.

Now a days many combinations of both type of sunscreens are being developed for long-term and better protection.

What are the dangers of unprotected sun exposure/tanning?

  1. Sunburns
  2. Phototoxic reactions
  3. Skin wrinkles, fastened aging process
  4. Abnormal pigmentation
  5. Skin cancers
  6. There are many skin inflammatory conditions can be aggravated by unprotected sun exposures

How often does sunscreen need to be reapplied?

Every two hours.  During extra sweating, swimming it should be reapplied more often.

Do we need to wear sunscreen even if there’s no sunshine, it’s cloudy?

Yes

What are the key benefits of applying sunscreen? How does it protect our skin?

Most harmful UV rays are at the time when the shadow is smaller than actual individual. One should plan outdoor activities accordingly. Sunscreens do not provide total protection and should be used in conjunction with other sun protective measures such as wearing sun protective clothing and staying indoors or out of the sun during peak sunshine hours. But using sunscreens as recommended can prevent from sunburns, prevent skin cancers and delay the aging process

How much can we tan, to maintain healthy skin?

There is no word like “healthy tan”. Skin tanning is a response to ultraviolet radiation skin injury.

Does applying sun protection stop skin from browning/tanning? (some people just apply oil to get the best tan- some piece of advice for them)

Basically, tanning is natural skin umbrella to protect deeper layers of skin. In white skin, where the melanin cells are not very active, they get irregular pigmentation in the form of sun spots. But rest of the skin remains under stress as it’s unable to make uniform melanin/tan to protect deeper structures, that stress can lead to skin cancers. Sunscreens are not 100% protection, but they are largely effective in sun protection if applied as recommended. Sun Tanning lotions (tan-in-a-bottle) are skin dyes, safe to use but they don’t provide any sun protection.

Do we need to wear SPF at night? In winter?

In winter – the answer is yes; we need to wear the SPF all the time.

At Night – many studies have suggested that indoor lights (some LED lights and screens) can also emit UV rays, though in very low quantities. If one has severe photosensitivity, should wear SPF all the times.

Does every member of the family need sun protection? Do kids need more than adults?

All members are equally susceptible to the damages done by UV radiation. Kids do need sunscreens as well.

What are the key misconceptions about skin, tanning, and sun protection?

  1. If going for few minutes in sun won’t harm – fact is each dose of ultraviolet radiation, large or small, adds up leading to skin damage
  2. There is nothing like healthy tan.
  3. If cloudy you don’t need sunscreen – the fact is, ultraviolet rays are not filtered by clouds.
  4. If indoors you don’t need sunscreen – the fact is, if you are sitting next to a glass window, indirect rays can do damage as well.
  5. Once a day application of sunscreen is enough – the fact is, sunscreen should be reapplied every two hours, should be applied more frequently when swimming or sweating.
  6. Small amount of sunscreen is enough for protection – in an average adult person needs 6 teaspoons of sunscreen lotion to apply on exposed areas.
  7. Excessive sunscreen can lead to vitamin D deficiency – the fact is, you need only 5 minutes (10 minutes for darker skin type) of sun exposure on small part of your body like arms and legs to get your daily vitamin D requirement.

As an expert on skin, share with us your guidance/advise on healthy skin in three short tips.

  1. Sun Protection.
  2. Hydrate by appropriate moisturizer that suits your skin type and hydrate internally by drinking at least two liters of water.
  3. Each meal should consist of as many natural colors it can to nourish your skin and body.

Please explain the difference between UVA and UVB rays, and mineral and physical sunscreen?

(for physical and mineral sunscreen see answer of question 3)

Ultraviolet light is a part of the daily sunlight with wavelength of 100-400nm. It can be broken down to three bands

  1. UVC – 100-290 nm. Very high energy radiation, most harmful. Fortunately, it is filtered by atmospheric ozone layer
  2. UVB – 290-320 nm. Injures skin by damaging DNA, cannot penetrate very deep in the skin. If DNA damage not repaired properly, can cause gene mutations which can be carcinogenic
  3. UVA – 320-400 nm. Long wave, can penetrate deep in the skin. Forms free radicals by damaging the skin. Which can be carcinogenic. As it can penetrate deep at the level of the collagen which can cause aging changes.

There is SPF 50, and SPF 50 PA+++ , what does that mean and is it actually better?

SPF (Sun protection Factor) is measurement of a sunscreen for protection against UVB.

PA is protection grade of UVA is denoted by in sunscreen.

SPF50 PA+++ is better than SPF50, means it has proven UVA protection as well

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