“How white you are! Don’t you sunbathe?” White people have (we have) this cross, the bad luck of not having been born in the 19th century. But dermatologists give us a breath of hope: you shouldn’t have tanned skin if you want to be healthy. We have been reading it for years and hearing it said, but specialists are increasingly forceful.
Yolanda Gilaberte is president of the Spanish Academy of Dermatology and Venereology and head of the Dermatology Service at the Miguel Servet Hospital in Zaragoza. As she explains to us, in the last 20 years, as a result of the obsession with tanning, melanoma has been on the rise.
We associate aesthetics with the skin, but it has a great role in health. Why is it so?
It is our defensive barrier against external aggressions. Thanks to it we maintain the water and electrolytes that the body needs. In addition, it defends us from ultraviolet radiation, from infectious agents. Healthy skin acts as a barrier against infections. In addition, the skin is an organ connected to the interior, and many of the things that happen inside the body are reflected in it.
If there is intestinal cancer or breast cancer, it can be discovered because there are some symptoms on the skin, they are paraneoplastic dermatoses. Also, a cancer can metastasize to the skin. Deficiency diseases, in which there is a lack of vitamin C, B or trace elements, have manifestations on the skin. There are also systemic diseases in general, such as thyroid, endocrine or gynecological pathologies, which can manifest themselves, for example, with acne or hair loss. There is a brutal connection. Sometimes, significant stress or a psychiatric disorder can make psoriasis or eczema worse… There is a great deal of connection.
Healthy skin and beautiful skin go together?
Yes, there can be no beautiful skin if you don’t have health. They are two inseparable concepts.
What are the most frequent consultations in dermatology? What are the most common skin problems?
Everything related to skin cancer. We have increasingly aged skin. All that are precancerous lesions or melanoma are very frequent. We have consultations for benign tumor pathologies (such as freckles or seborrheic keratoses), inflammatory pathologies (such as dermatoses or psoriasis), alopecia, changes in skin color, vitiligo, infections (such as viral warts, mycosis),… It is very varied.
Melanoma, from 2002 to 2022, has increased by 55% in women and 35% in men, according to the Cutaneous Melanoma Report to Spain…
Yes, there is an increase in melanoma and especially carcinoma. Mortality linked to these tumors has increased, because they occur in older people. 30 years ago you had to be very tanned, there was a passion to be very tanned, and the sunscreens that were available were not like those of today. Probably, the skin cancers we have now are the result of those behaviors. For 10 years the products have improved, people are more aware, but the concept of having to be tanned must be banished from beauty fashion.
He said in a press interview that trying to be tanned is like trying to have a fever. What do you mean?
Tanning is a defense system for our skin. If we are exposed to the sun, the best sunscreen is melanin. Our melanocytes make it to be placed on the skin and protect us from ultraviolet rays. The trigger for melatonin to work is that ultraviolet radiation does damage to the DNA of the skin: wanting to be tanned is wanting to damage the DNA of your skin. When we have an infection, the immune system reacts. When we have radiation, we manufacture melanin so that this is our natural sunscreen.
Wanting to be brown is wanting to have a health problem?
Being outdoors, walking outside… all this is healthy, much better than staying on the sofa at home. If I go out and go exercising or hiking, I will protect myself so that I don’t get burned and that in the long term I don’t age my skin or get skin cancer. At the leisure exhibition, even if I wear a hat and sunscreen, my skin will produce a little melanin, and I will take on color. Now, if I have the concept of going to the beach to sunbathe for three or four hours because I want to be tanned, this puts our skin at great risk. A sunscreen is not like staying at home, and lightning will always pass through. Exposure to rays like this will never be healthy.
Should being white be back in style?
Yes, Asians wear gloves and a sunshade because in their culture being tan is not equated with beauty. We would have to move towards oriental tastes: want everyone to have skin of their own color, not brown.
What general recommendations would you give to go to the beach?
Whenever we can, we have to avoid the sun from 12 to 16 hours, when most of the ultraviolet B radiation is received, which causes more skin cancer. I also recommend bringing a sunshade to avoid exposing ourselves to the sun for so long, and wearing a hat to protect the head a little. The photoprotector must be a minimum of 30, who burns easily at least 50, and also have photoprotection against ultraviolet A rays.
Do we do it very badly with sun cream?
We would have to put double the amount of cream that we put on. It is not very viable because we would spend a bottle every time we go to the beach, and also, nobody likes to be covered in cream. How can we compensate? Reapplying the cream, especially if we bathe or sweat. We use sprays or foams because the amount of product we put in is often less. But the best sunscreen is the one that the person likes.
And with daily skin care, do we do it very badly?
Regarding hydration, depending on age, we need more or less hydration. Young people need less because they have more sebaceous secretion. The place where we live also influences, in dry environments more emolliency is necessary, especially in winter; while in more humid places, it is not so necessary. Regarding soaps, many contain a lot of detergent and drag too many lipids from the skin, altering the microbiota. It is necessary to use soaps without detergents, or soaps such as shower oils. It has not been proven that showering often with soap is bad for the skin, as has been said on many occasions.
