May 23

Sunscreen Breakdown – What You Need To Know

What’s in your sunscreen is just as important, if not more important as its SPF number. When deciding which sunscreen to purchase, it’s easy to get overwhelmed by the multitude of choices out there. This is why Dr. Palm talked recently with to discuss the differences between the two main “groups” of sunscreens and why one is very much superior to the other. The active ingredients in sunscreens are what separate the good from the not-so-good – and they are divided into two broad categories: physical and chemical. 

Physical vs. Chemical – The Breakdown

What they’re made of

Physical sunscreens are often referred to as “natural” sunscreens, because they are made up of either zinc oxide or titanium dioxide (or both).  These are the only FDA-approved physical sunscreens and are both minerals, which is the reason they are often labeled as “natural.” 

Chemical sunscreens are made up with ingredients that are often hard to pronounce, such as avobenzone, oxybenzone, homoscalate, octinoxate and octocrylene. 

How they work

Physical sunscreen agents work by reflecting light that reaches the skin’s surface back into the environment. Many dermatologists, Dr. Palm included, prefer a physical-based sunscreen for this very reason. Zinc oxide has excellent coverage across the UV spectrum, even better than titanium dioxide, and published scientific literature shows that neither of the two are absorbed from the skin’s surface into the body. In fact, even micronized forms (where particles of sunscreen are invisible to the naked eye) cannot and do not penetrate the surface of the skin. They simply sit atop the skin’s surface, acting as a shield and reflecting the light back into the environment.

Chemical sunscreens work by converting light energy into heat on the surface of the skin, which may contribute to sun damage to the skin over time. The heat causes inflammation on the skin, which can cause premature aging. Anyone with melasma should be very weary of chemical sunscreens, as the heat produced on their skin by chemical sunscreens can further aggravate their pigmentation.

What to Look For When Shopping For Sunscreen

Dr. Palm recommends looking at the active ingredients on the label of the product. A physical sunscreen should list zinc oxide, titanium dioxide, or both. She recommends using a zinc-based sunscreen with a 7% or higher concentration of zinc oxide. It’s also important that a sunscreen has an SPF of 30 or more and that it states it is “broad spectrum,” meaning it protects against both UVA and UVB. 

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Dec 21

Indoor Tanning ban proposed for minors by FDA

On December 18, 2015 the FDA announced a Proposed Rule to help protect consumers against indoor tanning exposure.  Currently, 42 states have already enacted laws regarding indoor tanning bans, restrictions and consumer education regarding UV exposure from tanning beds, and the federal government is finally following suit.  The FDA has not addressed a ruling regarding on indoor tanning bed usage since 1985.


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Jul 27

Do It Yourself (DIY) Tips – Home Remedy Sunburn Relief

Sunny days in San Diego, California mean ample exposure with the sun.  Unfortunately, prolonged exposure, or lack of good sunscreens, can cause a nasty sunburn.  When you get a sunburn, your skin turns red and hurts. If the burn is severe, you can develop swelling and sunburn You may even feel like you have the flu -- feverish, with chills, nausea, headache, and weakness. A few days later, your skin will start peeling and itching as your body tries to rid itself of sun-damaged cells. If the unfortunate occurs, and you do experience a sunburn, what can one do to create sunburn relief? Continue reading

Jul 15

Sun Safe Skin Tips for Del Mar Races & Opening Day

Opening day is this week and Art of Skin MD wants to give you tips to keep your skin safe where the surf meets the turf!  The forecast calls for lots of sunshine and warm weather, which means sun safety is even more important amongst the dazzle of sundresses and fascinators.


Here are the Dr. Melanie Palm top tips for keeping it cool during Race Season:


1.  Slather on Sunscreen.  New FDA guidelines were released this year regarding best practices and proper labeling and usage of sunscreens.  Sunscreens should be broad spectrum, meaning they cover both UVA and UVB rays.  UVB rays cause the redness associated with sunburn, and UVA causes aging changes to the skin like sun spots, skin texture changes, and loss of collagen - not exactly the fashion statement to make on Opening Day.  Zinc oxide and titanium dioxide sunscreens are great as they act as physical blockers of the sun and offer broad spectrum protection.  Art of Skin MD offers a variety to choose from including the Elta MD line, Revision, Neocutis Journee, and the Art of Skin MD line.

top sunscreen choices san diego

Elta MD sunscreen offers cosmetically elegant formulations of micronized zinc oxide preparations












2.  Be unforgettable with Sunforgettable by Colorescience.  Got limited space in your purse or pockets to carry sun protection?  No problem.  We have a solution that fights shine and protects skin.  The Sunforgettable brush by Colorescience is an award-winning formulation endorsed by the Skin Cancer Foundation.  This brush delivers zinc-based sunscreen powder as a sheer film that works on skin that already has sunscreen or makeup applied.  It is great for the stands, Turf club, and even beyond.

Art of Skin MD sunscreen brush

An elegant and compact brush system, Sunforgettable packs a powerful punch against harmful UV rays













3.  Prep with a pill.  Heliocare, a popular supplement, classified as one of the newer popular "sunscreen pills" can be a potent and helpful supplement to good photoprotection.  Although not a substitute for good sunscreen habits, popping Heliocare prior to an afternoon of fun in the sun can work synergistically with sunscreen to increase your threshold of protection against UVA exposure.  Heliocare contains several agents to help against unwanted UV rays and is great for patients battling pigmentation such as melasma, or those with sensitivity to the sun.  Heliocare is a combination of potent antioxidants including the an extract of the fern plant Polypodium leucotomos, beta carotene, and green tea.  Taking Heliocare 1-2 hours before sun exposure can help to boost the effects of sunscreen.

Fern extract pill for sunburn

Heliocare supplement is consists of a combination of potent antioxidants including the polypodium leucotomos fern plant, beta carotene, and green tea

















4.  Seek shade.  A broad-brimmed derby hat is a great way to provide shade protection to your face.  The San Diego hat company makes UPF hats perfect for Opening Day.  Many styles are available at our local Beachwalk retail boutique Safarlou.  Escape to the Turf Club or the shady portions of the general admission stands to protect that glowing skin from the sun.  Check out the chic, stylish chapeaux offered by Safarlou in the YouTube video from the TV segment featuring Art of Skin MD below:



5.  Repair from the day of fun near the sun.  Feeling the burn from your fun in the sun?  Repair your skin using growth factors from the Neocutis line.  Neocutis' PSP exclusive human growth factor technology is featured in the Art of Skin MD favorite eye cream Lumiere Riche.  The Biocream and Biogel by Neocutis both contain the human growth factor to repair collagen and get your skin back on track.

Neocutis Journee sunscreen san diego

Neocutis line of skin products harnesses the collagen-repairing properties of growth factors













6.  Red alert:  Red light for sunburn.  Made the unfortunate mistake of getting a sunburn at a day at the Races?  Have no fear, Art of Skin MD offers the Healite II, an innovative red diode light that decreases the inflammation and redness associated with sunburn.  Best of all, treatment is affordable and sometimes billable to insurance in the treatment of sunburn.  See the clip below to understand how Healite works as I explain on the recent CW6 TV segment:



Have a great time at the Races this year.  Be sun safe, and when in doubt about how best to protect your skin during the summer months in San Diego, contact Art of Skin MD through the Art of Skin MD contact page or by calling our qualified staff at (858) 792-7546.





Jun 30

Sunburn Prevention & Treatment: Think Red Light and Ferns

According to the Skin Cancer Foundation, approximately 42 percent of us experience a sunburn at least once a year.  That is an astounding statistic!  We know that a history of severe sunburns is a risk factor for melanoma, and ultraviolet light exposure is strongly related to the development of other skin cancers including basal cell carcinoma and squamous cell carcinoma.   Check out the videos below featuring me (Dr. Melanie Palm) addressing sunburn treatment and prevention on San Diego TV outlets:       UT-TV SAN DIEGO ON PRIMETIME WITH TAYLOR BALDWIN:     SAN DIEGO 6 ON SAN DIEGO LIVING WITH KRISTIN MOSTELLER:     KUSI ON GOOD MORNING SAN DIEGO WITH MIKE CASTELLUCCI:     So what can we do to prevent sunburns and all of the uncomfortable sequelae that follows:  the pink skin, the hot flush to the skin, the feverish body aches, and the flaky skin that follows.  There are some simple and easy to remember steps that can help to minimize the opportunity for the San Diego skin scorching.   1.  USE SUNSCREEEN!  Pick a broad spectrum sunscreen that covers both UVA and UVB.  UVA is related to aging changes in the skin - pigmentation, loss of elasticity, and premature wrinkling.  UVB causes the burn like response following sun exposure.  Most dermatologists including myself recommend a physical blocking agent as one of the sunscreen's active ingredients - like zinc oxide or titanium dioxide.  Make sure that the SPF is 30 or higher.  Apply sunscreen prior to going outside and reapply often...usually every 90 minutes during outside activities.   2.  Seek shade and avoid peak hours.  Being a part of the beautiful weather is part of being a San Diegan, but that doesn't mean we can't be sun smart.  Try to avoid outside activities during peak sun hours of 10 am to 4 pm.  This is when the UV exposure is most intense and shadows are shortest and hard to find.   3.  Try supplementation.  In addition to the requisite sunscreen use, there are a few dietary supplements that can help minimize the opportunity for sunburn and have a protective role for your skin.  A fern extract for the polypodium leucotomos plant is packaged as capsules called Heliocare.  Ingestion of Heliocare prior to sun exposure is somewhat protective against damage waved by UV waves.  Oral intake of green tea has a similar somewhat protective effect.  However, neither is considered a suitable substitute for photoprotection and both should be used in conjunction with sunscreen.   Prevention is the best treatment for sunburn.  However, if one does occur, early intervention is key.  Contrary to popular belief, there are several measures that can be taken to alleviate a sunburn.  Here are some helpful steps:   1.  Take ibuprofen as soon as possible.  It is an non-steriodal anti-inflammatory that not only alleviates pain but decreases the inflammation associated with a sunburn.   2.  Use a topical steroid.  This is best done at the first sign of a sunburn.  Over the counter hydrocortisone works in a pinch, but a board-certified dermatologist can provide a prescription-strength steroid that better addresses a sunburn.   3.  Put on the red light.  Like the famous Police song "Roxanne," red light also works for sunburns.  A red diode light called the Healite II is used for Art of Skin MD patients to reduce inflammation associated with sunburn and make the redness subside more quickly.  The red light takes mere minutes, is covered by insurance, and is painless.   4.  Seek professional skin help.  If the sunburn is causing blisters, fever, flu-like symptoms, or other concerning side effects, call a health care professional immediately.  Although your dermatologist can handle most significant sunburns, occasionally hospitalization including care in the burn unit may be required to replenish fluid and decrease pain.   5.  Prepare to moisturize.  Once the sunburn has resolved, the skin often peels, sometimes significantly for the next week to 10 days.  It is important to use a moisturizer, and use it often.  Moisturizers that contain ceramides are particularly helpful.  Ceramides are cholesterol-derived, natural occurring fats that normally moisturize our skin surface.  During inflammation, they are depleted.  CeraVe and Cetaphil among others are brands that contain the dry-skin squashing ceramides.    

Jul 4

New FDA Rules on Sunscreens – What San Diego Adults and Kids Need to Know recently contacted me (Dr. Palm) wanting to know the scoop on changes in Sunscreen Labeling for the coming year according to the new FDA 2012 Rule.  Here are some of their questions and my answers below.

  1. The FDA's new sunscreen regulations can make consumers worried and confused. How can they be sure they are choosing sunscreen that offers adequate and appropriate protection for their needs?   "There are two important things to look for...1. That the sunscreen is "broad-spectrum" meaning that it covers both UVA and UVB rays and that the SPF is sufficient. The FDA recommends a Sun Protection Factor of 15, many dermatologists including myself prefer at least 30 SPF." 2. Consumers could also be confused about UVA and UVB protection. Can you briefly explain the, and why people need to be protected from both kinds of rays?and UVB cover different wavelengths of the ultraviolet spectrum of light radiation.  UVA are longer wavelengths (340-400 nm)--I usually tell patients that the "A" in UVA stands for "Aging"--UVA can cause skin aging effects related to significant sun exposure and UV exposure. These include sun spots, pigmentation, and wrinkling related to sun exposure. UVA has been related to some melanomas."  
Melanoma screening by Dr. Melanie Palm, a cosmetic surgeon in San Diego diagnosed this melanoma early
UVB are shorter wavelengths (290-320 nm). UVB is blocked by window glass, but UVA is not. The "B" in UVB can bring to mind "Burning." UVB is related to the red sunburn response seen after significant sun exposure. UVB is strongly related to the formation of nonmelanoma skin cancers including basal cell carcinoma and squamous cell carcinoma. Because both wavelengths have carcinogenic potential, a broad band spectrum sunscreen protecting against UVA and UVB is necessary.
Squamous cell carcinoma in San Diego

Squamous cell carcinoma of the scalp

  3. Many people buy sunscreen according to the SPF level. Under the new guidelines, will the SPF level still be as important, or is it more important consumers purchase one labeled broad spectrum?   "As explained above, these labels mean different things. SPF refers to the level of UVB protection. Broad spectrum coverage refers to the sunscreen's ability to protect against both UVA and UVB. Both are important, and understanding the difference is crucial to selecting an adequate sunscreen." 4. How will consumers be able to tell the difference between a sunscreen that was labeled according to the new regulations?   "These are relatively subtle changes in nomenclature--the way of describing the sunscreens. Waterproof is gone, replaced by water resistant and very water resistant. Broad spectrum will mean coverage against both UVA and UVB." 5. Many budget-conscious consumers purchase sunscreen at discount and closeout stores. After the FDA deadline, will these places still be able to carry sunscreen with the old labels? If so, what should consumers look for in the labeling to be best protected?   "My understanding is that these products can still be displayed as long as they are not expired. Products manufactured after the new FDA rule is in place will have to abide by the new Rules. Consumers should look for labels stating both UVA and UVB coverage. Ingredients such as zinc oxide, titanium dioxide, Mexoryl, and avobenzone (oxybenzone) are key ingredients for adequate UVA coverage. An SPF of 30 or above should be sought for adequate UVB coverage." 6. The new rules won't allow sunscreen to be labeled waterproof, only water-resistant. How long does a sunscreen, even one labeled water-resistant, really last?   "Water resistant is defined as sunscreen effective for at least 40 minutes of activity in the water. Very water resistant allows for 80 minutes. Sunscreens are strictly tested to be awarded this designation. However, patients are encouraged to reapply sunscreens after heavy activity including water sports by many dermatologists. At a minimum, most dermatologists recommend reapplication every hour and one-half to two hours when outside." 7. Do you have any other tips on what individuals should consider when it comes to purchasing their sunscreen protection?   "Choose a formulation you will use. If a product is thick and a body area needing to be covered is hair-bearing, this does not make for a good outcome. Apply sunscreen evenly and liberally. Rub in spray on products. Furtermore, the vast majority of consumers under-apply sunscreen. A full one-ounce should be applied to the body with each application (size of a shot glass). This means a typical bottle of sunscreen should only last 4 applications."
Proper sunscreen application is explained by Dr. Melanie Palm, a board-certified dermatologist in San Diego, CA

Proper amount of sunscreen (1 oz.) for full body application