How one photograph changed my perspective on skincare

Before I went to medical school, I didn’t have strong beliefs about sun protection. Then everything changed when I saw an image of what was going on under my skin…

What I used to believe

Growing up, I was best described as sun agnostic. I came from a family of artists who believed that “natural” always equaled good. They saw the sun as a source of health, not a source of harm. They also knew that turning tomato red and peeling sunburns were bad things, but that only happens at the beach, right? So, as an olive-toned child, sunscreen was something I used only when enjoying a day in the sand and surf.

Through my adolescence, on most summer days I’d leave the house sans sunscreen or hat. I was actually hoping to catch some rays in passing to give me that even tan - to make me look “healthy.”  My skin tone easily tanned but rarely burned, so I wasn’t terribly concerned about sun exposure. Because I was not very fair, I assumed that my skin was not at risk of damage from the sun. Wrong!

My sun protection routine today

Leaving the house today, I’m a very different sight. A strict and holistic approach to sun protection is part of my daily routine, 365 days a year. My strategy has two key parts: appropriate sun-shielding clothing and mineral-based sunscreen. Perhaps unsurprisingly, I also use The Base Layer to help my skin resist the free radical damage that does slip through.

So how did I go from being a mild sun worshipper to an adamant advocate for holistic, year-round sun protection? It wasn’t a slow transition, it was a rapid one, caused by a single photograph.

Dermatology has always interested me because it focuses on treating diseases that are visible to others, in a way that internal diseases often are not. I saw the effect that skin diseases can have on a person’s mental well-being, self-esteem and their interactions in society; life-long issues in addition to physical health

So, even before starting medical school, I cold-called dozens of dermatologists in the Boston area to see if someone may have an opportunity for me to learn more about the field.

Who was the one-in-a-hundred that returned by cold-call? None other than Dr. Alexa Kimball, the vice chair of dermatology at Harvard Medical School! It was an incredible opportunity - she invited me to work in her clinical trials research unit.

An example of UV-sensitive photography from Wikipedia. Darker skin indicates areas protected from sun.

The Photograph that Changed Everything

One of the clinical studies I was working on involved taking what are called “UV photographs” of the skin. This special type of photograph enables us to see sun damage that we can’t see with our eyes. One morning my coworker needed a volunteer for test pictures to ensure that the device was working correctly. I volunteered, assuming that my 21-year old skin would come back a picture of perfection - I was young, I wasn’t a skin type that burned, and above all, there were no signs of damage that I could see.

Boy was I wrong.

The image showed that beneath my skin’s surface, my face was already littered with spots of UV damage! I freaked out - was I doomed to premature skin aging and cancer?! This article shows that apparently, I’m not the only one with damage. My UV photo was not quite this severe but it motivated me to more deeply understand what was happening to my skin. Seeing that image made me realize I had a lot to learn about sun safety.

Thankfully, I had the privilege to be working in literally the top sun and skin research department in the world. I sat down with a dermatologist in our department and breathed a sigh of relief when I learned all was not lost.

At my age, she explained, most of the damage I saw was both typical and reversible. Most importantly, she instilled in me an understanding of how important rigorous sun protection would be going forward. That “healthy glow” I loved was no such thing! It was my skin desperately reacting to the damaging rays I was allowing - and sometimes even seeking to send - its way.

Sun protection is a 365-day activity 

That’s when I realized sun damage wasn’t just about burning and peeling from hours at the beach - it was happening every day I left the house without a plan for staying protected. It was happening as I walked my dog on a summer day without hat or sunscreen. It was happening as I squinted against the snow on a January morning. It was all around me, every day.

I now know adequate sun protection isn’t about slathering on a layer of who-knows-what-kind of sunscreen on the way to the beach. It’s a set of intentional sun-protection strategies that help me stay active and enjoy the sun safely for the long haul.

What do you think? Have any questions about sun damage or sun protection strategies? Post in the comments below, and let's continue the discussion.