Everything You

Need to Know
About Sunburns
A Guide to Sunburns and
the Damage They Cause
by Dr. Cynthia Bailey
Table of Contents

Introduction 3
The What, Why
4 and How of a
Sunburn
What About a Tan? 6
Actionable Steps
10 to Treat and
Commonly Asked Avoid a Sunburn
Questions About 12
Sunburn Treatment
Creating a Sun
13 Protection
Strategy
Alternatives to
14
UV Tanning
Tan Skin and the
16 Recent Aesthetic
Trend
Control the
Damage 17
Build Your
20 Complete Skin
Care Routine
Summary 21

22 References

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Dr. Bailey Skin Care, LLC © 2016
Introduction
Why Are Sunburns Bad? How Can You Heal Sunburned Skin?
What Can You do to Repair Some of the Damage?
The redness and pain that you experience and see on Sunburned skin often develops ‘sunburn freckles’ as a
your skin, and that we call a ‘sunburn’, is the result of a permanent reminder of the damage that occurred on that
cascade of inflammation occurring inside your skin. This carefree day when your skin was overexposed to ultra
inflammation is triggered by exposure to more ultra violet violet rays. The more often your skin is sunburned, the
(or, ‘UV’) rays than your skin can take. You can soothe more sunburn freckles you will have. Sometimes it only
the pain to make your skin feel more comfortable, but the takes one really bad burn to cause freckles.
inflammation and redness still has to run its course.
When I see ‘sunburn freckles’ on a skin exam I know
Your sunburn and the UV exposure that triggered it means that this person is at a greater risk of skin cancer and I
that the DNA of the cells on the inside and outer-most get extra worried about finding one on that area of skin.
layer of your skin has been damaged. There is no ‘cure’ Sunburns increase your risk of getting melanoma, the
or reversal for that consequence of the UV exposure that potentially deadly (a.k.a. big ‘C’) type of skin cancer.
resulted in the sunburn. That being said, you can help
your body fend off some of the consequences of that
DNA damage, and I will tell you how to do that later in this
ebook.

The damage is so extreme, even one blistering sunburn before

age eighteen doubles your risk of developing Melanoma.
Prevention is the best way to deal with a sunburn. And this means being prepared every time you step outside into the
sun.

I just gave you the ‘executive summary’ about sunburns. The details are important and I’m going to cover them next.
Understanding these details will help you build the best sun protection strategy for your lifestyle. They will also help you
understand how to support your body to fight off some of the damage that has already been done.

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The What, Why and How of a Sunburn
What Causes a Sunburn?
Sunburns are caused by solar UV rays penetrating the
cells and structures of your skin. There are 2 types of
solar UV rays that cause sunburns.
UVB Rays are the major UV ray that cause sunburns.
The intensity of UVB rays varies during the year and
according to where you are on earth. UVB rays are
most intense the closer the sun is to you. That’s
because they are absorbed by the earth’s ozone layer
- the more ozone between you and the sun, the less
UVB rays will reach your skin. Expect more intense
UVB rays,
1. During the middle of the day when the sun
is straight over you,
2. In summer when the sun is in your
hemisphere of the earth,
3. At the equator where the sun is always
closer to you,
4. At high altitudes where you have climbed up
closer to the sun.
outside, there are UVA rays bouncing around and
capable of damaging your skin. Yep, it’s true!
UVA rays also are reflected off of sand, snow and
many reflective surfaces and they penetrate into
water, just like UVB rays do. There are a lot more UVA
rays from the sun than there are UVB rays, BUT, UVA
rays still don’t contribute as much to your sunburn.
This is because the UVB rays are more rapidly efficient
at burning your skin and UVA rays are slower at it. You
usually get out of the sun before the UVA rays can
burn you because UVB does it first. Once UVB has
started to cause skin discomfort and the sensation of
an impending burn you naturally start to pay attention
and cover up or get out of the sun before the UVA
rays can significantly burn you too!

Two More Fun Facts You Need to

Know About UVB Rays
They bounce! Yep, if they missed your skin the first
time they get another chance to hit you when they
bounce off of reflective surfaces like sand, snow,
cement, rock, reflective buildings and windows. When
this happens, your UV exposure will be significantly
more intense. (This is why I love my UV Detecto Ring
as a teaching device – it has demonstrated surprising
UV exposure from bounced UV rays.)

Clouds don’t block much of the UVB rays and

neither does water. Ever been burned on a cloudy
day or while swimming? Foggy day sunburns in San
Francisco continue to surprise tourists – and even
people who live here!

Can UVA Rays Cause a Sunburn?

The answer is yes, but it’s complicated. UVA ray
intensity does not vary much during the day, at
different times of the year or between different places
on earth. Said another way, UVA rays are out all day,
all year, everywhere in the world. This means that
if you don’t need a flashlight to see when you are

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That said, anyone who has ever had a tanning bed
burn knows that UVA (which is the type of ray in a
tanning bed) are capable of burning skin. In a tanning
bed the UVA contributes entirely to the burn because
there is no UVB to burn you first and get you out of
there. This means that in a tanning bed you’re able to
tolerate getting a lot of UVA exposure – which is extra
bad for your skin! Here’s why.
UVA penetrates your skin more deeply than UVB
making it especially powerful at causing wrinkling
and damage to the deep layers of your skin. Your
moles also go deep down into the skin, where
UVA can reach, and we know that tanning beds
seriously increase the risk of getting melanoma
(the cancer of moles, and cells that make moles called
melanocytes). Tanning beds are bad.
To observe for yourself the efficiency of UVA at
causing structural damage to skin look closely at skin
that has tanned in a tanning bed. Do you see odd
freckling and a lot more leathery wrinkles and crinkled
texture than you might expect? That’s UVA damage. It
is really hard to fix because it is so deep. The tan color
your skin gets from a tanning bed looks different too if
you look closely. Bottom line is that tanning beds are
not a good idea for any reason. (Later in this ebook
I’ll also tell you why the ‘base tan’ that some think
they are getting by using tanning beds before a beach
vacation does not even protect their skin from UVB
sunburn!)
Dr. Bailey Skin Care, LLC © 2016
What Exactly is a Sunburn?
It’s actually a normal result of (mostly) UVB overdose
exposure to your skin. The overdose causes a
cascade of inflammation that leads to pain, redness,
swelling and some of the same type of physiology
you would associate with an infection or arthritis.
The mechanism is different and there is no infectious
organism at play, but nevertheless the symptoms
you feel are due to inflammation. The inflammatory
reaction that begins in the skin can spread to effect
the entire body in the case of a severe sunburn. No
matter how severe the burn, some of the cells of your
skin actually die, called ‘sunburn cells’
The Physiological Process of a Sunburn
1. Redness, typically starting 6 hours after UVB exposure
and peaking at 12-24 hours. The more extreme the sun
exposure the faster the reaction occurs (i.e. really fair
skin on a sandy equatorial beach at noon!).
2. Tenderness of the skin follows the redness.
3. Swelling (edema) of the skin.
4. Blistering happens in the extreme.
5. Peeling occurs in a week, even without blistering.
6. Severe exposure can lead to generalized symptoms
including:
• Fever
• Chills
• Nausea
• Rapid heart rate and even dangerously low blood
pressure.
These generalized symptoms can last up to a week
and can become a medical emergency.
Think of a sunburn as a UV overdose, poisoning or
sickness. Like poisoning, nothing good comes of it.
When the skin is made sick by the overdose of UV it
is injured and requires special care, which I’ll describe
below.
In the recovery phase following a sunburn the skin
appears to heal visually but is forever changed.
The more frequent and severe the burns, the more
damage there will be. In the worst case this means an
increased risk for melanoma (the ‘big C’ skin cancer).
5 or more blistering sunburns between the ages of 15
to 20 can increase the risk of getting melanoma by as
much as 80 percent. It can increase the risk of getting
non-melanoma skin cancer by almost 70 percent (See
Reference 1). That sunburn also means permanent
sunburn freckles and more wrinkles are in the skin’s
future.
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What About a Tan?
Your genetic skin type determines how much sun your
skin can take before burning. Obviously, the fairer your
skin, the less sun you’re designed to tolerate. The
ancestors of fair skinned people lived in places with very
weak UVB ray sun exposure and cooler temperatures
so they were often covered in layers of clothing that
protected their skin too. This is your genetic skin type
and you can’t change this. Fair skinned people will
sunburn faster than people with olive or brown skin.
But remember, every skin type can sunburn and
every skin type can suffer sun damage that includes
wrinkles, fragile thin skin, blotchy brown spots and skin
cancer.

Tanning is your skin’s way of trying to protect itself from

ultraviolet rays, which, as I described above, can poison
and harm skin. Not all tans are the same, not all tans
provide UV protection, but, all tans are indicative of UV
damage occurring inside your skin. Said another way, if
your skin is tan, you know that you have incurred DNA
damage in your skin’s cells.

The melanin pigment in skin does confer some UV

protection before DNA damage occurs. It’s not an
entirely simple subject however. To understand a tan
you first need to know about the genetic Fitzpatrick
Skin Types, which show how your skin’s ability to make
pigment is genetically determined. This also impacts
how much UV exposure your skin can tolerate before
becoming “overdosed” and burning.

Fitzpatrick Skin Type Scale

1. Always burns, never tans

2. Always burns and tans very little (this

describes my skin)

3. Burns somewhat but tans gradually (my

husband’s skin)

4. Burns a little but tans easily (olive skin)

5. Rarely burns and tans easily (brown skin, often

with ancestors from the sunnier places on earth)

6. Never burns, tans very darkly (dark brown/

black skin)

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Dr. Bailey Skin Care, LLC © 2016
 Your genetic skin color, or Fitzpatrick Skin Type,
is due to the type of melanin pigment your skin
makes. Melanin pigment is made by skin cells called
melanocytes. Everyone has the same number of
melanocytes in their skin, whether you are an albino or
have dark black skin. Your melanocytes make melanin,
which is actually a granular structure held temporarily
in the cells of your skin once it is made. People with
lighter Fitzpatrick skin types have melanocytes that
make fewer and smaller melanin granules that tend to
clump together instead of spreading out evenly in the
skin cells. People with darker Fitzpatrick skin types
have melanocytes that make larger and more numerous
melanin granules that spread out over the entire skin.
People who have inherited one or more genes for red
hair actually have mutations in melanin production
that causes a different type of melanin to be made.
This melanin is even less sun protective than the more
common form of melanin. These differences in melanin
production are genetic. They determine your Fitzpatrick
Skin Type, and thus your skin’s ability to tan (See
Reference 2).

Understanding the two types of tans, as well as the

timing and process of tanning will help you understand
why you sometimes sunburn even when you’re ‘tan’ and
expect your tan skin to protect you.

For all Fitzpatrick Skin Types, there are 2 types of tans.

These relate to the exposure from the 2 types of UV
rays, UVA and UVB. These rays create completely
different tanning responses in your skin because:
•The tans form at different times after UV exposure,

•The tans are structurally different with regard to the

amount of melanin created, the way it is distributed
in your skin and thus the protective nature of the tan
to subsequent UV exposure.

Understanding this will keep

you from falling for some of the
common ‘base tanning’ myths.
The Two Types of Tans
One of the types of tans does not produce melanin
and will not give you any protection from subsequent
UV exposure. The other type of tan does give you a
very tiny bit of extra sun protection due to melanin
production. Please know that even a generous layer of
pigment granules in your skin from this second type of

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Dr. Bailey Skin Care, LLC © 2016
tan only gives you a little extra sun protection, and for
your skin to make that protection takes time. The two
types of tanning response to UV light are Immediate
Pigment Darkening and Delayed Pigment Darkening.

Immediate Pigment Darkening

• This type of tan occurs immediately after UVA
or UVB exposure and is maximal after just a few
hours.

• The tan is created by redistribution of melanin

pigment that was already in your skin. No new
melanin granules are made.

• The UVA in tanning beds creates this type of

tan.

• This UVA and/or UVB exposure results in the

formation of free radicals in your skin and these
free radicals damage your skin’s DNA.
No new melanin is created and this tan gives
absolutely NO protection from the sun. Positively
none! Not even a little! This is why you can’t use
tanning beds to ‘get a little base tan’ and protect your
skin for that sunny vacation.

Along with this ‘tan’, this type of UV exposure causes

an increase in the thickness of the dead skin cell
layer of your skin (called the stratum corneum). This
thickening is your skin’s way of trying to protect itself
because a thicker dead skin cell layer will block some
UV ray penetration (think palms and soles which have
really thick dead skin cell layers and thus rarely burn).
The stratum corneum’s ability to deflect some UV rays
is why exfoliating dead cells can make skin more sun
sensitive. This means that if you are tanning, you can
chose to either exfoliate to have soft skin which is also
naturally more vulnerable to the sun, or accept leathery
skin that is more sun protective – you can’t have both if
you are tanning and hoping to lower your sun damage.
It’s one of those ‘you can’t have your cake and eat it
too’ situations. Slight sun protection and dull, leathery
skin, or exfoliated soft skin and less sun protection
when tanning. Anyone who’s read my blog before
knows that I’d chose soft exfoliated skin and good sun
protection practices using clothing, sunscreen and
shade! We’ll talk about that later.

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Delayed Pigment Darkening
• This is delayed tanning that takes time to
occur because your skin is making more melanin
pigment granules.
• Pigment granules are made then spread out
within the cells of your epidermis (top living cell
layer).
• As the cells naturally mature, die, and are shed,
so is the tan.
Tans have unfortunately been associated with health,
vitality and beauty in the last century. This erroneous
association is relatively new, historically. Before
nearly 100 years ago, tans were actually considered
undesirable – people who were able took proactive
steps to avoid them. I’m looking forward to the return of
this sensibility.
So, this is the sad truth and bad news about sun
burning. Now let’s turn to what you can do when you
are sun burned, and how you can support your skin
going forward to enjoy life outside without accumulating
more sun damage.

• Melanin granules are only made in response

to exposure to UVB rays! You can’t stimulate
melanin production from the UVA in tanning beds.

• Melanin production begins 2 to 3 days AFTER

exposure, becoming maximal at 10 to 14 days (2
weeks!).

• You do get a modest amount of sun protection

from this type of a tan because melanin content
was increased in your skin.

• Melanin production happens in response to

DNA damage by the UVB. Said another way,
the presence of a tan means DNA has been
damaged!

Remember, UVB is the same sun ray that causes

sunburns, so tanning is part of the continuum of events
that include a sunburn.

Remember too, that tans are temporary because these

melanin granules grow up and out of your skin as your
cells shed. They give your skin a nominal SPF that
is nowhere near the SPF 30 sunscreens or UPF 50
clothing that we recommend.

Aesthetically, these tans also lead to thicker, leathery

skin. This is because the dead cell layer is also
thickened and leathered from this type of tan, just like
the Immediate Pigment Darkening Tan. Yes, your skin
is trying to create some protection from UV exposure by
leathering up, so exfoliation is counterproductive if you
are going to get more sun and want to mitigate some
damage. If you are tanning with the intent to sun protect
your skin, you should not exfoliate, instead, you should
embrace the thicker skin that develops.

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Dr. Bailey Skin Care, LLC © 2016
Actionable Steps to Treat and
Avoid a Sunburn
Don’t look back at your sunburn or past sun exposure and beat yourself up or get mired in regret. I tell my patients to
look backwards only to learn what worked and didn’t. Move forward with a new strategy. Learn how to sun protect
your skin for your lifestyle and activities, and then watch to see how that strategy works. If your skin tans or gets a
sunburn you need to improve your strategy. Don’t be afraid, just be smart! My advice here is about moving forward.

There are four main topics related moisturizer by disrupting your skin’s barrier. Keeping
your sun-sick skin well hydrated will promote healing.
to caring for sunburned and sun Your skin will likely start to peel eventually. Resist the
damaged skin. temptation to scratch or peel off the flakes and continue
to apply moisturizer after bathing to help lock in the
1. How to treat a sunburn moisture.

2. Creating a sun protection strategy that works reliably
for your lifestyle
3. Finding alternatives to sun tanning that give your skin
a warm golden glow
4. Proven ways to take good care of your skin going
forward so you can help your skin fight skin cancer from
past damage and revitalize your skin with good skin
care.
Supportive Medical Treatment to
Promote Healing of a Sunburn
Even the most careful and motivated person can
‘accidentally’ fall victim to a sunburn. You can’t reverse
the DNA damage but you can make your skin more
comfortable until it heals on its own.
2.
Take an anti-inflammatory
agent.
Anti-inflammatory agents help reduce redness
associated with inflamed skin. In the case of a sunburn,
it must be taken prior to or immediately after sunburn
before significant redness develops. Aspirin is a non-
prescription option - however, you must be careful to
not exceed the maximum dosage in a day or for a given
period of time, or you may experience nausea and in
extreme cases, seizures. Indomethacin is an option that
can be prescribed by your treating physician.
3. Apply pure aloe vera gel.
The soothing sensation decreases the discomfort of
sunburned skin. Aloe vera is the most commonly used
ingredient in products marketed for sunburn treatment.
Some products containing aloe vera also contain topical

1. Cool the skin and

rehydrate it to help it heal.
Apply cool or lukewarm water compresses for 15
anesthetics such as benzocaine or lidocaine. Avoid
these. They can cause allergic reactions that will make
your skin both hurt and itch at the same time…Not fun.

minutes, 4 times a day. The cool water will help relieve

the heat and redness of the burn and it also speeds
recovery by constricting your skin’s capillaries, which
are causing the inflammation and pain. After each
compress, apply a bland moisturizer within 3 minutes
after gently patting your skin dry. By ‘bland’ I mean one
without any irritants or allergens. Coconut oil or Vaseline
are options. My All Natural Lotion is another. Know that
the sun exposure sapped your skin of its natural
4.
Apply prescription topical
cortisone creams.
If applied within 6 hours of the sunburn these medicines
may provide some relief. Like all prescription medicines,
this treatment requires a doctor’s supervision.

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Dr. Bailey Skin Care, LLC © 2016

Natural Sunburn Remedies
Many people ask for natural home remedies to soothe
sunburn pain. There are some very effective ones that
I recommend along with the cool compresses and
moisturizer treatment described above. The best natural
sunburn remedy is cool pure aloe vera juice or a cool
paste made of cucumbers, or a combination of the two.
Pure aloe vera gel or juice from the plant soothes
inflamed skin and is a good home remedy for burns.
Apply cool pure aloe vera gel to sunburned skin to help
relieve discomfort and inflammation.
Dr. Bailey Skin Care, LLC © 2016
Cucumbers are rich in natural botanical compounds
that have both antioxidant and analgesic properties
(See Reference 5) The best way for using cucumbers
on sunburned skin is to make a paste out of chilled
cucumbers. Chill your cucumbers, then use your kitchen
blender to create a paste. Apply the paste to sunburned
skin to help soothe sunburn pain and inflammation
naturally.
You can add some of the aloe vera juice or gel to your
cucumber paste to combine the healing properties
of both. Remember to use cool gel or paste as the
coolness also speeds recovery by constricting your
skin’s capillaries, which are bringing in the building
blocks of pain and inflammation.
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Additional Commonly Asked Questions
About Sunburn Treatment
Q: Is it good to put ice packs
on your sunburn? Q: What other TLC do you need to
heal your sunburn fast?

A: is helpful, but the direct

Gently cooling the skin
A: sunburned skin because it’s
You need to baby your

application of ice isn’t gentle. more vulnerable to irritation

As I mentioned above, cooling causes your skin’s
than healthy skin.
capillaries to constrict. When skin is red, like when it’s
Its barrier strength is damaged because the cell layers
sunburned, the skin’s capillaries are wide open and
are swollen and may flake apart. Even if you don’t have
flowing with blood circulation to bring in building blocks
visible blisters, you do have swelling and microscopic
of inflammation. When capillaries are constricted,
edema (little microscopic blisters) under your skin,
these building blocks aren’t so easily delivered to the
which weaken your skin barrier. Your skin cells are also
skin and inflammation is lessened. For inflamed skin in
more vulnerable than normal because they have lost
general, dermatologists usually recommend cool soaks
some of their protective outer dead skin cell layer as the
as I mentioned above. Another option is to put a towel
sunburned skin starts peeling.The bottom line: your skin
over a bag of frozen peas or an ice pack, and use this
is porous and fragile and needs to be “babied,” which
to cool your skin. The idea is to gently cool your skin,
means:
so don’t apply anything frozen directly to your injured
skin as this would be too harsh. Also, I have patients
1. Don’t excessively rub, peel, or expose sunburned
use the covered-ice-pack trick for a maximum of 10
skin to harsh products such as acne medicines, alpha
minutes at a time because any longer causes a reflexive
hydroxy acid anti-aging products (glycolic acid),
opening of circulation, which of course will bring in the
retinol or tretinoin (Retin A or Renova), harsh soaps,
inflammatory building blocks again.
or chemicals. You’ll notice that if you do, your skin will
sting.

Q: Should you avoid getting hot

water on a sunburn?
2. Don’t re-expose sunburned skin to the sun until it
is entirely healed. This is because the outer protective
dead skin cell layer is damaged, so more harmful UV

A: Relying on the same principles rays will pass into it, and you’ll get a sunburn even more
quickly – starting the whole story over again.
that make cool water helpful,
you should avoid exposing If you don’t baby your sunburned skin and give it lots
of TLC then you’re just compounding the injury - you’ll
sunburned skin to hot water. have more redness and more discomfort and it will take
longer to heal.
Hot water opens up the skin’s capillaries, increasing
blood flow, and thus bringing inflammation. This will
create even redder and more inflamed skin. Plus,
sunburned skin hurts when you expose it to hot water.

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Creating a Sun Protection Strategy
for Your Lifestyle
How Can You Enjoy Carefree Time in
the Sun Without Getting a Sunburn?
First and foremost, cover your skin with sun protective
clothing! This is the easiest option for sun protection.
Sun protective fabric is now being made into good
looking sunny weather clothing suitable for most
activities. Your skin will actually feel comfortable when
your wear the new high tech garments available. Look
for clothing rated as UPF 50 and cover as much of your
skin as you can. The brand I trust the most is Coolibar,
which has advanced sun protection fiber technology
that lasts the lifetime of the garment. Coolibar makes
clothing for all activities including walking, running,
golf, tennis, swimming, snorkeling, etc. I garden, hike
and swim in Coolibar all year long. Another alternative
is to use a product called SunGuard to wash into your
favorite garments – this will create sun protective
clothing out of what is already in your closet.
Did you know that a simple tee shirt has an SPF of
about 5? That’s not good enough for your skin!
For every inch of skin that you can’t cover with clothing,
such as your hands, face, ears, neck, etc., you need
to work hard to protect from the sun. I teach people to
“A.S.K” themselves, will my exposed skin be protected?
Sun protection is as easy as 1, 2, 3!
Step 1. Apply
Apply SPF 30+ broad spectrum sunscreen to all
uncovered skin. Reapply it every 2 hours that you are
outside, and always after swimming or rubbing product
off your skin.
My opinion is that mineral zinc oxide sunscreens give
the most reliable sun protection of all sunscreen types.
For years I have recommended to my patients to select
a product with at least 5% or more zinc oxide listed
as an active ingredient. Zinc oxide technology has
evolved rapidly in the past decade and now there are
many elegant, transparent and easy to use zinc oxide
products to fit every skin type and activity.
Dr. Bailey Skin Care, LLC © 2016
“Zinc oxide sunscreens are the best!...
(On my cruise vacation) other people
were using SPF 50s and burning. Because
mine had zinc it worked and my skin
didn’t burn like theirs.”
Brenda W, Sebastopol CA
Because I’m such a zinc oxide advocate I have made
it my business to find and stock really high quality
mineral zinc oxide sunscreens to fit every complexion,
activity, value system and budget. I’ve watched these
sunscreens serve my thousands of patients, who now
trust these products. I’ve also seen other products
fail, and my patients burn while using them. For these
reasons, I’m particular about sunscreen. To see the
sunscreen products that I use in my practice, for my
family and myself, click here.
Step 2. Seek Shade
Create it for your face and scalp by wearing a wide-
brimmed hat. Shade your delicate eye area skin by
wearing UV blocking sun glasses. Shade the rest of
your skin too by being one of the smart people under
umbrellas or in the shade of trees and shade structures.
I have practical recommendations on what constitutes
an ideal and attractive sun hat as well as an affordable
collection of easy to wear sunhats to help get you
started.
Step 3. Know
Know about the sun intensity you are exposing your
skin too and be careful about your protection when the
sun is most intense. Try to avoid direct sun exposure
at those times when UVB intensity is the highest
such as 10am-2pm std time, or 11am-3pm daylight
savings time. UVB is more intense in the summer, near
the equator and at high altitude. Know that from sun
up to down UVA rays are everywhere and your skin
still requires protection - so don’t be fooled by the
seemingly ‘softer’ morning and late afternoon light -
stay protected.
Click here to download my free infographic that
summarizes these recommendations. The graphics are
wonderful! Please share this infographic with the people
you love - everyone needs good sun protection for their
precious skin.
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Alternatives to UV Tanning to Give Your Skin
a Warm, Golden Glow All Year
There are several tricks for a healthy golden hue to your
skin color that don’t involve the sun’s damaging UV
rays.

1. Eat Veggies High in

Beta-Carotene
Your skin will quickly take on an attractive warm golden
glow when you supply it with beta carotene from
the inside out. These same veggies are also rich in
antioxidants, and are some of the best foods for your
overall health.

Foods High In Beta-Carotene

Yellow/orange vegetables: carrots, sweet potatoes,
pumpkins, winter squash

Dark green and/or leafy vegetables: kale, broccoli,

spinach, collard greens, turnips and their green leaves,
beet leaves, mustard and dandelion greens, watercress,
cilantro, chicory, endive, escarole

Yellow/orange fruits: apricots, cantaloupes, papayas,

mangoes, nectarines, peaches

Other beta carotene rich vegetables and fruits: summer

squash, asparagus, peas, sour cherries, prune plums

Tips to Get the Most Beta-Carotene

Out of Your Foods
Eat them with a little fat or oil because you’ll absorb
beta carotene better with a little fat in your digestive
tract at the same time.

Chopped or juiced foods release more beta carotene

than large chunks of food (carrot juice is a great source
of beta carotene).

Eat your fruits and veggies as fresh as possible because

beta carotene is fragile and begins to be lost when the
fruits or veggies are processed or stored.

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2. Use Self-Tanner
Like an Artist
Self-tanners can look great or they can look awful.
There are 3 simple steps for getting a great look from
self-tanners. The important thing to know is that self-
tanners stain the outer, dead skin cell layer of your skin.
The tanning ingredient will accentuate areas with thicker
dead cells and flakes of dry skin. Understanding this is
the key to getting a soft and natural golden glow when
you use self-tanners.
The executive summary for self-tanning: Exfoliate and
moisturize before you apply self-tanners AND apply less
(or no) product on the thicker areas of your skin like your
knees, elbows and feet.
Three Steps to Getting a Natural
Look With Self-Tanners
Step 1. Prepare Your Skin
Exfoliate in the shower with a Salux Cloth, shower mitt
or granular body scrub. Scrub gently, but use more
pressure and scrub longer over the parts of your skin
with a thicker stratum corneum layer (dead cell layer).
These areas are usually your knees, elbows, the back
of your hands, your ankles and the tops of your feet.
Immediately after toweling dry (within 3 minutes, no
more) apply a rich moisturizer. Ideally your moisturizer
should contain an alpha hydroxy acid (AHA) for
additional exfoliation. My preferred AHA product is
Glytone Body Lotion. Less strong, but still effective are
the drug store products AmLactin Cream or Lacticare
Cream. Do this for a day or two before you start
using your tanner.
Step 2. Know When and How to
Apply Self-Tanners
Self-tanner should be applied immediately after toweling
off from your exfoliation in the bath or shower. You can
apply it before, or in place of, your moisturizer. Do not
put tanner on your skin if you have not just bathed –
this will give you the alligator look. You can apply an
AHA moisturizer like Glytone Body Lotion on top of the
tanner if you’re using a tanner product that has a thin
consistency. This will give you the best results.
Apply very little product over areas of your body with
thicker skin. Using your leg as an example,
Dr. Bailey Skin Care, LLC © 2016
Using your leg as an example,
• put some product in one palm,
• rub your hands together to create a thin layer of
product on your entire palms,
• smooth the product over the thinner skin on your lower
leg and thigh,
• avoid touching your knee or foot until you have almost
no product left on your palms, at which point you can
very briefly rub your palms over the back of your foot
and the front of your knee.
Always wash the product off of your palms entirely when
you are done to prevent them from staining a deep tan.
If some areas look too dark you can lighten the tan color
by physically exfoliating them in the shower with the
Salux Cloth or your favorite body scrub. Once you have
started using tanner, know that exfoliation in the shower
will lighten the color. You may want to exfoliate only
once or twice a week to build a darker tan in between.
Step 3. Be an Artist
Refine your technique to get an even more natural look.
Apply more product, or a second layer, over the parts of
your skin that would naturally be darker with a sun tan.
This means that the tops of the arms should be darker
than the under surface of the arms, etc.
To reach your back, use a back applicator. Apply a thin
amount of product on the sponge since application
precision is a little tricky on the back. Or, you can enlist
the help of a friend.
Also, if you don’t intend to apply the tanner to your
entire skin surface, then feather it in to the areas you
want tan-free by gradually applying a thinner layer as
you approach them. Don’t stop abruptly, leaving a big
color difference. Self-tanner application is a lot like
painting. You can dial in the color you want by putting
more or less product on your skin, and you can soften
distinction between darker and lighter areas by blending
the color gradually. If you would like my free infographic
on how to apply self-tanner click here.
I prefer self-tanning products with a thin consistency
that can be easily layered and applied under a
moisturizer. My personal preference is Avene
Moisturizing Self-Tanning Lotion. There are many other
options.
15
Tan Skin and the Recent Aesthetic Trend
It’s been scientifically proven that people prefer the warm
golden glow of beta carotene infused skin over the ashy
brown of a suntan (See Reference 3). The enhanced
beauty of a kale and carrot infused beta carotene glow
works for all Fitzpatrick Skin Types. A scientific study
proved that complexions warmed with beta carotene are
found more attractive than UV tanned complexions. We
are currently living in a small historic blip of time when
aesthetic considerations have tempted people to sun tan.
For eons, however, tans were considered unattractive and
people went to great lengths to avoid them. History will
look back at this era with regret; we already do.
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Dr. Bailey Skin Care, LLC © 2016
Consider gently letting your mindset evolve regarding
what is attractive on your own skin. Healthy moist
and soft skin with the warm glow of a beta carotene rich
diet radiates vitality. The less sun damage your skin has,
the better your complexion will look too. Consider using
self-tanners mostly to limit the appearance of deeper skin
issues like visible leg veins or cellulite dimpling. Moisturize
and sun protect your skin daily, and find out how well your
skin ages over the years.
Control the Damage Already Done and Stop
Future Damage
Diligent sun protection moving forward will stop the addition of cumulative damage to your skin. But, what can you do
about your ‘actinic indiscretions from the past’?
Assess Your Risk of Skin Cancer
Do monthly self-exams on your own skin and seek
professional exams if you have higher risk factors for skin
cancer. Some of the risk factors for skin cancer include:
• Anyone with fair skin. Fair skinned people have a
higher risk of skin cancer.
• People with a lot of moles. Having more moles is
associated with having a higher risk of skin cancer.
• Having a blood relative who has had melanoma or
skin cancer.
• Having a history of blistering sunburns.
• Having a history of sun exposure throughout your
lifetime.
Dr. Bailey Skin Care, LLC © 2016
Even people born with a lot of pigment in their skin are
at risk of skin cancer. (Many believe they are lower risk,
however, skin cancers in darker Fitzpatrick Skin Types are
often found at later and more advanced stages, which
means the cancers are harder to cure.)
Everyone should do monthly self-skin exams. I tell my
patients to look over their skin once a month after a
shower or bath. Use a mirror to see your back or ask
a friend, spouse or partner. If anything looks newish or
unfamiliar then see your dermatologist. Early diagnosis of
skin cancer often ensures it’s only a minor inconvenience
to have it cured. When skin cancer becomes deep and
advanced the story changes entirely.
17
What Should I Be Looking For?
We all have our unique pattern of moles, freckles
and spots. Take the time to learn what yours are.
A dermatologist is a great partner when it comes
to helping you learn what to look for. See your
dermatologist and ask them to teach you what a
suspicious spot might look like on your skin. Some of
the worrisome skin changes you want to watch for on
your skin cancer exam include:

• A sore that won’t heal? Remember that cancers can

be fragile and bleed.

• A new spot that doesn’t match your others? Is that

spot growing, changing or acting strange?

• A new ‘mole’ that shows up on your skin. Our skin

grows moles mostly in our teens, 20s and 30s. Any
new mole after those years is suspect and should be
checked. Many spots look to the untrained eye as a
mole. Learn what your moles look like by seeing your
dermatologist.

• A change in an existing mole. Growing, itching, and

even vanishing can indicate melanoma. Better to be
safe and get it checked. We teach people to know the
A, B, C, D, and E ‘signs’ of worrisome moles. These
include:

A for asymmetry
B for border that is irregular
C for colors that are odd, irregular or variegated
D for diameter bigger than a pencil eraser
E for evolution and change

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Dr. Bailey Skin Care, LLC © 2016
Protect Your Skin
The combination of sun and unprotected human skin
creates trouble. There’s no way around it. Take the
time to learn how you can enjoy the outdoors while
protecting against sun damage.
The great news is that these precautions will lower the
number of skin cancers your prior actinic indiscretions
may have created based on DNA damage. The DNA
damage from sun exposure often takes years to
manifest skin cancer, and your body is always on the
look-out for cancer transformations. Yes, it is true.
DNA damage from past sun exposure creates little
time bombs in your skin that can go off at any time.
You have cells that are trying to find them and fight
the cancers they would cause. Amazing, I know!
Unfortunately, these cells stop working well when you
get sun exposure. This is because the sun exposure is
immunosuppressive to your skin’s detective cells that
find and remove cancers. So you can keep these cells
on the job by sun protecting your previously sun
exposed skin.
Four Skin Care Steps to Halt and
Reverse the Appearance of Sun
Damage
1. Protect your skin from UV rays with the best quality
broad spectrum mineral zinc oxide sunscreen and
avoid direct sun exposure as much as possible.
2. Protect your skin from free radicals by using proven
antioxidants in high concentrations including green
tea and vitamin C formulated into stable skin care
products.
3. Build up the cells, structure, and vital components
of the two living layers of your skin - the epidermis
and the dermis - using proven active ingredients
including retinoids, glycolic acid and vitamin C.
4. Brighten your skin’s texture and tone to create a
more youthful and healthy complexion with exfoliation.

Sun protection will also help slow or stop the thinning,

wrinkling and blotchy pigmentation that goes along
with sun damage. Did you know that even small
amounts of UV exposure will activate a gene in your skin
that actually breaks down your skin’s collagen? Yes,
you have a gene in your skin (matrix metalloproteinase
1) that breaks down your collagen, and this gene is
easily turned on by sunlight. Once turned on that gene
keeps running and your collagen is continually broken
down until your skin is thin and wrinkled; it becomes a
self-perpetuating cycle of collagen degradation, like an
app running in the background of your smart phone. As
if that’s not bad enough, UV exposure also suppresses
your skin’s ability to make collagen. Based on all this,
who needs UV?! (See Reference 4)

Turn the collagen degrading gene off and turn on

collagen synthesis with sun protection and skin care
that is able to flip these switches. Here are the proven
ways to improve and revitalize sun damaged skin with
your home skin care routine.

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Dr. Bailey Skin Care, LLC © 2016
Build Your Complete Skin Care Routine
Build your complete skin care routine using the best
proven cosmeceutical and pharmaceutical skin care
product ingredients to fight skin aging and wrinkling.
These include:
• A broad spectrum mineral zinc oxide sunscreen
used 365 days a year on all exposed skin
• Retinoids (prescription tretinoin and non-prescription
retinol)
• Glycolic acid with a free acid content of over 10%
• Vitamin C with a stable concentration of L ascorbate
at 10% or higher PROTECT
• Green tea antioxidant polyphenols added in high
concentrations to a product.
You can also quickly improve the luster of skin by
brightening it with physical exfoliation. You can do this
gently CLEANSE
on a daily basisCORRECT HYDRATE
or more intensely several times a
week. Exfoliation doesn’t change the structure or cause
COMPLETE SKIN CARE
of skin aging, but it ‘picks up’ the youthful glow almost
instantly. When you moisturize skin that has just been
exfoliated it haswww.DrBaileySkinCare.com
the dewy and smooth look of younger
skin.
PROTECT
CLEANSE CORRECT HYDRATE
www.DrBaileySkinCare.com
COMPLETE SKIN CARE = RESULTS
20
Dr. Bailey Skin
Depending on your skin type and the part of your skin
you’re treating, your skin care routine might include:
Daily Facial Skin Care to Fight Sun
Damage
Depending on your skin type and the part of your skin
you’re treating, your skin care routine might include:
1. Cleanse with a facial cleansing product matched
to your skin type.
2. Correct with Green Tea Antioxidant Therapy
followed by Vitamin C Professional Wrinkle Serum
or Glycolic Acid Anti-wrinkle Cream.
3. Hydrate with a facial moisturizer matched to your
skin type.
4. Protect with a mineral zinc oxide sunscreen
matched to your skin type.
A
Apply mineral makeup on top of your sunscreen if
desired; this will provide some additional protection as
the minerals will reflect sun rays. Exfoliate twice a week
with a physical exfoliator such as Replenix Scrub.
Build Complete
Skincare
B GET AMAZING RESULTS
Complete Skin Care Logo
FINAL
Care, LLC © 2016
July 23, 2015
Nightly Facial Skin Care to Fight Sun
Damage
1. Cleanse with a facial cleanser matched to your
skin type.

2. Correct with Retinol Intensive Anti-Wrinkle Night

Cream. You can apply Glycolic Acid Anti-Wrinkle
Cream after the Retinol if your skin can tolerate
the two together.

3. Hydrate as needed with a moisturizer matched

to your skin type.

This is the ideal anti-aging skin care routine with

the best ingredients proven by science to fight the
damage from UV sun rays. It is also an intensive skin
fitness routine that has to be started slowly since 3
of the products require slow skin adjustment: Retinol,
Glycolic Acid and Vitamin C. Each of my product pages
have product use advice from my practice for these
ingredients.

Skin care options for non-facial sun damaged skin is

more limited due to the fact that the skin is thicker and
so product ingredients penetrate poorly. In my practice
I use my AHA Body Kit to Cleanse, Correct and Hydrate
body skin. I then have my patients apply a sun screen
matched to their skin type and activities on all exposed
skin to Protect.

21
Dr. Bailey Skin Care, LLC © 2016
In Summary
The sunburn or sun tan story is a bad news/good news
story. The bad news is that your skin is being damaged
every time it gets a sunburn or sun tan. The good news
is that you can soothe the pain of a sunburn and move
forward into the future taking better care of your skin. You
can make skin care choices that will reduce some of the
damage, and you can do self-skin exams and see your
dermatologist to catch skin cancer early when it may still
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Dr. Bailey Skin Care, LLC © 2016
be easily curable. We now know a lot about the physiology
of how the sun alters human skin, and we have effective
products and advice to enjoy life outdoors without the
damage that our ancestors had to tolerate generations
ago. So remember to A.S.K. yourself if you are thoroughly
protecting your skin, create a strategy that works for your
lifestyle, and go play outside!
References
1. Long-term Ultraviolet Flux, Other Potential Risk Factors, and Skin Cancer Risk: A Cohort Study, Shaowei Wu, Jiali Han, Francine
Laden, and Abrar A. Qureshi, Cancer Epidemiol Biomarkers Prev; 23(6); 1–10. ©2014 AACR

2. Andrews’ Diseases of the Skin, 12th edition William D. James, Dirk M. Elston, Timothy G. Berger, Elsevier. Pages 1-3

3. Facial Skin Coloration Affects Perceived Health of Human Faces, Stephen ID, et. al., Int J Primatol, 2009 Dec;30(6):845-857.

4. Dermal Damage Promoted by Repeated Low-Level UV-A1 Exposure Despite Tanning Response in Human Skin, Frank Wang, MD;
Noah R. Smith, MD et. al., JAMA Dermatol. 2014;150(4):401-406

5. Kumar D, Kumar S, Singh J, et al. Free Radical Scavenging and Analgesic Activities of Cucumis sativus L. Fruit Extract. J Young
Pharm. 2010 Oct;2(4):365-8. 2010.

6. International Prevalence of Indoor Tanning, Mackenzie R. Wehner, MPhil; Mary-Margaret Chren, MD et. al., JAMA Dermatology.
2014;150(4):390-400 “The Known Health Effects of UV.” WHO. WHO, n.d. Web. 13 Jan. 2015

7. Miyamura Y, Coelho SG, Schlenz K, Batzer J, Smuda C, Choi W, Brenner M, Passeron T, Zhang G, Kolbe L, Wolber R, Hearing VJ.
The deceptive nature of UVA tanning versus the modest protective effects of UVB tanning on human skin. Pigment Cell Melanoma
Res. 2011 Feb;24(1):136-47.

8. Andrews’ Diseases of The Skin, 11th Edition, William D. James, MD, Timothy Berger, MD and Dirk MD Elston, MD, Saunders 2011,
pages 24-25

9. Improvement of Naturally Aged Skin With Vitamin A (Retinol), Reza Kafi, MD; Heh Shin R. Kwak, MD, Arch Dermatol. 2007;143:606-
612

10. Improvement of photoaged facial skin in middle-aged Japanese females by topical retinol (vitamin A alcohol): a vehicle-controlled,
double-blind study. Kikuchi K, Suetake T, Kumasaka N, Tagami H, J Dermatolog Treat. 2009;20(5):276-81

11. Choosing Topical Retinoids for Aging Skin, Sachs, DL, Dermatology Focus, Summer 2013 Vol 32 No 2 page 4

12. Application of Retinol to Human Skin In Vivo Induces Epidermal Hyperplasia and Cellular Retinoid Binding Proteins Characteristic
of Retinoic Acid but Without Measurable Retinoic Acid Levels or Irritation, Sewon Kang, Elizabeth A. Duell, et. al., J Invest Dermatol
105:549-556, 1995

13. Vitamin A Antagonizes Decreased Cell Growth and Elevated Collagen-Degrading Matrix Metalloproteinases and Stimulates
Collagen Accumulation in Naturally Aged Human Skin, James Varani, Roscoe L Warner, Mehrnaz Gharaee-Kermani, et. al., J Invest
Dermatol (2000) 114, 480–486;

14. Topical Tretinoin for Photoaged Skin: a Double-blind Vehicle-controlled Study, Weiss JS, Ellis CN, et. al., JAMA. 1988, 259: 527-
532

15. Tazarotene Cream for the Treatment of Facial Photo Damage: a Multicenter, Investigator-Masked, Randomized, Vehicle-Controlled,
Parallel Comparison of Tazarotene 0.01%, 0.025%, 0.05%, and 0.1% Creams and Tretinoin 0.05% Emollient Cream Applied Once-
Daily for 24 Weeks. Kang S, Leyden JJ, Lowe NJ, et al., Arch Dermatol. 2001;137:1597-1604.

16. Mechanisms of Photoaging and Chronological Skin Aging, Gary J. Fisher, PhD; Sewon Kang, MD; et. al., Arch Dermatol.
2002;138(11):1462-1470

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