Conversations About Photoprotection During the Pandemic

Julia Siegel, MD is a Board-Certified Dermatologist at Boston Dermatology and Laser Center.

In this video, Dr Siegel discusses the importance of photoprotection, sunscreen, and how the pandemic has affected patient skin exams.

TRANSCRIPT-

Dr. Julia Siegel:  Whenever I'm doing a full skin exam, I start usually with the question, "Do you wear sunscreen?" If they say yes, I say, "What SPF?" I make sure they're wearing 30 or higher.

When they say no, it's a different story. When they say no, I usually say, "Why not?" There's usually some pause. People are a little uncomfortable. It's like the dentist asking you why you don't floss.

To fill the silence, I used to give a bunch of reasons. Is it because you don't feel like putting it on? Is it because you don't like how it feels? Is it because you don't think you need it? I realized that by me supplying those answers, patients weren't actually telling me what their reason was.

They were saying yes to one of those. Just get it over with and move on because it's something you don't really want to admit to a dermatologist. I started after saying, "Why not?" just pausing and allowing for that pause, that silence, to be there for a few seconds. I noticed that people were much more honest about why they weren't using it.

Then they also would come up with ideas about maybe how they could use it in the future if they said why not. Like they'd say, "Well, I haven't found a formulation that doesn't just look white on my skin, but I guess I could try others. Do you have any samples?" If you pause, people will give you more of an answer.

Then also I realized, instead of asking "Do you wear sunscreen?" it would be better to say, "How do you protect yourself from the sun?" because there are so many methods, aside from sunscreen, that are important. Sun protective clothing, hats, sunglasses, avoiding peak hours in the sun. There's lots of different ways to protect yourself.

By asking more broad questions, it allows patients to think about what they're doing, and doesn't pigeonhole them into just one modality, and then also maybe allows them to think about what they could be doing if they're not doing something right now.

In terms of how the pandemic has changed things, a lot of us have seen more skin cancers coming up since the pandemic because people haven't been in to see their dermatologist.

People that would normally get an every three-month or every six-month full skin exam have pushed it out to a year, year and a half. Also, we've seen further progressed skin cancers because of that.

That really stresses the importance for self-skin exams, and that goes back to education. What to look for? The ABCDEs of melanoma. What to look for in keratinocyte carcinomas also.

If we can educate our patients, then they're going to be more likely to find things even if they can't come in for their regularly scheduled visit. Especially if there is some resurgence or anything in the future that prevents them from coming in as scheduled, I think self-skin exams and education are particularly important.