You do your best to protect your skin from the sun. But did you know Mother Nature ups the ante on windy days? Our experts share some breezy advice.
By Jennifer C. Tang, MD, and C. William Hanke, MD, MPH, FACP
Outdoor recreational activities can be fun and healthy, but they can also take a toll on your skin. As dermatologists, we see the effects of being outside on our patients’ skin every day.
It’s pretty common to have a patient come in with a red face, for example. The culprit could be sunburn, of course. Another possibility is photosensitivity, when the skin overreacts to the sun’s ultraviolet (UV) light. This reaction is usually triggered by certain medications or topical skin products. A patient could also develop redness after a procedure in a dermatologist’s office, such as photodynamic therapy for precancerous spots known as actinic keratoses. It could also be a sign of rosacea, an inflammatory condition that makes the face look flushed.
After ruling out those scenarios, though, and being assured that the person also used and reapplied sunscreen appropriately, doctors should consider a less obvious cause: the wind.
Yes, wind can make a difference. Dermatologists have learned to look for certain signs. For instance, a person who has a red face but isn’t red around the eyes may report a recent long-distance bike tour, motorcycle ride or ski trip. Other red-faced patients include surfers, boaters and others who are out in the wind a lot. So, what is it about wind that causes this redness, and when should you be concerned?
Feeling the Burn?
Patients with red faces after boat rides or skiing often dismiss their symptoms as windburn. But what exactly is windburn? Turns out there’s not a medical consensus on that. Is it an irritant effect from the wind? Or is it a misnomer and actually a sunburn from skimping on sun protection when it’s, say, cloudy, windy and cool outside? (Those UV rays get through just like they do on a hot, sunny day!)
Wind can reduce the natural sun protection in your skin, letting more of the sun’s ultraviolet rays penetrate and cause damage.
We think that wind most likely has a double impact on the skin: It’s a direct irritant that causes the upper layers of the skin to slough off, and that shedding leaves the newly exposed skin more vulnerable to damaging UV rays. Two main types of UV rays can cause DNA damage in your skin, even from brief exposures. UVB rays cause sunburn, while UVA rays cause tanning as well as skin aging and wrinkles. Over time, the damage from either or both types of rays accumulates, leading to mutations in your DNA that can develop into skin cancer.
The outermost layer of your skin, the top part of your epidermis called the stratum corneum, plays a key role in all of this. It provides a protective barrier while still allowing in certain things, such as air and light and your moisturizer. This layer of your skin also contains urocanic acid, a natural sunscreen that helps absorb some of the UV light that leads to skin damage. While your urocanic acid offers only a low sun protection factor (SPF) of 1.5, a 2011 study in the Journal of Investigative Dermatology suggested that it may reduce DNA damage from the sun by as much as 33 percent.
Wind + Sun = ?
Being exposed to wind may reduce this natural skin protection, however, according to research summarized in the medical textbook The Environmental Threat to the Skin. Being exposed to wind can cause the outer layer of skin to dry out and weaken. The force of the wind can then make these dry, fragmented skin cells fall off. Losing some of that outer layer of skin reduces the sun-protective effects of the stratum corneum.
When that happens, more of the sun’s UV rays penetrate your skin, and the immune system in that outer layer has a harder time recognizing and repairing all the damaged cells so they don’t develop into skin cancer. A 1977 study in the British Journal of Dermatology showed that rats exposed to UV radiation and wind developed more skin cancer than those not exposed to wind. (Understandably, this experiment was not repeated on human test subjects.)
If wind can reduce the natural sun protection in your skin, it can also affect the topical sunscreen you rub or spray on your skin. When you apply sunscreen, it coats the surface of the stratum corneum. If your skin is exposed to prolonged wind, the stratum corneum will dry and slough off, and your topical sunscreen will go with it, making you more susceptible to UV rays and the damage they cause. So practicing thorough sun protection is more important than ever when the wind is blowing.
Jennifer C. Tang, MD, is a fellow of Mohs micrographic surgery and dermatologic oncology at the Laser and Skin Surgery Center of Indiana.
C. William Hanke, MD, is a Mohs surgeon at the Laser and Skin Surgery Center of Indiana in Carmel, Indiana. A senior vice president of The Skin Cancer Foundation and a member of its Amonette Circle, he has served as president of 13 professional societies.
Published on May 18, 2017