July 9th, 2009
02:47 PM ET

The importance of practicing safe sun

By Caitlin Hagan
CNN Medical Associate Producer

Few things can make me as happy as a hot summer day at the beach. I'm a total sucker for sunshine but unfortunately, until recently, I had not been able to spend much time romping around in the sand. So when I packed my beach bag I made sure to bring not one, not two, but three bottles of sunscreen: plenty of protection to make sure my skin was sunkissed, not sunburned. Sounds like a great plan, right? Except all three had different SPFs, some but not all were broad spectrum, and one was just for my face. For a woman who wants to avoid a sunburn but maximize her vacation, things got a little confusing.

Apparently my dilemma is not that uncommon. Dr. Ariel Ostad is a dermatologist and assistant professor of dermatology at New York University who deals with this issue often. According to him, which SPF, or sun protection factor, you choose is not as important as what kind of radiation you're being protected from. SPF protects you from ultravoilet B, or UVB, radiation, the kind that causes sunburns. But when you are outside in the sun, your skin is also exposed to another type of damaging radiation. "Make sure your sunscreen contains an ingredient to block UVA radiation. 'Broad spectrum' is really the term that people should be looking for," advises Ostad. Since UVA rays are responsible for premature wrinkles and sun spots, it is best to keep your skin out of their reach.

But why isn't SPF the top priority? According to Ostad, the higher and higher SPFs for sale now are more about marketing than actual increased protection. It turns out that a sunscreen with a high SPF such as SPF 80 does not offer exponentially more protection, as most people think it does. According to the American Academy of Dermatology, there are diminishing returns the higher the SPF reaches. Sunscreen with SPF 30 lets in about 3 percent of the sun's harmful rays and a sunscreen with SPF 85 does not do much better, letting in more than one percent. "Anything above an SPF 30 makes absolutely no difference," says Ostad.

Keep in mind though, not all sunscreens are equal, even if they are broad spectrum. People worried about breaking out after slathering on sunscreen should opt for non-comedogenic products, which means that they won’t block pores. Sunscreens with an active ingredient of zinc oxide or titanium dioxide are good bets for people with sensitive skin who worry about too many chemicals in their products.

Now I know that the next time I head out for a day in the sun, there's no need for confusion (or three bottles).

How do you keep your skin protected?

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July 9th, 2009
06:00 AM ET

What pain relief options does a recovering addict have?

As a regular feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta:

From Jolene: 
"I have a friend who needs to have his wisdom teeth pulled and will need pain medication. The problem is, he is a recovering addict. Any suggestions?"


Jolene, first of all, congratulations to your friend for making it to and staying in recovery. More than 23 million Americans struggle with substance abuse problems every day, according to a recent government survey, but only about 4 million of them actually receive some kind of treatment for their addiction to alcohol or illicit drugs.

That being said, it’s true that since he’s a recovering addict, your friend faces a greater challenge than many when it comes to any type of surgical procedure that’s going to require pain management.

But his pain definitely needs to be treated, regardless. The reason: Studies have shown that if a patient does not receive adequate pain treatment in surgical recovery, his tissues don’t tend to heal as well. Pain that goes untreated can also lead to what pain experts refer to as “wind-up,” meaning the spinal cord gets so bombarded with continuous pain signals that it can lead to a longer, more chronic pain situation. So it’s important to “quiet” the spinal cord by bringing the pain under control.

While the vast majority of patients who undergo oral surgery do take some type of narcotic drug afterward for relief, some people are able to successfully treat their pain with anti-inflammatory drugs such as prescription-strength ibuprofen. These non-habit-forming drugs might be the first step for your friend to try. He will need to discuss this option with his doctor, because there is a greater concern about bleeding with this class of drugs, although usually they are safe especially if taken only for a few days.

If the anti-inflammatory drugs don’t work, however, there are some narcotic drugs that are thought to be less addictive than others. Tramadol is one option. It’s a chemical that works as an antidepressant but also has a weak effect on your brain’s opiate receptors, meaning it can provide pain relief but it doesn’t work as assertively on the brain’s reward system (which can lead to addiction). It’s thought to be safer for people who struggle with addiction. Your friend will need to work with his physician to weigh the risks and benefits of trying a narcotic drug before going down this path.

The critical part of keeping a recovering addict from falling back into a cycle of substance abuse with painkillers is making sure that both the doctor and patient vigilantly monitor the course of pain management. For a procedure like wisdom teeth removal, a patient should start feeling better after a few days, maybe a week max. The doctor should follow up with the patient so that if he still complains of pain, the doctor can re-evaluate what could be causing the pain to continue.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.