Winter UV Exposure: Why Photoprotection Should Be a Year-Round Conversation

Although sun protection is often associated with warmer months, UV exposure remains an important consideration throughout the fall and winter. Previous Dermatology Times coverage has highlighted the importance of winter UV education and improving patient adherence to photoprotection, particularly as patients may underestimate exposure during colder months. Factors such as altitude, reflective snow, geographic location, and time spent outdoors can further influence exposure.

Consistent photoprotection extends beyond sunscreen alone. Dermatologists increasingly emphasize a comprehensive approach that incorporates sunscreen, shade, hats, and UV-protective clothing, as well as individualized counseling based on a patient’s skin type, lifestyle, and exposure.

In an interview with Dermatology Times, Angelo Landriscina, MD, a board-certified dermatologist and founder of SOUL-A, discussed common misconceptions surrounding winter UV exposure, strategies for counseling patients on comprehensive sun protection, and the role of ultraviolet protection factor (UPF) clothing in everyday photoprotection.

Dermatology Times:

What are some of the biggest misconceptions patients have about UV exposure during the fall and winter months?

Landriscina:

Many patients do not consider sun protection at all during the winter months. How many of us have heard a patient express surprise that they have to use sunscreen “even in winter”? The truth is that the UV index can climb during the colder months in many locations.

Patients with conditions worsened by sun exposure should also be aware that their condition may worsen with sun exposure regardless of the UV index. Although many winter-weight fabrics are excellent at filtering UV, we still have to instruct patients to consider exposed areas of skin year-round.

Dermatology Times:

How much does UV exposure change seasonally, and are there certain environmental factors, such as snow, altitude, or spending time outdoors, that can increase exposure during colder months?

Landriscina:

Seasonal changes in the UV index depend on location, with the greatest variation occurring the farther you are from the equator. UV exposure is also more intense at higher altitudes, which is important to consider in high-altitude locations and particularly for individuals participating in winter sports such as skiing.

Snow is also very efficient at reflecting UV and can contribute to sunburn. Furthermore, we have to keep in mind that climate change may play a role in UV exposure, with overall warming potentially leading to more time spent outdoors and changes such as reduced cloud cover.

Dermatology Times:

When counseling patients on year-round photoprotection, how do you recommend balancing sunscreen, protective clothing, shade, and other measures without making sun protection feel overwhelming?

Landriscina:

I always recommend designing a comprehensive sun protection strategy that makes sense for the patient’s lifestyle. This can include checking the UV index daily, using sunscreen, wearing hats and protective clothing, and seeking shade.

Clinicians can discuss the advantages and disadvantages of each strategy, including considerations such as sunscreen reapplication and potential gaps in protection. Overall, we want to take the guesswork out of sun protection.

Dermatology Times:

Where does UPF clothing fit into a comprehensive photoprotection strategy, and are there situations or patient populations for whom you find it particularly useful?

Landriscina:

For too long, sun-protective clothing has been relegated to the beach or sporting activities. In the same way that we recommend daily sunscreen, we should be recommending other sun protection measures as well.

That is part of why I created my line, SOUL-A. We design sun-protective clothing intended to fit into everyday life. Although photoprotection benefits everyone, I think it is especially important for individuals at higher risk for skin cancer, those who are prone to burning, and those who are investing heavily in cosmetic treatments.

Dermatology Times:

What should dermatology clinicians explain to patients about the difference between UPF-rated clothing and simply covering the skin with everyday clothing?

Landriscina:

Clinicians should ensure that patients understand that the sun-protective value of textiles varies greatly and that fabrics we often think of as “summer” materials may provide relatively low UPF.

For instance, most denim used in jeans can have a UPF of more than 1000, whereas linen typically has a single-digit UPF. This variation is why having an actual UPF rating on protective clothing is so important.