All right, so I'd like to welcome everyone to this well session.

Um, today we have Christina Flavin with us.

She is a physician's assistant in dermatology at Dartmouth Hitchcock in Manchester.

She's a graduate of Northeastern University, um, physician's assistant program there.

Christine has worked in a variety of settings, including emergency medicine, internal medicine, and for the past 22 years at the dermatology department at Dermouth Hitchcock in Manchester, which she knows as home, which is wonderful.

Um, Christine diagnosis and treats a variety of medical conditions in both children and adults and performs numerous procedures, including biopsies of potential skin cancers.

Christine works closely with the physicians in the dermatology department to provide complete and comprehensive care to all their patients with a strong focus on education, and she's happy to be here today to talk with us about skin UV, everything under that umbrella.

So one housekeeping note if we could keep questions till the end.

Um TV is recording this session, and they've asked that we try to do that so that we can move a mic around so that those that can't watch this or be here for the live that watch it will hear those questions.

So Christine, thank you.

So thanks for spending your lunch hour with me today.

Um, like she mentioned, I've been in dermatology now for over 22 years, and um have a lot of experience in diagnosing and treating skin cancer, but we really want to prevent that from happening.

So we're gonna go through a few things today.

This is very casual.

I'm not here to preach.

I've been sunburned myself.

I did use tanning beds for a short period of time.

So, you know, I've live and learn.

So, and this is my first um slides presentation I've ever done back in the day when I was in high school, we didn't have this kind of software.

So if I mess things up, just bear with me.

It's pretty simple, but I hope it gets the point across.

So here's the sun.

It's your frenemy.

We love the sun, it makes us happy, it keeps us warm, it helps things grow, it helps provide some vitamin D that we do need.

There is a debate in the dermatology world about how much sun is good sun.

Um there's some dermatologists who just say nothing, don't, it's just sun is bad, it's a known carcinogen, don't go out there.

Other people believe that you know, 15, 20 minutes of natural sunlight is very good to help with your vitamin D.

Um, I kind of fall in the middle ground.

Get outside, just be smart, you know, don't burn to a crisp.

Uh we do know that photo or ultraviolet light is a carcinogen, so it is a known contributor to skin cancer, and it also accelerates the aging process.

So when I have young kids in the office, I they all think they're invincible, so I don't harp so much on you're gonna get cancer.

I harp on you're gonna have leather disgusting blotchy skin, right?

And we see movies like something about Mary with just that uh lady down there with the blonde hair, the leather skin, it's it's gross.

So the culprits here are ultraviolet uh A and B light.

There is a UV C, but that does not penetrate through the atmosphere, so we don't have to worry about that.

Uh UVA contributes to the aging process, uh, wrinkles and sunspots, some people call them liver spots, but those are the brown splotches that we see commonly on the face, the chest, the arms.

Uh yeah, we all have them.

Uh UVB, though that will give us sunburns and damage the DNA of our cells, which can then contribute to the skin cancer.

And you'll notice in that little diagram, the sun screens will reflect or prevent the absorption of the ultraviolet uh A and B rays.

Some most sunscreens now are broad spectrum, meaning they will block both A and B.

So the fountain of life, the sun is not.

Uh, sun damage is cumulative.

So some people say, well, the damage has been done when I was young.

Why bother now trying to keep myself healthy?

Well, only about 23% of life uh of the damage was done before you were 18.

So you can make big improvement by starting at any point.

Um, yes, there is some damage, but going forward, use the hats and the sunscreen, and you can make a difference.

80% of visible skin aging in Caucasian women is caused by the sun.

So we're always looking for this fountain of life and trying to look younger.

Biggest thing is protect yourself from the sun.

And of course, it decreases the risk of melanoma.

So on the left side, these are identical twins.

One twin uh she did a lot of indoor work, she was a professional, wasn't outside very much, was good in the sun.

Her twin on the right there uh loved the sun, loved the beach, was also a smoker.

So you can see the difference in their skin tones, the blotchiness, the decreased elasticity of the face.

And the man that's on the right, his profession was a truck driver, and you can see his driving side is significantly more wrinkled and thickened because he didn't use his sunscreen.

So indoor tanning needs to stop for most people.

There's a caveat to that, which I'll talk about in a minute.

But you're basically in a pressure cooker in a tanning bed.

And you know, it's been the rage for a long time.