Interested in saving your skin?

Who isn’t, especially women who love the outdoors? Whether it’s summer boating season, time to head south for winter or get ready for winter sports like skiing, the harsh rays of the sun are taking their toll on our largest organ, our skin.

Outdoors enthusiasts like boaters and anglers, end up with a lot of sun exposure. In fact, the number one type of injury suffered by scuba divers is sunburn. And a recent survey found that a high number of American, 95%, recognize that sun exposure harms skin cells but a surprising 81% still thought a tan made them “look good.“

The good and bad news is that cancer rates overall in the U.S. are plummeting, but not skin cancer. It’s the fastest growing form of the disease in the U.S., due largely to our sun-worshipping culture of old.

Out on the water, as much as 40% of the sun’s rays can be reflected back onto a boater’s skin, making sunscreen, shirts with collars and hats part of the boat’s standard equipment. A canvas awning or bimini alone is not enough to block the rays as the reflected sunlight bounces up. Sand on beaches, concrete pavements and snow also reflect up to 40% of the harmful ultraviolet (UV) rays.

“ I see skin cancers all day long,” said Dr. Flor Mayoral. The Miami dermatologist had just been treating an attractive 45-year-old woman more concerned about getting botox injections for wrinkles than the risks she was taking using a tanning bed. Mayoral said the woman pointed out a mole that had changed shape and she was subsequently diagnosed with a malignant melanoma, a potentially life-threatening form of skin cancer.

As a resident of sun-drenched south Florida, Dr. Mayoral is on the front lines of an epidemic rise in skin cancer in the United States. One million new cases will be diagnosed this year, with a shocking 87,900 of them melanoma, resulting in 7,400 deaths. She agrees that some people, like her tanning-bed patient, have not taken sun exposure seriously.

Dr. Mayoral takes precautions year-round whenever she goes out with her husband on their Boston Whaler. As a scuba diver, she enjoys going out on the water as often as possible, but she plans the outings for early morning or late afternoon when the ultraviolet-B rays are not so fierce. (UV-A rays are actually more harmful, penetrate deeper into the skin layers, are present at all hours of the day and can travel through glass.)

“ The biggest misperception that I see is about cloudy days,” Mayoral said. “People think if the sun isn’t out they won’t get any exposure. Or if they’re not on the boat or at the beach, sun exposure isn’t occurring. Not so,” she said. Just walking through a parking lot or walking a dog brings exposure that is damaging to the skin and the effects are cumulative over a lifetime. Wrinkles, dried out skin, premature aging of skin or worse are the end result.

“People are also not applying thick enough sunscreen or re-applying it soon enough,” she said, citing a recent study by the American Academy of Dermatology. It found that in a sampling of Colorado skiers, those that re-applied sunscreen every two hours or less were five-and-a-half times less likely to get sunburned. Another study of beachgoers in Texas found that most were wearing sunscreen but after swimming did not re-apply it, resulting in sunburns.

Sunscreens that are SPF 15 or higher are recommended and the amount needed to adequately cover exposed skin is equal to a full shot glass, according to dermatologists. Every hour to 90 minutes, it should be reapplied, says Mayoral, or immediately after swimming. (“Water resistant” means a sunscreen will maintain some level of effectiveness for 40 minutes in the water; “waterproof” extends it to about 80 minutes. In either cases, it washes off.)

A product referred to as “sun block” doesn’t really “block” the sun, it slows up the damage. SPF 15 means the amount of time you can stay in the sun without beginning to burn is 15 times what it would be without sunscreen. Sweating, rubbing and water will shorten that time frame considerably. A broad-spectrum sunscreen is best— it should protect against both UV-A and UV-B rays.