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Sunshine feels great — especially after a long, cold winter. Getting some sun is a good way to improve mood, energy level, and sense of optimism.

A little bit of sunshine can also help your body process vitamin D, which is important for bone health. Just 10 minutes of outdoor light each day is enough.

But too much sun exposure can be dangerous. It can cause skin cancer, cataracts, wrinkles, and painful burns that may permanently damage skin. It can also make side effects of some chemotherapy worse. While not always predictable, chemotherapies can also cause some people to become sensitive to sunlight, leading to increased skin reaction, tanning, and burning. Intense sun exposure can also weaken the immune system even more than treatment has already.

Skin in an area that's receiving radiation therapy should be protected from the sun with a bathing suit or other clothing, since the skin may already be red or burned from the treatments.

It's also important to use sunscreen. Sunscreens work in different ways. Chemical sunscreen absorbs ultraviolet light before it can harm the skin. Chemical sunscreen acts as a filter and does allow some radiation to get through, which is why tanning is still possible. Physical sunscreen — sometimes called sunblock — reflects ultraviolet light so that it can't penetrate the skin, creating a barrier between sun and skin. Zinc oxide or titanium dioxide are examples of physical sunscreen ingredients.

If you're undergoing radiation therapy, ask your radiation oncologist or nurse whether using sunscreen is likely to irritate your radiated skin.

Still, you don't have to hide inside on bright summer days just because you're receiving breast cancer treatment. According to dermatologist Margo L. Weishar, M.D., of Springhouse, PA, you can enjoy the sun if you take these precautions:

  • Schedule your sun time for early or late in the day. Wear a tightly woven, wide-brimmed (5 inches) hat, and clothing that covers most of your body.
  • Forget the notion that any sunscreen SPF (sun protection factor) higher than 15 is a waste. Go for the highest number you can buy. "Most people don't apply sunscreen the way it's tested in the lab, me included," Dr. Weishar says. "You may be getting only half the protection you think you are." She recommends 45 SPF containing Parsol (chemical name: avobenzone) in a waterproof formula. Parsol is a chemical sunscreen that does a good job of absorbing harmful rays.
  • Don't step outside without your sunscreen on! The Skin Cancer Foundation recommends using 1 ounce (a shot glass full) of sunscreen to cover your body. Apply sunscreen at least 30 minutes before you go outside, because it takes time to absorb and start protecting your skin. If you swim, sweat a lot, or towel off, you should reapply even waterproof sunscreen.
  • For best face protection, Dr. Weishar advises using physical sunscreens that contain zinc. Physical sunscreens containing zinc deflect harmful rays, while chemical sunscreens absorb harmful rays. You may remember those bright white stripes of zinc on your nose from summertimes past, but newer products contain tiny particles of zinc that block harmful rays but are invisible when applied.
  • Protect your head. If you've lost your hair, the exposed skin has probably never seen sunlight before and will burn easily. Your ears may also be vulnerable. "The best thing is to wear a hat," Dr. Weishar says. "Otherwise, use a good zinc sunblock."
  • Apply topical vitamin C before sunscreen or makeup. Sold in liquid form, it can protect your skin against sunlight damage. Choose one that comes in a brown, light-sensitive bottle, Dr. Weishar says. This is because the vitamin C molecule is easily destroyed and should not be stored in a clear container.
  • If you have a fresh surgical scar, keep the area well covered. The new skin is very delicate. It can get pinker, then darker, if it's exposed to the sun.
  • Don't rely on the SPF ratings you see on makeup or face lotions to protect your skin. If you're going to be outdoors for longer than 15 minutes, use a sunblock or sunscreen.
  • Remember that most T-shirts give you a sun protection factor of only about 8.
  • If you're going through radiation treatment, protect your skin from the drying effects of chlorinated pool water by using a barrier product such as A&D ointment or Vaseline petroleum jelly.
  • After underarm lymph node dissection, try to avoid poison ivy, bug bites, cuts, or any other outdoor risks for infection or allergic reaction on that arm. Any of these irritants or injuries can trigger lymphedema in the affected arm.
  • If you're currently in breast cancer treatment, avoid hot tubs, Dr. Weishar notes. She says she's seen many cases of "hot tub folliculitis" — a condition caused by bacteria in hot tub water that can cause painful red sores on the skin. Although the condition is not serious, she says it could be worse for someone whose immune system is weakened.

With a little care, summer really can be a day (or week) at the beach, despite breast cancer treatment. Says Dr. Weishar, "I tell women, 'Put on a zinc sunblock, cover up, and enjoy!'"

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