“A tan is not a healthy glow — that’s a sign of damage. It’s a wound,” said Lawrence J. Green, a board-certified dermatologist in Montgomery County, clinical professor at George Washington University and vice president of the American Academy of Dermatology.
That reframing is at the heart of modern skin care guidance. What many people view as a sign of health is, in reality, the skin responding to injury from ultraviolet radiation.
From a medical standpoint, healthy skin has little to do with color and everything to do with care. A “glow,” Green said, comes from consistency — wearing sunscreen daily, using gentle cleansers and incorporating products like antioxidants that support the skin’s barrier. Tanning, even gradually, is not a sign that the skin is adapting. It is a visible response to damage.
Both tanning and burning trigger the body’s repair mechanisms after exposure to ultraviolet rays, Green explains. Over time, repeated exposure leads to visible changes. Patients often develop what he describes as “irregular mottled pigmentation,” along with sun spots, fine lines and deeper wrinkles. With enough cumulative exposure, those changes can progress to precancerous or cancerous growths.
That kind of damage is cumulative and often delayed. Green notes that much of what dermatologists see in older patients reflects sun exposure that occurred years earlier, long before visible changes appeared.
Ultraviolet radiation damages the skin in different ways, he said. UVA rays penetrate more deeply and contribute to aging, while UVB rays are more directly associated with sunburn. Both types of radiation can
lead to skin cancer, which is why dermatologists emphasize protection against both, not just one.
Despite years of public health messaging, many people still fall short when it comes to sunscreen. The most common issue, Green said, is simply not using enough or failing to apply it evenly. People routinely miss key areas, especially the ears, the backs of the hands and the back of the neck — parts of the body that are regularly exposed but easily overlooked.
Even among those who are diligent, technique matters. Spray sunscreens have become popular for their convenience, but they can create a false sense of security. Much of the product can disperse into the air rather than reaching the skin, and what does land may be unevenly distributed.
“Half of the can is going in the air,” Green says. “It’s not safe.”
Creams, lotions and gels tend to provide more reliable coverage, particularly when applied carefully and rubbed in, he says. Dermatologists also stress the importance of reapplication. For full-body coverage, about an ounce of sunscreen — roughly the amount that fits in a shot glass — is needed, and it should be reapplied every couple of hours when outdoors. In practice, that often means reapplying after swimming, sweating or towel-drying, even if the product is labeled water-resistant.
Another common misconception is that a higher SPF number alone guarantees better protection. In reality, SPF refers only to protection against UVB rays. Without broad-spectrum coverage, a sunscreen may offer little defense against UVA rays, which penetrate deeper into the skin and contribute to long-term damage.
“You can have an SPF 100 and have no UVA protection,” Green says. “That’s not so good.”
Sun protection works best as a layered approach, Green explains, combining sunscreen with behavioral changes. Limiting time in direct sunlight during peak hours, seeking shade and wearing protective clothing all reduce exposure.
“The time of day you’re outside is important,” he says. “If you can’t avoid it, hats and clothing are your best protection.” Wide-brimmed hats, sunglasses and lightweight long sleeves can provide consistent coverage that does not wear off or require reapplication.
Clothing, in particular, offers a level of consistency that sunscreen does not, Green notes. Lightweight, long-sleeved shirts and sun-protective fabrics can reduce the need for constant reapplication, especially for people who spend extended time outdoors.
Dermatologists are also paying closer attention to visible light, which can affect the skin in ways many people do not realize. While ultraviolet radiation is the primary driver of skin cancer, visible light can contribute to pigmentation changes, especially in individuals with darker skin tones.
“Visible light has been shown to cause irregular pigmentation,” Green says.
Tinted sunscreens, which often contain iron oxides, can help block visible light and reduce uneven darkening over time, he said.
Awareness of skin cancer signs is another critical piece of prevention. New or growing spots, particularly those that increase in size over time, should be evaluated. Changes in color, especially gradual darkening, can also be a warning sign, Green said, noting that patients should pay attention to anything that continues to evolve.
“If you’re unsure, it’s never a bad idea to play it safe,” he says.
For many people, the challenge is not understanding the risks but maintaining consistent habits. Daily sunscreen use remains the single most important step, even on cloudy days or when spending only short periods outdoors, Green emphasizes.
A true summer glow, he said, has little to do with tanning at all.
“A healthy glow is someone who’s taking care of their skin,” he says. “A tan is the opposite of that.”
