from a sunburn later on."

從後來的晒傷。"

You know, a tan is temporary, but your skin never forgets.

你知道，晒黑是暫時的，但你的皮膚永遠不會忘記。

"I'm covered -- I applied sunscreen

"我的身體很好 -- 我塗了防晒霜

on my face, arms, and legs."

在我的臉上、手臂和腿上"。

You're not covered.

你不在保險範圍內。

"Getting sunburned once is harmless."

"被晒傷一次是無害的。"

All it takes is one blistering sunburn.

只需要一次起泡的晒傷就夠了。

One.

一。

Hi, my name is Jeremy Brauer.

嗨，我的名字是傑里米-布勞爾。

I am a board-certified dermatologist

我是一名經委員會認證的皮膚科醫生

and a fellowship-trained Mohs surgeon.

和一位接受過獎學金培訓的莫氏外科醫生。

I have a new practice in Westchester, New York,

我在紐約威徹斯特有一個新的診所。

called Spectrum Skin and Laser

稱為光譜皮膚和脈衝光

as well as practicing in Manhattan for about a decade.

以及在曼哈頓執業約十年。

Hi, I'm Dr. Michelle Henry.

你好，我是米歇爾-亨利博士。

I'm a board-certified dermatologist and skin-cancer surgeon.

我是一名經委員會認證的皮膚科醫生和皮膚癌外科醫生。

I have a practice called Skin & Aesthetic Surgery

我有一個名為 "皮膚與美容外科 "的診所。

of Manhattan. I specialize in high-risk skin cancers,

我是曼哈頓的一名醫生。我專門研究高風險的皮膚癌。

lasers, aesthetics, and general dermatology,

脈衝光、美學和普通皮膚病學。

and today we'll be debunking myths about sun care.

今天，我們將揭開有關陽光護理的神話。

"A higher SPF is always better."

"更高的SPF值總是更好的"。

So, that, I would have to say, is a myth.

是以，我不得不說，這是個神話。

SPF is great when we think about UVB,

當我們考慮到UVB時，SPF是偉大的。

or ultraviolet B, rays,

或紫外線B，射線。

but we also have to worry about our ultraviolet A rays,

但我們也必須擔心我們的紫外線A射線。

which also cause sun damage and skin cancer.

這也會導致陽光傷害和皮膚癌。

So in that regard, you're looking more for

是以，在這方面，你更多地是在尋找

a broad-spectrum, UVA/UVB-protective sunscreen.

一種廣譜的UVA/UVB保護性防晒霜。

The other part of this that makes it a myth

使之成為神話的另一部分是

is higher is not always better.

是越高越好，不一定是越好。

Yes, 30 is better than 15, 50 is better than 30,

是的，30比15好，50比30好。

but at some point, roughly around 50,

但在某種程度上，大致在50左右。

you're already at 98% blocking of your UVB rays.

你已經有了98%的紫外線阻擋率。

And SPF 100 only takes you 1% more, to 99%,

而SPF100只讓你增加1%，達到99%。

and is that really significant? Likely not.

而這真的有意義嗎？很可能不是。

What's most important to me is that

對我來說，最重要的是

you're wearing 50 when you're outdoors,

當你在戶外活動時，你要穿50的衣服。

but you also want to make sure you're wearing sunglasses,

但你也要確保你戴上了太陽鏡。

utilizing shade structures, you're wearing a hat,

利用陰涼的結構，你戴著一頂帽子。

you're paying attention to your skin.

你要注意你的皮膚。

"You can have a 'healthy tan.'"

"你可以有一個'健康的晒黑'。"

Absolutely not.

絕對不是。

So, this is complete fake news.

是以，這完全是假新聞。

We know that UV light is a known carcinogen,

我們知道，紫外線是一種已知的致癌物。

so there really is zero safe dose of UV light.

是以，紫外線的安全劑量真的為零。

I would agree.

我同意。

Healthy and tan do not go together, by definition.

根據定義，健康和晒黑並不相配。

When your skin is tanned, it's damaged.

當你的皮膚被晒黑時，它就被損壞了。

And when you have damaged skin,

而當你有受損的皮膚時。

you increase your risk of skin cancer.

你會增加你患皮膚癌的風險。

We know that approximately 90% of all skin cancers

我們知道，所有皮膚癌中約有90%是

are directly related to exposure

與接觸直接相關

to ultraviolet A and B rays, and guess what?

對紫外線A和B射線，你猜怎麼著？

Those are what causes a skin to tan.

這些都是導致皮膚晒黑的原因。

Exactly. You know, a tan is essentially

正是如此。你知道，晒黑基本上是

just your skin's stress response.

只是你的皮膚的壓力反應。

So your skin is distressed when it's tan.

是以，你的皮膚被晒黑後會很苦惱。

If you want tan skin,

如果你想晒黑皮膚。

A, understand that your skin is OK

A，理解你的皮膚是可以的

and beautiful the way it is.

和美麗的方式，它是。

But if you for the summer want to look a little bit tanner

但是，如果你在夏天想讓自己看起來更黑一點的話

and you want to do that in a safe way,

而且你想以安全的方式做這件事。

there are many companies that provide very safe

有許多公司提供非常安全的

sunless tanning creams, lotions, and sprays

防晒霜、洗劑和噴霧劑

that can give you the look that you want

可以給你帶來你想要的外觀

but also keep you safe.

但也能保證你的安全。

And that is my singular recommendation for being tan.

這就是我對晒太陽的唯一建議。

"Getting a base tan will protect you

"晒底可以保護你

from a sunburn later on."

從後來的晒傷。"

The tanning salons will tell you

日光浴沙龍會告訴你

that if you get a base tan before you go out into the sun,

如果你在出去晒太陽之前做了一個基礎的晒傷。

it's going to protect you.

它將會保護你。

So, a base tan probably gives you about an SPF of 3.

是以，底層晒黑可能給你帶來大約3個SPF值。

So if you burn in 20 minutes,

是以，如果你在20分鐘內燃燒。

now you're going to burn in 60 minutes.

現在你要在60分鐘內燒燬。

That's nothing. It doesn't really help you significantly.

這不算什麼。它對你的幫助其實並不明顯。

But what it has done

但它所做的是

is increase your risk for skin cancer,

是增加你患皮膚癌的風險。

increase your risk for accelerated aging.

增加你加速衰老的風險。

And, you know, a tan is temporary,

而且，你知道，晒黑是暫時的。

but your skin never forgets.

但你的皮膚永遠不會忘記。

So what I tell my patients is that skin cancer

所以我告訴我的病人的是，皮膚癌

is like the straw that broke the camel's back.

就像壓垮駱駝的那根稻草。

You never know when you're getting that one last exposure

你永遠不知道你什麼時候會有最後一次曝光機會

that is now going to tip your skin cells

現在要提示你的皮膚細胞

over into being cancerous.

變成了癌症。

So there really is zero safe level of UV.

是以，紫外線的安全水準真的是零。

"You can't get sunburned in the shade."

"你不能在陰涼處被晒傷。"

Incorrect. So, you can absolutely

不正確。是以，你絕對可以

get sunburned in the shade.

在陰涼處被晒傷。

Are you skiing? Are you at the beach? Is there sand?

你在滑雪嗎？你是在海邊嗎？有沙子嗎？

Are you sitting right next to an aluminum garbage can?

你就坐在鋁製垃圾桶旁邊嗎？

No matter where you are, the sun can reflect

無論你在哪裡，太陽都能反射出

off of the concrete, the sand, the snow especially.

特別是混凝土、沙子、雪的脫落。

With snow, about 80% of the sun's rays actually reflect.

有了雪，大約80%的太陽光實際上會反射。

So you're actually still at risk

所以你實際上仍然有風險

and still quite vulnerable,

而且仍然相當脆弱。

even if you're under a shade structure.

即使你在陰涼的結構下。

"You only need sunscreen if you're going outside."

"只有當你要出去時才需要防晒霜。"

That is definitely a myth.

這絕對是一個神話。

We know for sure that whether you're indoors

我們可以肯定的是，無論你是在室內

sitting by a window or if you're in a car driving,

坐在窗邊或如果你在車裡開車。

you are going to get exposure to ultraviolet light.

你將會接觸到紫外線。

Primarily it's ultraviolet A,

主要是紫外線A。

but as we've been talking about,

但正如我們一直在談論的那樣。

ultraviolet A is just as dangerous as ultraviolet B.

紫外線A和紫外線B一樣危險。

And even then, while these windows do protect you

即使如此，雖然這些窗戶確實可以保護你

against most of ultraviolet B,

對抗大部分的紫外線B。

it's not all of ultraviolet B.

它不是所有的紫外線B。

Henry: Curtains aren't perfect, because, you know,

亨利。窗簾並不完美，因為，你知道。

clouds aren't even perfect, right?

雲都不完美，對嗎？

So UVA makes its way completely through the clouds.

是以，UVA使其完全穿過雲層。

So curtains alone won't do it.

所以光靠窗簾是不行的。

You know, sunscreen alone won't do it.

你知道，僅靠防晒霜是不行的。

It is a comprehensive plan to keep your skin safe.

這是一個全面的計劃，以保持你的皮膚安全。

"I'm covered -- I applied sunscreen

"我的身體很好 -- 我塗了防晒霜

on my face, arms, and legs."

在我的臉上、手臂和腿上"。

You're not covered.

你不在保險範圍內。

We also think about arms,

我們還考慮到了武器。

but what about the backs of your hands?

但你的手背呢？

And if you're outside wearing flip-flops

如果你在外面穿著人字拖鞋

or open-toed shoes, sandals,

或露趾鞋、涼鞋。

the tops of your feet as well

腳面也是如此

need to be protected with sunscreen.

需要用防晒霜進行保護。

Henry: The lips. That's an area that's really high risk

亨利：嘴脣。那是一個真正高風險的區域。

for skin cancer, and as skin-cancer surgeons,

皮膚癌的治療，以及作為皮膚癌外科醫生。

we know that's one of the areas

我們知道那是一個領域

where skin cancers can metastasize.

皮膚癌可能轉移的地方。

Another area: the part.

另一個領域：零件。

When men lose their protective covering

當男人失去了他們的保護罩

on the scalp, you want to make sure

在頭皮上，你要確保

that you're protecting those areas.

你正在保護這些地區。

The chest, behind the legs, underneath the chin.

胸部、腿後、下巴下方。

I treat skin cancers underneath the chin all the time.

我一直在治療下巴下方的皮膚癌。

So even if you're just out on a patio

是以，即使你只是在庭院裡

having lunch with a friend,

與朋友共進午餐。

that light is getting reflected.

光線被反射。

So don't forget underneath the chin as well.

所以不要忘了在下巴下面也是如此。

"Getting sunburned once is harmless."

"被晒傷一次是無害的。"

No. This is absolutely incorrect.

不，這是絕對不正確的。

All it takes is one blistering sunburn

只要有一次起泡的晒傷就夠了

in your lifetime to increase your risk of skin cancer.

在你的一生中，增加你患皮膚癌的風險。

One.

一。

Henry: Those young formative years,

亨利：那些年輕的成長期。

not only are they psychologically important,

他們不僅在心理上很重要。

but they're clinically important to keeping you safe.

但它們對保持你的安全在臨床上是很重要的。

We know that five sunburns before the age of 18

我們知道，18歲之前有五次晒傷的情況

can double your risk for melanoma.

可使你患黑色素瘤的風險增加一倍。

So it's really important

所以這真的很重要

that you're protecting your skin early.

你要及早保護你的皮膚。

I would say the best way to stay away from us

我想說的是，遠離我們的最好辦法是

is actually coming to see us.

實際上是來見我們的。

Henry: Oh, yes, I like it!

亨利。哦，是的，我喜歡它!

Brauer: Everyone, as you said,

布勞爾：每個人，如你所說。

everyone is incurring sun damage.

每個人都在遭受陽光的傷害。

Everyone should have a skin check

每個人都應該進行一次皮膚檢查

by a board-certified dermatologist.

由委員會認證的皮膚科醫生負責。

And the idea is not just

而這個想法不僅僅是

for the dermatologist to take a look at your skin,

為皮膚科醫生看一下你的皮膚。

but also have a conversation with you

但也要與你對話

about what your skin looks like

關於你的皮膚看起來像什麼

and how you can prevent future sun damage,

以及你如何防止未來的陽光傷害。

prevent development of skin cancer,

防止皮膚癌的發展。

what sunscreens might be appropriate for you.

哪些防晒品可能適合你。

Henry: Once you've had one skin cancer,

亨利。一旦你得了一次皮膚癌。

you're at an increased risk

你的風險增加

of having another one in the next year.

明年再來一次的機會。

And so it's just, once you've accumulated that damage,

所以它只是，一旦你積累了這種損害。

you continue to have them,

你繼續擁有它們。

and you continue to have them.

而你繼續擁有它們。

And so it's really important

是以，這真的很重要

that you take every sun exposure seriously,

你要認真對待每一次陽光照射。

because you never know when you're near your tipping point.

因為你永遠不知道你什麼時候接近你的臨界點。

And so, yes, what has happened has happened,

是以，是的，已經發生的事情已經發生。

but it doesn't mean that it's too late,

但這並不意味著為時已晚。

and we absolutely can do things for you

我們絕對可以為你做事情

to help minimize the risk

以幫助儘量減少風險

of development of skin cancer in the future.

在未來發展為皮膚癌的可能性。

"The sun is strongest when it's hottest."

"太陽在最熱的時候是最強的。"

This is not necessarily true.

這不一定是真的。

The heat that you feel over the course of the day

你在一天中感受到的熱量

is actually cumulative, so for most of us,

實際上是累積的，所以對我們大多數人來說。

we actually feel the hottest

我們實際上感覺到最熱的是

a little later in the day, usually about 3 o'clock.

在一天中稍晚的時候，通常是3點鐘左右。

So if you're out at 10, 11 o'clock

是以，如果你在10點、11點時外出

and you don't feel it's all that hot outside, guess what?

而你並不覺得外面有多熱，你猜怎麼著？

That's when the UV is actually strongest.

那是紫外線實際上最強的時候。

There are certain times of the day

一天中的某些時間

where the sun is at the highest in the sky.

太陽在天空中最高的地方。

And at that period of time, we believe

而在那個時期，我們相信

that the ultraviolet light that we've talked about,

那就是我們已經談到的紫外線。

UVA/UVB, is at its strongest and most damaging.

UVA/UVB，是其最強和最具破壞性的時候。

In general, we talk about 10 a.m. to 3 p.m.

一般來說，我們談論的是上午10點到下午3點。

It can vary slightly, maybe 11 to 4,

它可以略有不同，也許是11比4。

but that doesn't necessarily mean

但這並不一定意味著

that's when it's hottest during the day.

那是白天最熱的時候。

A little trick that I often use is the shadow trick.

我經常使用的一個小技巧是陰影技巧。

If your shadow is shorter than you,

如果你的影子比你矮。

the sun is higher in the sky.

太陽在天空中更高。

If your shadow is a little bit longer or taller than you,

如果你的影子比你長一點或高一點。

so in the late morning or the late afternoon,

所以在上午晚些時候或下午晚些時候。

then the sun is likely not at its peak.

那麼太陽很可能不在其高峰期。

The other thing to think about is on a cool day,

另一件要考慮的事情是在涼爽的日子裡。

on a cloudy day, even on a winter day

在陰天，甚至在冬天的時候

high up in the mountains, when you're skiing,

在山的高處，當你滑雪時。

you're getting ultraviolet damage occurring.

你得到了紫外線損害的發生。

"People with darker skin don't need sunscreen."

"皮膚較黑的人不需要防晒霜。"

So, everyone needs sunscreen.

是以，每個人都需要防晒霜。

It does not matter your skin type.

這與你的皮膚類型無關。

So we know that melanin is protective,

所以我們知道黑色素具有保護作用。

but melanin is not perfect.

但黑色素並不完美。

So even the deepest, darkest skin

是以，即使是最深、最黑的皮膚

ranges from an SPF, let's say, 4 to SPF 13.

範圍從SPF，比方說，4到SPF13。

And what do we recommend?

那我們有什麼建議呢？

SPF 30 and above.

SPF30及以上。

So even dark skin is not 100% protective.

是以，即使是黑皮膚也不是100%的保護。

We know that we see skin cancers in darker skin types.

我們知道，我們在較深的皮膚類型中看到皮膚癌。

What's also important is that in darker skin types

同樣重要的是，在較深的皮膚類型中

there's often a lower index of suspicion,

通常有較低的懷疑指數。

so we find them later.

所以我們後來找到了他們。

And because of this, the outcomes can be quite worse.

也正因為如此，結果可能相當糟糕。

So in darker skin types,

所以在較深的皮膚類型中。

we see that the five-year survival

我們看到，5年生存率

for melanoma is about 65%.

黑色素瘤的發病率約為65%。

In lighter skin types, it's about 90%.

在較淺的皮膚類型中，大約是90%。

And part of that is because

而其中的部分原因是

of that lower index of suspicion.

的懷疑指數較低。

The thing about skin of color

關於彩色皮膚的事情

is that redness looks different,

是，紅腫看起來不同。

sun damage looks different, but it's still there.

晒傷看起來不同，但它仍然存在。

Skin cancers look different.

皮膚癌看起來不同。

So some of the most common skin cancers,

是以，一些最常見的皮膚癌。

like basal cell skin cancers,

如基底細胞皮膚癌。

which we classically describe as a pearly pink papule,

我們經典地將其描述為珍珠狀的粉紅色丘疹。

in a darker-skin patient might look brown.

皮膚較黑的病人可能看起來是棕色的。

It might, instead, it's a pearly brown papule.

它可能，相反，它是一個珍珠色的棕色丘疹。

And so, you know, it's not that it doesn't happen.

所以，你知道，並不是說它沒有發生。

It's about being trained in a way

這是關於以一種方式接受培訓

to read those changes, because they're there,

來閱讀這些變化，因為它們就在那裡。

they're present, and it's critical to find them.

他們是存在的，而且找到他們是至關重要的。

"All sunscreen works the same."

"所有防晒霜的效果都一樣。"

Fortunately, they do not,

幸運的是，他們沒有。

because variety is really important,