Sun skin care chat with Dr Sarah Brewer

I have very fair skin and have always steered clear of the sun. Is this to be my fate for life? What factor of sunscreen would take me through a lovely Mediterranean holiday? And what else can we poor lasses with thin, fragile skin do?
Kirsten

Sadly, fair-skinned people will always have to be careful in the sun. As a general rule, the highest SPF products are best for those with fair skin. As well as covering up in the sun and avoiding exposure to sun during the hottest time of day (11am-3pm), look after your skin with moisturising products, take evening primrose oil to nourish it internally, and consider an antioxidant supplement to help reduce premature skin ageing.

I tend to break out in tiny little spots all over my back and chest in the sun. It was diagnosed as acne years ago and I got Dalicin. Is there anyway of preventing these? I'm off to Spain and want to avoid a spot breakout!
Tara

This sounds like prickly heat - a common and irritating skin rash linked with excess sweating. It usually affects areas where sweat accumulates such as at the chest, waist, back, armpits and groin. Its medical name, miliaria rubra, literally means red millet seeds and describes the appearance of tiny, multiple inflamed, itchy spots in affected areas. The rash is accompanied by irritating prickling sensations due to over-stimulation of nerve endings, which makes you want to scratch. In some cases, salt crystals form in the sweat gland ducts too and small fluid-filled blisters appear (miliaria crystallina), which usually disappear without problems. It is thought to occur when unevaporated sweat builds up on the skin in hot humid conditions so the skin becomes soggy and sweat glands are blocked. Sweat is thought to leak from the glands into surrounding tissues to trigger inflammation.

In some cases, heat rash is complicated by fungal skin infections, in which case applying an antifungal cream (e.g. one per cent clotrimazole) will help the irritation settle. Some people find antihistamine tablets or cream helpful, while a cream or lotion containing anti-itch treatments such as crotamiton or calamine may bring relief.

Prickly heat usually improves as you become acclimatised to the heat, and on returning to cooler weather.

• If you suffer from the heat, try to stay in places with air-conditioning
• Wear loose cotton clothing so sweat can evaporate
• Avoid tight clothes that pinch at the waist or that bunch up at elbows or knees
• Take frequent cool showers or swim in open-air pools or the sea
• Sponge down affected areas with plain water (no soap)

Aloe vera gel has anti-inflammatory, antiseptic and healing properties and usually works well for skin conditions such as prickly heat. Herbalists advise bathing the affected area with a cold infusion of marigold or lavender to reduce inflammation.

An aromatherapist may suggest adding one drop of sandalwood and four drops of lavender essential oils to 30ml calendula carrier oil to make a soothing lotion that can be applied to the skin.