• Strategy of collaboration and early intervention
• Integration of multiple specialties:
  • Pediatrician
  • Transplant surgeon
  • Dermatologist
  • Dermatologic Surgeon (Mohs Surgery)
  • Nephrologist/Gastroenterologist
  • Cardiothroracic/Cardiologist

General Principles:

• Preventive education
  • sun protection
  • skin self exam
• Risk assessment
  • skin type, skin history, UV exposure history
• Early intervention
  • Topical and oral prophylactic regimens
  • Standard follow-up intervals
  • Rapid and direct access to dermatology and dermatologic surgery

Sunprotection:

• Sun avoidance
• Avoid sunlight from 10am to 3pm
• Sunblock (read more, link to Sunblock in General Guide)
• Use a sunblock with SPF >/=30 with broad UVA/UVB protection
• Apply at least once daily, more frequently with perspiration or water exposure
• Lipbalm with sunblock
• UV protective clothing (read more)
  • Hats
  • Long sleeved shirts
  • Long pants
  • Special UV protective clothing for everyday use is available from several manufacturers (SunPrecautions Clothing, Coolibar, etc…)
  • Sunglasses with UV protective coating
• Tanning beds expressly prohibited

Sunblock Recommendations:

• SPF >/= 30 with broad UVA/UVB protection.
• Types of sunblock
  • Chemical blockers: absorb the energy of UV radiation
    • Most only block a narrow range, must use combinations of chemical blockers to provide broad spectrum coverage
    • Parsol 1789 (avobenzone)-best UVA coverage
    • Mexoryl broadest coverage
    • Not FDA approved (Antihelios™), available on internet
  • Physical blockers: scatter UV radiation
  • broad spectrum UVA and UVB protection
  • titanium dioxide and zinc oxide
  • Good for sensitive skin
• Sunblock Use
  • Apply ~20 minutes prior to sun-exposure.
  • Apply to all sun-exposed areas. Don't forget lips, ears, back of neck, or back of legs.
  • Apply a sufficient coat of sunscreen- most common mistake is being too stingy
  • Reapply every 2 hours when out in the sun- more frequently if in water or sweating