TIME Healthcare

10 Reasons You Feel Cold All the Time

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Check if you're drinking enough water

Feeling chilly when the AC is blasting is one thing. But if you’re always shivering, or your hands and feet feel like blocks of ice while everyone else nearby says the temperature feels toasty, then it’s time to investigate. It’s common for women to report feeling cold, partly as a result of physiology and also a greater susceptibility to conditions that can contribute to coldness, says Holly Phillips, MD, medical contributor for CBS2 News and author of The Exhaustion Breakthrough. This checklist of 10 reasons your internal thermostat is out of whack can help you get a handle on why you’re chronically freezing your butt off.

You’re too thin

Low body weight—defined as a BMI hovering around 18.5 or under—can chill you out for a couple of reasons. First, when you’re underweight, you lack an adequate level of body fat to insulate you from cold temperatures, explains Maggie Moon, RD, a Los Angeles–based nutritionist. The other thing is, to maintain that low BMI, you have to reduce your food intake so you likely aren’t eating very much at all. Skimping on calories puts the brakes on your metabolism, so you don’t create enough body heat. Consider putting on a few pounds by loading up on whole, healthy foods that contain lots of protein, fat, and complex carbohydrates.

Your thyroid is out of whack

Add cold intolerance to the long list of health issues you can blame on the butterfly-shaped gland in your neck. “Always being cold is a telltale sign of hypothyroidism, which means your thyroid doesn’t secrete enough thyroid hormone,” says Dr. Phillips. Without the right level of this hormone, your metabolism slows, preventing your body’s engine from producing adequate heat. Other signs of hypothyroidism are thinning hair, dry skin, and fatigue.

Approximately 4.5% of Americans have this condition, and rates are higher in women who have recently been pregnant or are over age 60. If you suspect a thyroid problem, see your doctor, who can confirm the diagnosis with a blood test and get your thyroid out of the slow lane with prescription meds.

You don’t get enough iron

Low iron levels are one of the most common reasons for chronic coldness. Here’s why: Iron is a key mineral that helps your red blood cells carry oxygen throughout your body, bringing heat and other nutrients to every cell in your system, explains Dr. Phillips. Without enough iron, red blood cells can’t effectively do their job, and you shiver.

Iron is also crucial because a deficiency can make your thyroid lethargic, leading to hypothyroidism, which further leaves you freezing, says Moon. Iron supplements can help, but the best way to boost your iron intake is through healthy food: meat, eggs, leafy greens like spinach, and seafood are the best options, says Moon.

You have poor circulation

If your hands and feet are always like ice but the rest of your body feels comfortable, then a circulation problem that keeps blood from flowing to your extremities might be to blame. Cardiovascular disease can be one cause; it’s a sign that your heart is not pumping blood effectively, or a blockage of the arteries prevents blood from getting to your fingers and toes, explains Margarita Rohr, MD, internist at NYU Langone Medical Center in New York City. Smoking can also bring on circulation issues, since lighting up constricts blood vessels, says Dr. Phillips.

Another possibility is a condition called Raynaud’s disease, which prompts blood vessels in your hands and feet to temporarily narrow when your body senses cold, says Rohr. Reynaud’s disease can be treated with meds, but you need to check in with your doctor for a diagnosis first.

You don’t get enough sleep

“Sleep deprivation can wreck havoc on your nervous system, throwing off regulatory mechanisms in the brain that affect body temperature,” says Dr. Phillips. It’s not clear why this happens; studies suggest that in response to the stress of not getting quality snooze time, there’s a reduction in activity in the hypothalamus, the control panel of the brain where body temperature is regulated. A study from theEuropean Journal of Applied Physiology appears to back this up: researchers documented a drop in body temperature in 20 sleep-deprived young adults. Metabolism may be a culprit here as well. When you’re fatigued from a restless night, your metabolism works at a more sluggish pace, says Dr. Phillips, producing less heat and slower circulation.

You’re dehydrated

“Up to 60% of the adult human body is water, and water helps regulate body temperature,” says Moon. “If you’re adequately hydrated, water will trap heat and release it slowly, keeping your body temperature in a comfortable zone. With less water, your body is more sensitive to extreme temperatures.” Water warms you up another way as well. It helps power your metabolism, and a sluggish metabolism translates into less overall body heat. Aim for the requisite eight glasses a day at a minimum, recommends Moon, but always drink more before and after workouts.

You don’t consume enough vitamin B12

This nutrient found only in animal products plays big role in preventing big chills. “The body needs vitamin B12 to make red blood cells, which carry oxygen through your system,” says Moon. “Not having enough can lead to B12-deficiency anemia, or a low red blood cell count, resulting in chronic coldness.” Vitamin B12 deficiency can be caused by a poor diet, so aim to get more lean meat, fish, and dairy into your meals. But sometimes low levels are triggered by an absorption issue. If your diet is high in B12 but you shiver all the time, check in with your doctor for a vitamin B12 test.

You’re a woman

Find yourself in a constant battle with your spouse or male officemates for control of the thermostat? Turns out that feeling cold really is a gendered condition. “In general, women are better at conserving heat than men,” says Dr. Rohr. “In order to do this, women’s bodies are programmed to maintain blood flow to vital organs such as the brain and heart.” This directs blood flow toward these organs and away from less vital organs like hands and feet, says Dr. Rohr, which leaves these body parts chronically cold. Science bears this out: a University of Utah study found that though women had a slightly higher core body temperature than men, their hands came in at an average of 2.8 degrees cooler.

You have diabetes

Diabetes that’s not kept in check can lead to a condition called peripheral nephropathy, a constant attack on the nerves that provide sensation to your hands and feet, says Dr. Rohr. “When this develops, you experience numbness and sometimes pain in the hands and feet, and since these nerves are also responsible for sending message to the brain regarding temperature sensation, your hands and feet may feel cold,” she says. Diabetic nephropathy develops gradually, so you may not realize you have it. But if you are diabetic or have symptoms of the disease (frequent urination, feeling tired, and having increased thirst are three classic signs) see your doctor.

You need to bulk up your muscle mass

Muscle helps maintain body temperature by producing heat, says Dr. Rohr, so not having enough muscle tone contributes to feeling frosty. Also, having more muscle mass fires up your metabolism, which fights the perma-freeze feeling. Hitting the weight room at the gym or investing in free weights will help build the muscle that powers your furnace and functions like an internal blanket so you can throw off that wool one wrapped around your shivering shoulders.

This article originally appeared on Health.com

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TIME public health

5 Essential Tricks for Treating a Sunburn

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Remember to constantly moisturize your skin

Of course you understand the importance of sunscreen, but sometimes, no matter how diligent you were with reapplying, you still end up getting too much sun. While the damage of a sunburn can’t be undone (sadly), there are things you can do to speed up the healing process and soothe your red, inflamed skin. We asked Joshua Zeichner, MD, director of cosmetic and clinical research in the department of dermatology at Mount Sinai Hospital in New York City, about the best way to feel better fast.

Work from the inside out

So you’re on the way home from the beach, and one look in the rearview mirror tells you that you’re in trouble. As soon as you realize your skin is a little too red, take an over-the-counter anti-inflammatory pill like ibuprofen or aspirin, Dr. Zeichner recommends. This can help stop inflammation and redness from getting any worse and ease pain.

Cool down

Once you get to a shower, rinse off with cool water to soothe skin and remove any chlorine, salt water or sand that may be lingering and causing more irritation. Have a bath? Even better! Add a cup of whole oats to the cool bath water for extra calming power.

Moisturize

The sun zaps moisture from the skin, so be sure to replenish it regularly over the next few days with a rich moisturizer. Zeichner recommends looking for ones that contain aloe, glycerin or hyaluronic acid like Sun Bum Cool Down Aloe Spray ($12, nordstrom.com). If it’s a small area like your nose, neck or ears, try a 1% hydrocortisone ointment like Cortizone 10 Hydrocortisone Anti-Itch Cream Plus 10 Moisturizers ($9, walgreens.com) to reduce inflammation. Hot tip: Keep your moisturizers in the fridge for an extra refreshing treat.

Use a DIY compress

Try using a cool compress soaked in skim milk, egg whites or green tea. The proteins in milk and egg whites coat and calm the burn while green tea reduces inflammation.

Drink up

Not only does the sun take away the moisture from your skin, it also dehydrates the rest of your body as well, which is why you may also feel extra tired after a long day in the sun. Counteract the sun’s damage by drinking lots of water and eating water filled fruit like watermelon, honeydew melon, cantaloupe, or grapes.

This article originally appeared on Health.com

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3 Things You Can Catch from a Pool

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Outbreaks of illnesses from hot tubs and pools have been increasing in recent years

Think a chlorinated pool is a safe, sterile place? Think again. There are a few dangers lurking in a shared pool, whether at a gym, a community center or even a fancy resort. In fact, outbreaks of illnesses from hot tubs and pools have been increasing in recent years, with 90 outbreaks causing 1,788 illnesses and one death between 2011-2012, according to a new report from the Centers for Disease Control and Prevention. Learn what icky things you can pick up, plus how to ward them off.

Diarrhea

One of the top causes of post-swim illness is a parasite called cryptosporidium (crypto for short), which leads to diarrhea, stomach pain and nausea. According to the new CDC report, of the 69 outbreaks associated with treated water, more than half were caused by crypto. Symptoms can last for up to two weeks. The parasite ends up in the water if feces (even trace amounts from someone who didn’t shower first) of an infected person gets in the pool. The bug is resistant to chlorine and survives outside the body for long periods.

Protect yourself: Crypto spreads when you accidentally swallow contaminated pool water or you touch your mouth before washing your hands. Don’t touch your face until you’ve had your post-swim shower, with soap and hot water.

Pinkeye

Burning eyes, excessive tearing and redness can occur because of an allergic reaction to chlorine, or an infection if the pool isn’t chlorinated enough. It can also happen if people aren’t showering before swimming or are (ugh!) peeing in the pool. Urine, as well as cosmetics and other chemicals that can wash off people’s skin, can irritate your eyes.

Protect yourself: You can shield your eyes from all of this by wearing a pair of well-fitting goggles every time you go for a dip.

Hot Tub Rash

This is an itchy skin infection that can lead to a bumpy, red rash, often worse in the areas covered by your bathing suit. Chlorine can easily kill the germ that causes it, but the warm water in a hot tub makes chlorine break down faster, so it’s more likely you’d pick it up there.

Protect Yourself: The risk of hot tub rash goes up the longer the contaminated water touches your skin, which is why it seems to show up in areas your wet bathing suit clings to. Save your dip in the hot tub for the end of your pool day, shower and change shortly after your soak and wash your swimsuit before wearing it again.

Contributed reporting by Amelia Harnish.

This article originally appeared on Health.com

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TIME

A Brain-Eating Parasite Has Killed a 21-Year-Old California Woman

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Mark Newman—AP 'Do Not Allow Water To Enter Your Nose' Amoeba (Naegleria fowleri) warning sign at thermal pool, Roger's Spring, Lake Mead, Nevada, U.S.A.

This is the second such fatality in the U.S. to occur in the last year

Public health officials have confirmed that a brain-eating amoeba caused the death of a 21-year-old woman in eastern California last month, the Los Angeles Times reports.

The woman contracted the parasite on private property in the town of Bishop, about 60 miles southeast of Yosemite National Park. She awoke from a nap last month with flu-like symptoms; physicians at Northern Inyo Hospital initially diagnosed her with meningitis. When her symptoms worsened, she was transported to a hospital in Reno, where she ultimately died of cardiac arrest.

Naegleria fowleri, as the amoeba is officially known, can thrive in warm freshwater and soil; infections result when contaminated water enters the nose, allowing the parasite to travel to the brain. It manifests itself first in flu-like symptoms — fever, vomiting, headaches — before inducing hallucinations, seizures, and, in more than 95 percent of instances, death.

This is the second naegleria fowleri-related fatality in the U.S. to occur in the last year. In July 2014, nine-year-old Hally Yust died from the infection after water skiing in a contaminated lake in Kansas. The majority of cases in the country have been in the southeast.

Health officials are eager to note, however, that the occurrences of the amoeba are rare and infections even rarer.

“I want to emphasize that there have been no evident cases of amoeba contamination in the U.S. in well-maintained, properly treated swimming pools or hot springs,” Richard Johnson, a public health officer in Inyo County, California, told the Times.

TIME Crime

Scientist Who Faked HIV Vaccine Research Sentenced to Prison

Dong-Pyou Han AIDS research
Charlie Neibergall—AP In this July 1, 2014 file photo, former Iowa State University researcher Dong-Pyou Han leaves the federal courthouse in Des Moines, Iowa.

He was sentenced to more than 4 ½ years in prison

(DES MOINES, Iowa)—A former Iowa State University scientist who altered blood samples to make it appear he had achieved a breakthrough toward a potential vaccine against HIV was sentenced Wednesday to more than 4 ½ years in prison for making false statements in research reports.

Dong-Pyou Han, 58, also must pay $7.2 million to a federal government agency that funded the research. He entered a plea agreement in February admitting guilt to two counts of making false statements.

Government prosecutors said Han’s misconduct dates to 2008 when he worked at Case Western Reserve University in Cleveland under professor Michael Cho, who was leading a team testing an experimental HIV vaccine on rabbits. Cho’s team began receiving NIH funding, and he soon reported the vaccine was causing rabbits to develop antibodies to HIV, which was considered a major breakthrough. Han said he initially accidentally mixed human blood with rabbit blood making the potential vaccine appear to increase an immune defense against HIV, the virus that can cause AIDS. Han continued to spike the results to avoid disappointing Cho, his mentor, after the scientific community became excited that the team could be on the verge of a vaccine.

Iowa State recruited Cho in 2009, and his team — including Han — continue the research with NIH funding. A group of researchers at Harvard University found in January 2013 the promising results had been achieved with rabbit blood spiked with human antibodies.

Han’s attorney Joseph Herrold, a federal public defender, asked for probation instead of prison.

“Here, there is little reason to believe that Dr. Han has not already been deterred from any future criminal conduct. His conduct is aberrational in an otherwise admirable life,” Herrold wrote in a sentencing report filed Monday. “He regrets the hurt he has caused to his friends and colleagues, the damage he has caused to government funded scientific research, and the pain he has caused any members of the public who had high hopes based on his falsehood.”

Herrold said Han has lost the ability to work in his field of choice and is likely to be deported by immigration officials “and possibly never permitted to return,” separating him from his wife and two adult children who are U.S. citizens. Han, who was born in Seoul, South Korea, is a lawful permanent U.S. resident.

Government prosecutors sought prison time to serve as a deterrent to Han and others who might consider research fraud.

“It is important that we stand up not just for punishing the fraud committed against the United States government, but for the research that should be legitimately taking place on this devastating disease,” U.S. Attorney Nicholas A. Klinefeldt said in a statement.

Judge James Gritzner sentenced Han to 57 months in prison and three years of supervision upon release. Han must repay the National Institutes of Health $7.2 million.

Cho’s team continues to work on the vaccine at ISU and has subsequently obtained funding.

TIME medicine

FDA Approves New Cystic Fibrosis Drug

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Gregory Bull—AP In this March 4, 2015 photo, research scientist Tony Huang works in a laboratory at Vertex Pharmaceuticals Inc. in San Diego.

It will cost more than $250,000 a year

(WASHINGTON)—Federal health officials have approved a new combination drug for the most common form of cystic fibrosis, the debilitating inherited disease that causes internal mucus buildup, lung infections and early death. But it will come at a steep price — more than $250,000 for a year’s treatment.

The Food and Drug Administration cleared the twice-a-day pill from Vertex Pharmaceuticals Inc. for a variation of cystic fibrosis that affects about 8,500 people in the U.S. who are 12 years and older. The approval notice was posted to the agency’s website Thursday.

The new drug — to be sold as Orkambi — is Vertex’s follow-up to its breakthrough pill Kalydeco, which became the first drug to treat the underlying cause of cystic fibrosis in 2012. Orkambi combines Kalydeco with a new drug ingredient, lumacaftor.

Kalydeco is only approved for a cluster of rare cystic fibrosis forms that affect about 2,000 patients who are 2 years old and up.

About 30,000 Americans live with cystic fibrosis, which is caused by variety of genetic mutations passed from parents to their children. The disease causes sticky mucus to buildup in the lungs and other organs, which leads to infections, digestive problems and eventually death.

Vertex said Orkambi will cost $259,000 per year. That’s less than the $311,000 annual price tag for Kalydeco.

Dr. Robert Giusti of New York University’s Langone Medical Center noted that half of all U.S. cystic fibrosis patients have the form targeted by Orkambi, which occurs when a child inherits two copies of a certain genetic mutation — one from each parent. He expects the FDA will eventually expand the drug’s approval to patients as young as 6, increasing the number of people who could benefit.

“This is really exciting because this is a disease that causes a 1 to 2 percent deterioration each year in lung function of patients,” said Giusti, who directs the center’s cystic fibrosis program. “Now they have a therapy available to potentially reverse that effect.”

In the 1950s, children with cystic fibrosis seldom survived long enough to complete elementary school. Due to improvements in care, the typical cystic fibrosis patient today can expect to survive into their early 40s, according to the Cystic Fibrosis Foundation.

Prior to the approval of Kalydeco, drugs used to treat cystic fibrosis focused on controlling symptoms — such as opening up lung airways and breaking up mucus. Kalydeco was the first drug to target the underlying genetic defect that causes the disease.

Expectations for Vertex’s new drug have been tempered by study results that, while statistically significant, were not as dramatic as those first reported with Kalydeco. In company trials, patients treated with Orkambi for six months reported a 2.5 to 3 percent improvement in lung function, a key measure for cystic fibrosis patients. That improvement met the FDA’s standards for effectiveness, but did not equal results seen with Kalydeco, which improved lung function by about 10 percent.

Company officials have pointed out the differences in the forms of the disease targeted by the two drugs. Kalydeco was developed for patients who have a problem with a protein on their cell walls, which doesn’t properly balance the flow of water and salt from the cell. Orkambi targets patients with two problems — the protein does not reach the cell wall and, once there, does not work properly.

Shares of Vertex rose $5.07, or 4 percent, to close at $131.26 in trading Thursday. Its shares are up almost 34 percent over the past year.

Vertex’s cystic fibrosis drugs grew out of a long-term partnership with the Cystic Fibrosis Foundation. Vertex Pharmaceuticals Incorporated received roughly $120 million in research and funding from the foundation, culminating in the 2012 approval of Kalydeco. The twice-a-day pill had sales of $464 million last year, according to the Cambridge, Massachusetts company.

Last November the Cystic Fibrosis Foundation sold its royalty rights to Kalydeco and Orkambi for $3.3 billion.

TIME Mental Health/Psychology

How Fireworks Can Trigger PTSD

Fireworks will be going off with a bang all weekend, but for some, they cause more anxiety than celebration

You may see the signs popping up around your neighborhood this July 4—red, white and blue notices that indicate the home of a vet with the request to “Please be courteous with fireworks.”

The signs are the work of a Facebook-launched nonprofit, Military With PTSD, begun by Shawn Gourley, whose husband, Justin, served in the Navy for four years and returned with post traumatic stress disorder (PTSD). Sudden and loud noises can trigger episodes of PTSD, bringing veterans back to traumatic experiences they have lived through during their service. According to the U.S. Department of Veteran Affairs, up to 20% of military personnel who served in Iraq or Afghanistan experience PTSD each year.

The signs are posted on the lawns of veterans’ homes to alert people to be more considerate when setting off fireworks in the area. According to Gourley, who spoke to CNN, the group has mailed 2,500 signs, some of which were paid for by donations and others by the vets themselves, while 3,000 people remain on a waiting list.

The signs are not meant to quash any Fourth of July celebrations, but to raise awareness that the explosive sounds, flashes of light and smell of powder may trigger unwelcome memories for some. “If you are a veteran, on the one hand July 4th should be one of the most patriotic holidays that you feel a part of,” says Dr. John Markowitz, professor of psychiatry at Columbia University. “On the other hand, the rockets’ red glare and the bombs bursting in air are likely to evoke traumatic memories, and you might want to hide. It’s a tricky one.”

Having advanced knowledge of a fireworks display can help some people with PTSD to better prepare and cope with any symptoms they may experience. “A big component of the startle response and PTSD is the unexpected,” says Rachel Tester, program director of the Law Enforcement, Active Duty, Emergency Responder (LEADER) Program at Harvard Medical School’s McLean Hospital. “When people are able to anticipate, they are able to put into place mechanisms they have to cope ahead of time.”

That might include things such as relaxation techniques or being able to see the fireworks show and therefore know that they’re coming, as well as having headphones, music or other distractions at the ready.

Such strategies may not work for every PTSD patient, but being more aware that the explosive celebrations of the holiday might affect those with PTSD is an important step toward ensuring that everyone can enjoy the holiday without fear, anxiety or pain.

TIME public health

First Person Dies of Measles in U.S. Since 2003

The death is the first in Washington since 1990

(SEATTLE) — Washington state health officials say measles caused the death of a woman from the northwest part of the state in the spring — the first measles death in the U.S. since 2003 and the first in Washington since 1990.

The measles infection was discovered during an autopsy.

Washington State Department of Health spokesman Donn Moyer says the woman was hospitalized in Clallam County for several health conditions before being moved to the University of Washington Medical Center in Seattle, where she died. He says officials are withholding her age to protect her identity, but she wasn’t elderly.

Officials didn’t say whether the woman was vaccinated, but they did note she had a compromised immune system.

Moyer says the woman likely was exposed to measles at the Clallam County medical facility. Clallam County had an outbreak of five cases this year.

TIME Research

90% of Americans Eat Too Much Salt

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A new report sheds light on Americans' sodium habits

Consuming too much sodium can be a risk factor for heart problems, and new federal data shows more than 90% of Americans eat too much.

The findings show that from 2011 to 2012, the average daily sodium intake among U.S. adults was 3,592 mg, which is well above the public health target set by the U.S. Department of Health and Human Services (HHS) of 2,300 mg. The data comes from the U.S. Centers for Disease Control and Prevention’s (CDC) 2013 survey of 180,000 American adults in 26 states, D.C. and Puerto Rico. The findings were published Thursday in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

Some Americans, however, are taking action to cut back, the report shows. About half of the U.S. adults surveyed said they were monitoring or reducing their sodium intake, and 20% said they had received medical advice to do so. People with high blood pressure were more likely to report they were doing something about their sodium consumption, and overall, people in Southern states were more likely to report such action or advice from medical providers.

Public health experts argue that people without high blood pressure could also benefit from cutting back. “Among adults without hypertension, most did not report taking action to reduce sodium intake, and an even smaller proportion reported receiving professional advice to reduced sodium,” the study authors write. “These findings suggest an opportunity for promoting strategies to reduce sodium consumption among all adults, with and without hypertension.”

Sodium intake recommendations have been the focus of controversy, with some researchers arguing that sodium levels are safe and that cutting back to very low recommended levels could be harmful. Others argue that high sodium consumption is related to serious health complications and contributes to millions of deaths every year. Some groups recommend limits that are even lower than the HHS; for instance, the American Heart Association recommends less than 1,500 mg a day.

In the new CDC report, researchers say that a high sodium habit doesn’t come cheap; medical costs for cardiovascular disease are predicted to triple from $273 billion to $818 billion between 2010 to 2030, and cutting back on sodium intake by 1,200 mg a day could save $18 billion in costs each year, they say.

TIME public health

Dermatologists Warn About the Dangers of Sunburn Art

Artistic sunburns are spreading through social media—and raise risk for melanoma, doctors say

Searching for a creative outlet? Some people are turning to sunburn art, the hottest bad idea for your health.

A few photos—but perhaps not enough to qualify as a trend—tagged #sunburnart have popped up on social media, showing people intricately burned by the sun with the help of a strategically placed pattern.

That awful sunburn actually turned out to be pretty badass but still hurts like a MF #sunburn #ouch #sunburnart

A photo posted by Brenden Eleen (@bbear430) on

Popularity of the practice is suspect, but it’s warranted enough media attention that Deborah S. Sarnoff, MD, the Skin Cancer Foundation’s senior vice president, released the organization’s official position on sunburn art today:

The Skin Cancer Foundation strongly advises the public to avoid sunburns at all costs. A sunburn is not only painful – it’s dangerous, and comes with consequences. Sunburns cause DNA damage to the skin, accelerate skin aging, and increase your lifetime skin cancer risk. In fact, sustaining five or more sunburns in youth increases lifetime melanoma risk by 80 percent. On average, a person’s risk for melanoma doubles if he or she has had more than five sunburns.

The Skin Cancer Foundation recommends adopting a complete sun protection regimen that includes seeking shade, covering up with clothing, including a broad-brimmed hat and UV blocking sunglasses, in addition to daily sunscreen use.

Neither dermatologist we talked to had seen sunburn art in the flesh—although people who intentionally burn themselves are probably not the most likely to book skincare appointments.

“I’ve definitely seen it advertised online, where they have little tracings and they just mark it out, the part that’s covered,” says Dr. Aurora Badia, a dermatologist at Florida Skin Center, who first learned about sunburn art years ago. “It definitely is not a good idea. Any time you get a sunburn, you’re at more risk for melanoma, but there’s no inherent difference between sunburn art and regular sunburn.”

MORE: This Is The Only Sunscreen Article You Need To Read

Dr. Melissa Piliang, a dermatologist at Cleveland Clinic, says she, too, has yet to see a patient with intentional sunburn art—but art, of course, is open for interpretation. “Certainly we see people who have what’s loosely termed a ‘farmer’s tan’, or when people apply their sunscreen and miss a spot,” she says. Other accidental sunburn artists include children who’ve forgotten to remove a sticker, a watch or a bracelet while playing in the sun, she says.

Sunburn art is treated the same way a normal sunburn is, both doctors agree, and it’s every bit as dangerous; sunburns, artistic or not, raise your risk for skin cancer.

“I’d encourage people to wear their sunscreen,” says Dr. Piliang. “Cover up, seek the shade, and really be safe in the sun over the Fourth of July weekend.”

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