I've always been very sporty and athletic. Twelve years ago after the birth of my youngest child (when I was 38), I had to have an abdominal hernia operation. The surgeon sewed the muscles one on top of the other (the Mayo system), and they were not held in by a mesh netting. Now my stomach sticks out terribly, as if I were pregnant. As I am not fat, it's very noticeable. If I wanted to get it fixed, do I have to undergo a repeat operation in which my abdomen is reopened? Is it even advisable? What about laparoscopy? L.B., Petah Tikva Dr. Yaakov Ulano, a veteran hernia surgeon at Laniado Medical Center in Netanya, comments: This sounds like a recurrent hernia, most probably umbilical. Since you are athletic and active, you should certainly have it repaired. Laparascopic repairs can be highly successful with early return to activity because of minimal post-surgical pain. So-called open repairs are also highly successful, usually incorporating a mesh, with somewhat longer post-operative discomfort. The decision whether to do the laparoscopic approach is the surgeon's, dependent on size of defect, other health conditions, the number and types of previous operations and the surgeon's experience. With summer here, I am always confused about what one needs in a protective sunscreen. How high a sun-protection factor (SPF) does one need? Must it protect only against UVB rays or also UVA? Are the latest sunscreens any different than the old-style ones? P.J., Herzliya Dr. Zoe Draelos, a veteran dermatologist from High Point, North Carolina, comments: Sunscreens have evolved over the years, and we now have a variety of formulations - from creams and gels to lotions and sprays - that more effectively protect the skin from the sun's harmful UVA and UVB rays. The SPF number on sunscreens largely reflects the product's ability to screen out UVB rays, the sun's shorter wavelength UV rays that are primarily linked to sunburn and skin cancer. In August 2007, the FDA proposed to categorize the SPF factor, from the lowest to highest protection, to help guide consumers with this selection. Importantly, the FDA also acknowledged that sunscreens should reflect their ability to provide protection from UVA rays, which are longer than UVBs and can pass through window glass and penetrate deeper into the skin. These rays are primarily linked to premature aging and wrinkling of the skin, but the latest scientific evidence indicates that they may also contribute to the development of skin cancer. Dermatologists are hopeful that the new SPF and UVA protection rating systems will be developed for sunscreens under the new regulations. It's important to note that an SPF of 50 doesn't offer twice the UV protection of an SPF of 25; however, a higher SPF can be beneficial for people with very fair complexions or in instances where a person is going on vacation to a very tropical or sun-intense climate. The American Academy of Dermatology recommends a minimum of SPF 15 regardless of skin type, and it should offer UVA protection as well; look for products that indicate "broad-spectrum" on the label or read the active ingredients listed on the back panel. While two of the main active inorganic filters in sunscreen - zinc oxide and titanium dioxide - are very effective in protecting the skin against UV radiation, their gritty consistency can leave a visible white film on the skin. Now, new grinding technologies can turn zinc oxide and titanium dioxide into extremely small particles that are more transparent on the surface of the skin. Active ingredients in sunscreen absorb or scatter UV radiation, but in doing so, the sunscreen breaks down and becomes less effective, essentially decreasing its SPF and level of UV protection. Today, there is photostabilized sunscreen, with a chemical added to the formulation to absorb more UV radiation - allowing the sunscreen molecule to remain unaltered and absorb or scatter UV rays for a longer period of time. Remember to generously apply water-resistant sunscreen with an SPF of at least 15 that provides broad-spectrum protection from both UVA and UVB rays to all exposed skin. Reapply every two hours, even on cloudy days, and after swimming or sweating. Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and residence.

Rx for Readers

How high a sun-protection factor does one need? Must it protect only against UVB rays or also UVA?