Insurance Changes and Lisa Peters is Moving Away

Lisa Peters FNP Leaving in June 2021

One of my two nurse practitioners, Lisa Peters, has decided it is time to move on. She is moving to Idaho to be closer to her mother. We are sad to see her go. Jamie Barbara FNP is still here and available to see patients.

I have 3 RNs available for cosmetic procedures: Leslee, Careline and Allie. Leslee has worked with me for 19 years, and is a wife and mother as well. Careline joined us in October, works part-time and is going to OHSU's Nurse Practitioner program. Allie is our most recent addition, and is being trained in Botox and fillers currently by yours truly. In addition, my assistant Erin is working on her RN degree, as is Michelle. Fawn loves doing the Hydrafacials.

Regarding Insurance Companies
The last few years the insurance companies have escalated their efforts to put obstacles between you the patient and the prescriptions and treatments you need. The overhead of running my business is too high. Five of my employees spend the majority of their time working on prior authorizations (PAs) for medications, PAs for procedures, benefits check, checking the notes to make sure enough documentation is present, sending out claims, receiving denials, and appealing claims. Often the work is futile, it is always frustrating, and I can't stand it anymore. I have to say, "STOP!" the only way I know how...which is by breaking up with them.

The patient may be in the exam room for 10 minutes, but after they leave it takes about 20-25 minutes to write the chart note. They are now three full typed pages long! Still the insurance company denies claims saying it lacks the "appropriate" documentation. They actually want us to measure the size of acne lesions now. My MAs/RNs spend hours trying to get prescriptions covered. They might spend 1-2 hours so you can save $10 on a tube of cream. It takes many more hours to get a biologic approved. I am not willing to do it anymore, because it is not a logical way to run a business.

Beginning October 1, 2021 we will no longer be participating with Medicare, MODA, Aetna, Cigna and UHC insurances as well as several others. This includes any Medicare with a supplemental plan type of insurance. We will not be billing them for visits, nor will we deal with their PAs. All patients with those insurance plans will still be welcome in the office, but on a self-pay basis.

We will continue to participate only with Blue Cross, Pacific Source, and Providence for now. Jamie Barbara FNP and I (Dr. Klein) will both be available for medical and cosmetic visits.

It makes me sad because I know this is goodbye to many of the medical patients I have cared for over the last 24 years. On the other hand, this should come as great news for those of you who want me to do your Sculptra or Voluma and cosmetic consultations. I know what works, come talk to me.

Please contact us if you wish to transfer your chart to another office or have a copy for yourself. There is a medical release form on our website, we just need that signed, and we will either fax or copy your chart one time at no charge.

Most importantly, please do not yell or be mean to my receptionists, this isn't their fault. If you are angry and want to vent, call your insurance company. There needs to be a reform for health insurance companies.


June - all non Rx skin products (Epionce!!) 10% off
July - Botox treatments with a NP or RN are $40 off

Celebrate life and treat yourself well,

Marla M. Klein, M.D.

Call or text to schedule an appointment at 503-445-2200

©2021 Klein Dermatology & Associates - Marla Klein MD | 5200 Meadows Rd. Ste 250, Lake Oswego OR 97035


After the challenges that came with 2020, we wish you all a prosperous and healthy 2021!
Things are starting to look brighter as more people get vaccinated and start to come out of their homes again. Thank goodness for babies and dogs that brighten our days.

We  are...
- open and want to see patients.
- vaccinated or partially vaccinated at this point.
- doing procedures like fillers, microneedling and IPL again.
- sanitizing thoroughly with Clorox products, since I am allergic to Lysol.
- wearing masks and concerned about keeping you safe.
- hoping you will come in and see us.

Melanoma and skin cancer are still a major health problem, and the sooner caught the better off the person is.

Please call us at 503-445-2200 to schedule an appointment.

TEXTING - if you just want to send us a message quickly, you can text a message using that same number 503-445-2200. We have friendly smiling receptionists waiting for your call or text. No automated phone trees here.

Botox Bonanza Days

Has 2020 given you a frownie face? Let us fix that for you!

Botox Bonanza means getting your Botox treatments at $11/unit instead of $14/unit with a minimum of 20 units. You can combine with your Alle account. Leslee has appointments available on Feb 12 and on March 26th all 3 are available: Leslee, Careline and Jamie.

The price on fillers and Sculptra will be going up $50-$100 on July 1, 2021. If you are thinking it is about time to get your face done, you may want to get in and see me, Dr. Klein, soon.

Facial procedure expertise is something I am nationally known for, I've been doing them since the days of collagen injections in the 1990's.

February Specials $50 OFF Hydrafacial and 25% off CoolSculpting for 2 treatments.

March Specials - 25% off CoolSculpting for 2 treatments, $50 Off microneedling including the face or any area, and 10% off hair removal laser treatments. Voluma is 3 syringes for $2100.

Please be kind and patient with each other,
Marla M. Klein, MD

My favorite dog - still William the Corgi

My favorite app: Premium Motivation
My favorite procedures: Sculptra and Voluma
The thing I miss the most: people's smiles
Most proud of: my two sons
My favorite skin care product: Epionce Intense Defense Serum

Sign seen recently in Beaverton:

A woman cannot live by chocolate alone,

she also needs a dog.

We are Open Again

We are open again, as the first phase of businesses reopening after the COVID-19 crisis.

I am happy to announce that KDA is open again and ready to meet your dermatology needs. I have been concerned about being temporarily closed and not being able to do our routine screening for melanoma and non-melanoma skin cancers. We diagnosed nine (9) melanomas in January and February. Since closed mid March, we have not diagnosed a single one. If you haven't been seen in over a year, and you are ready to leave your home, please call us at 503-445-2200 to schedule your appointment. It is vital to catch melanomas and treat them while they are still in an early phase.

Regarding COVID-19, this is what we are doing:

* Every employee is wearing a mask when with patients.
* We have fewer patients than normal in office (<50%).
* We are spacing employees 6 feet or more apart from each other.
* We have fewer employees than normal at work.
* No one is allowed to come to work if they or anyone at their home has been sick in the last 2 weeks.
* We wash our hands with soap and hot water frequently.
* The assistants are disinfecting the rooms and doorknobs in between every patient.
* We are offering TELEHEALTH appointments with our nurse practitioner Jamie Barbara whenever possible. (Full skin exams require a live visit with either Lisa Peters NP or Marla Klein MD)
* Any immune-compromised employee is staying home.
* We are postponing the following types of appointments: Hydrafacials, microdermabrasion, microneedling, IPL, chemical peels and lip fillers.

Here is what we are asking of patients:
* Come alone to appointments if you are over 18 years old.
* Wear a mask.
* When you arrive for your appointment, call from the parking lot before entering building. We are trying to avoid having more than one person in the waiting room at a time.
* Wash your hands frequently.
* Remember to do your best not to touch your nose, eyes, or mouth.
* In addition to a mask, when you cough or sneeze, use your elbow.

Please reschedule your appointment:
* if anyone in your home has been sick in the last 2 weeks
* if you have had a fever, cough, or shortness of breath in the last 2 weeks
* if you or anyone in your family has been diagnosed with COVID-19 in the last 3 weeks.

Regarding our hours: 

We are open Monday - Friday. Our hours right now are a mystery to me. We will start every business day out as normal, ready to see patients. If there aren't many patients we will go home early that day. For the next week or so our hours will be 8:00 am - 4:00 pm. We would like to see our hours go back to normal which were 8 am -5 pm. We will adapt, and we will be here for you. If you see a treatment you want, and don't see it mentioned above, please call us.

If you know someone who isn't on our newsletter list, please forward this to them.

Good job everyone at staying home and keeping Oregon safe,
Marla Klein, MD

True story:   I used to tell my two sons that staying inside and playing video games the entire day was simply not healthy. They have now proven me wrong.

© 2020 Klein Dermatology & Associates - Marla Klein MD | 5200 Meadows Rd. Ste 250, Lake Oswego OR 97035

Summer 2019 Klein Dermatology Newsletter

Summer 2019 Newsletter

Sunscreen Controversy
Recently more patients have been bringing up the topic of, "Is sunscreen safe?" The answer is, "YES! Safe and strongly recommended!"

But why are they asking now? In the USA, sunscreens are classified as an over-the-counter drug, and thus regulated by the FDA. Recently, the FDA asked the sunscreen manufacturer's to give them more data on some chemical sunscreens, but the FDA still recommends that people apply sunscreen. Some media have a strange way of twisting the facts to sensationalize their stories.

No controversy exists around the zinc oxide and titanium dioxide sunscreens, also referred to as barrier or mineral sunscreens. They are "GRASE" meaning generally regarded as safe and effective. In addition, places with coral reefs approve of the zinc and titanium sunscreens, in that they won't harm the reefs.

The controversy is over the chemical sunscreens: oxybenzone, avobenzone, ocisalate, octocrylene, homosalate and octinoxate. What is the controversy? The FDA just wants more data on these chemicals. No one has said that they aren't safe and to stop using them. So what if they can be found in your blood? I'd rather have sunscreen in my blood than melanoma cells in my blood.

Please, to reduce skin cancer and aging skin, please seek shade, wear a hat and apply sunscreen on a regular basis. Oregon and Washington are among the top five states in the country regarding number of skin cancers diagnosed and treated.

Coming Soon
We will soon be able to accept payments for medical visits via our website portal. It is being set up now. Details will be in our next newsletter.

Special Offers
August 22, 2019 - Botox Bonanza Day ($10/unit with Alicia or Jamie)
September 19, 2019 - Cool Event - get 15% off & maybe win a prize
October - Sculptra is 15% off with Dr. Klein, scheduling now and Botox is $40 off (with a 20U minimum with Alicia or Jamie)

Effective Treatment for Cold Sores
Cold sores, also called fever blisters, are a common viral infection caused by the herpes virus (HSV). For those of you that haven't heard, there is a very effective Rx pill for people who have this problem called Valtrex, sometimes referred to as the blue horse pill. Summertime is a common time for these to flare, triggered by the sun. Cold sores are also triggered by stress. At the first sign of tingling/itching called the prodrome phase, if one takes the Valtrex, the blisters might not even surface. Only four pills need be taken for the entire treatment. There are all sorts of over the counter treatments, but Valtrex works the best and is completely safe. If you have been in the office in the last 12 months, just give us a call and we can send a Rx to the pharmacy for you. If you haven't been seen in the office this year, call to make an appointment. Don't let these outbreaks bring down your summertime enjoyment.

General Skin Care Tips Link

Protect your skin,

Marla M. Klein, M.D.

Klein Dermatology & Associates


© 2019 Klein Dermatology & Associates - Marla Klein MD | 5200 Meadows Rd. Ste 250, Lake Oswego OR 97035

Klein Dermatology - April 2018 Newsletter

April 2018 header

What is New at Klein Dermatology & Associates? Babies!

Our latest wonderful news is that nurse Leslee has had her 2nd daughter, Allison Marie, and is now back to work and helping us out. She does a lot of behind the scenes work in relation to prior authorization letters and requests, billing, administrative work, CoolSculpting, and helping with medical dermatology patients.

Allison Marie

Born 02/05/18 @ 3:07 pm
7 lbs. 10 0z. and 20 inches long

Ashley, who is a receptionist and an M.A. at our office had her little boy Thorin James, just a couple weeks ago. Normally you might see her super friendly face at the front desk helping patients, but we expect she will be out a few more weeks with her little one. We are happy to report that both babies are healthy and doing well.

Thorin James

Born: 3/14/18 at 3:28 am
8 lbs. 3 oz. 20.5 inches long


We are Now Ready to "Dual Sculpt!"

Our new CoolSculpting Suite is now open. It is located on the lower level of our building. It is a luxurious space we have added for the greater comfort of our patients and staff. It has a VIP parking space next to the back entrance which is close to the suite.

We have 2 CoolSculpting machines now and the next Cool Event is on April 5th.

We will be hosting a Mother's Day Special for the month of May for CoolScupting. 10% off each and the ability to sit and visit together while you both get your treatments done. There is also a TV and Echo/Alexa music for people who prefer to be alone for treatments.

Call us at 503-445-2200


Do you want pretty feet for summer?

The best way to soften feet with lots of callouses and thick skin is to use a Urea cream. This 40% strength has been Rx for as long as I can remember, and now you can get it over the counter without a prescription for only about $10 at some drugstores. The method is to apply cream at night to heels and rough areas before bed, put on socks. In the morning shower, or soak feet in water, then use a good tool to pumice off all that dead skin that the cream softened up. If you have ugly toenails, then you could get started right away on something to treat fungus like Lamisil pills or a topical such as Jublia or Lamisil.

SPF Clothing

The easiest way to protect you and your loved one's skin is to use special clothing with added sun protection. You can find these type of clothes at many places, for example Land's End, Athleta, Coolibar and Patagonia. Regular shirts don't do an adequate job of protecting the skin, because they only filter at a level of about 5. Try getting SPF 50 or SPF 100 clothing for better protection to prevent skin cancer! Get your skin checked once a year to screen for melanoma and other skin cancers.

MAY SPECIAL: 15% OFF Sculptra

JUNE SPECIAL: 10% off all nonRx Skin Care Products

Reminder - all of our non-prescription skin care products are 10% off for the month of June. June is a great time to stock up on your favorite SkinMedica, Epionce and EltaMD products. SkinMedica products are part of Allergan/Brilliant Distinctions.

Take Great Care of Your Skin,
Marla M. Klein, M.D.

CoolSculpting Exceeds Expectations!

CoolSculpting Logo


CoolSculpting is a non-surgical, non-invasive way to permanently remove pockets of fat using a machine to freeze the targeted fat and destroy it permanently.  After attending a dermatology conference in February 2017, where I listened to Dr. Suzanne Kilmer's presentation on the various body contouring devices that are now available, I decided to find out more about CoolSculpting®.

I had been somewhat aware of CoolSculpting prior to this meeting, but I was also jaded and disappointed from my history of buying other devices in the past.   They either failed to do what they promised or worked great but the patients weren't interested in spending the money to replace the cost of the machine.  Therefore, I really had no intention of buying anymore lasers/machines.

However, having known Dr. Kilmer for years, I strongly respect her opinions and admire her contributions to dermatology.   At this meeting, she discussed CoolSculpting with great enthusiasm.  When I realized that she had worked on creating CoolSculpting  with the genius scientist dermatologist Dr. Rox Anderson - - that was enough for me, I knew I had to get one.

In March, we received our CoolSculpting machine and training and we have been using it non-stop since.  There is no problem finding staff or patients who want to remove a pocket of fat here or there on their bodies.   I'm grateful for that.   Now that it is August we have only had the machine five months, and we are ecstatic about the results we are seeing in our staff and patients!


 CoolSculpting® is an Alternative to Liposuction

Years ago I performed tumescent liposuction.  It was gratifying to see the results, but it was hard work, and it took a great toll on my shoulder and elbow.   Liposuction is invasive and has its risks, plus the patients need to be mildly sedated and need time off of work.  There is also the messy drainage and garments.

Comparing CoolSculpting to liposuction is a simple "no-brainer".    CoolSculpting® is very safe.  It involves no drugs, no needles, no surgeon, no downtime and gets great results - CoolSculpting is absolutely amazing!

CoolSculpting was approved in 2009, and it has been tweaked several times since.  I have heard it was quite painful with the older parallel plate model they had.  The skin had to be pulled out and held between parallel cooling plates for an entire hour.  (Picture a mammogram in your mind, for an hour, super cold.)  Since then, they have changed the applicators to be more like a goggle-sized applicator cup with a little bit of suction, and it isn't painful at all.  Also, it is faster, each cycle with an applicator takes approximately 35 minutes.  The mini and the outer thigh applicators take longer.


It Works Efficiently

I expected it to work, based on my research and what Dr. Kilmer had shown at the meeting, but I still didn't expect it to work quite this well.   The roll around my waist was gone after one session (lost more than 2 inches!)  so I can understand why they say this can get addicting.  We are making double chins disappear, cinching waists and flattening abdomens.   A major breakthrough is how well it treats "bra fat" (those annoying rolls on the back) and "bat wings" on the arms!   Oh yes, we are very happy with what we are seeing in our follow-ups.    Although the machine's indication is for fat reduction (but not weight loss) we are seeing a great deal of skin tightening happening as a bonus, even on our patients in their 70's!  That is something liposuction did not do.

Besides doing the initial training and become a "Certified" CoolSculpting center, Jamie, Tasha and I also recently went to the CoolSculpting University for advanced training.  I think the tips they gave have been very helpful and have improved our results as well.  Our nurse Leslee will be going soon.

Consultations are free and necessary before scheduling a treatment session.  They can be scheduled with Tasha Gouin ANP or Jamie Barbara ANP (both are nurse practitioners) by calling 503-445-2200.  A treatment plan needs to be devised.  One or two sessions typically are needed per area.


Cool Events

We will be offering some "Cool Events" in the near future so that patients can learn more about CoolSculpting.   Cool Events are designed to be an educational event, where the patient can get transformation consultations and event-only pricing (15% off discounts).   Our Cool Events will be posted on our Facebook page.   We can only have about 15 patients do this per event, so  invitations and RSVP's will be required.  (We order food too.)  If you are interested in attending a CoolEvent, please call the office and let one of the receptionists know.

I look forward to seeing you soon,

Marla Klein, MD,  Klein Dermatology & Associates , 5200 Meadows Rd. Ste 250, Lake Oswego OR 97035

CoolSculpting at Klein Dermatology & Associates         

Klein Dermatology - April 2017 Newsletter

  Klein Dermatology & Associates - the place for all your skin care needs


Call for an appointment 503-445-2200, phones are open M-F 8-12:30 and 1:30- 5 pm

1. BOTOX $40 OFF  (20 unit minimum) this is a treatment to treat wrinkles between the brows and by the Crow's feet (and so much more). This special price is only applicable when scheduled with Alicia, Jamie or Tasha. You may also add on Brilliant Distinctions coupons.
2. Volbella $50 OFF  This is the latest HA filler by Allergan, thin, lasts 1 year, and especially well suited to lips and perioral lines and smoothing out the lips without making them big. Being referred to as the internal lip gloss in my medical meeting. Schedule with Dr. Klein or Alicia.
3. Hair Removal Laser 20% OFF typically requires 3-4 treatments scheduled 6-8 weeks apart. Please schedule with Tasha or Jamie.  Imagine having smooth underarms, bikini and legs that you never have to spend time shaving anymore.  It is a huge time-saver!

BOTOX BONANZA DAY is April 27th. BOTOX is only $10/unit that one day and can only be scheduled with Tasha, Jamie, or Alicia. It does not combine with the $40 OFF special.   Schedule now if you want to be included in this amazing special.



Elta MD UV Clear is my absolute favorite sunscreen for the face.  It is zinc based, meaning it is not a chemical sunscreen, and therefore good for sensitive skin.  It is micronized and it doesn't block pores.  It doesn't make acne worse or cause milia for most patients.  In the summer, remember to protect your skin with a hat, shade, sunscreen and SPF clothing.  Re apply sunscreen every 3-4 hours if you are outside.  We sell this at the front desk.  $28 a can.

Open for appointments Monday - Friday from 7:30 am - 5:30 pm
Hair Removal laser appointments are typically scheduled towards end of day.

Tanned skin (whether by sun or self-tanner) cannot be treated with the hair removal laser. This laser works best on dark hair and fair skin, particularly the armpits, bikini region and lower legs.

Marla M. Klein, M.D.

Klein Dermatology & Associates     5200 Meadows Rd. Ste 250     Lake Oswego OR 97035   Phone 503.445.2200




Things To Do Lake Oswego

Besides being an expert in skin care ... now as the business owner I am leanring better ways to display my work.  If you haven't checked out the KDA website for awhile, the latest addition to the Klein Dermatology & Associates website is a section called "BEFORE & AFTER".   This shows the natural type of work we do here.   We are not extremists by any means, and I can't stand it when I see celebrities with those weird up front giant cheeks that make their eyes look weird when they smile.  Patients must consent to this before anything can be shown, so each of the patients has given their full consent.  In the world of aesthetic dermatology, being able to show one's work is important because it is artistry, and the result is going to be different with Botox and fillers depending on who is performing the procedure.

I'm learning to make videos too.  I've bought some different cameras and software... but so far I can tell you that the very EASIEST way is to use the phone version of QUIK, and it is FREE!  I can show you the first video I've ever made.


I hope you all had a wonderful Thanksgiving,

Marla Klein M.D.


Just Returned from Italy - September 26, 2016

The view in Vernazza  photo-sep-13-6-24-56-am   , Manarola,  manarola-harbor  Camogli,  photo-sep-18-10-24-24-am  Siena,   photo-sep-21-2-29-38-am  & Tuscany photo-sep-20-9-16-28-am

Many of you who know me, know that I don't take a lot of vacation.  However, over the last few years I have been fortunate enough to be able to take one "big trip" per year, and it gives me something to really look forward to.  This year I went to Italy, the Cinque Terra and Tuscany region to explore.  September is a nice time to go, there aren't as many tourists so it isn't as crowded.  I think no matter what time of year you go to Italy, the food is fabulous.  I ate too much, gained some weight, but it was fun.

photo-sep-21-4-09-36-am     photo-sep-18-4-14-07-am     photo-sep-16-11-11-36-pm     photo-sep-15-8-49-43-am      photo-sep-18-10-50-48-am   photo-sep-18-4-12-22-am  that's a cheese wheel he is preparing a pasta dish inside!


and of course GELATO!

photo-sep-14-1-57-17-am      photo-sep-21-2-14-58-am   when I retire (in about 12 years from now I hope) my desire is to have a gelateria!


I'm back to work now, all refreshed, but have to pick a new place to look forward to visiting.  It was my first experience with AirBnB and everything went quite well.


Yours truly,

Marla Klein MD


Skin Cancer - Myths and Facts

Young woman who forgot the sun tan lotion

What is fact and what is myth of the 9 following statements?

  1. I only need to get checked for skin cancer if I see something weird on myself.    False. While it is true that self-examination is important, but anyone with a personal or family history of skin cancer should be seen by a dermatologist for a full skin exam at least once a year.
  2. You can't get skin cancer on a part of the body that doesn't ever see the sun.  False.  While it is true that basal cell carcinoma and squamous cell carcinoma occur in areas that received sun exposure, melanoma (the life-threatening skin cancer) can occur anywhere on the body.  It is very hard to see one's own scalp, back and buttocks to see if anything new is there, so get checked.
  3. Dark skinned people aren't at risk for skin cancer.  False.  My favorite example here is Bob Marley.  Bob Marley died because of a melanoma on his foot.  In fact skin cancer can be deadlier in dark skin people because it is often detected at a later stage.
  4. People who freckle are more susceptible to skin cancer.  True.  Freckles are a sign of previous sun exposure, and they are an indication of sun damage.  Freckles are more common in fair-skinned people, who have an increased risk of skin cancer.
  5. The SPF in my foundation is enough protection.  True and false.  For everyday exposure in Portland Oregon in the winter, makeup with sunscreen (15 or higher) can provide adequate protection.  However, your makeup should not  be used as a substitute for sunscreen if you are going to be spending extended time outdoors.  For those times, look for a  broad spectrum sunscreen over 30.  You know you are doing a good job if you get absolutely ZERO TAN.  Browning of the skin is a sign of sun damage.  There is no "good" tan, not even a so-called base tan is good for you.  Our favorite sunscreen at Klein Dermatology & Associates is the EltaMD brand that contains zinc.  The EltaMD UV Clear is specially designed for acne and rosacea skin types.
  6. Skin cancer looks like a weird mole.  True and False.  While melanoma skin cancer sometimes looks like a weird mole (and not all weird looking moles are necessarily cancer), the most common types of skin cancer (basal cell carcinoma and squamous cell carcinoma) can appear as a pink bump or patch or sore or pimple that won't heal.  The key is to seek a dermatologist's opinion as soon as you see anything on your body that looks new or suspicious.
  7. I need to get my Vitamin D, so I expose my skin to as much sun as I can.  Bad idea.  It's best to obtain vitamin D through diet and vitamin supplements.  The harmful effects of sun exposure far outweigh any vitamin D benefits.   With the new Vitamin D serum levels advised you can't get enough through the sun alone.  Dermatologists did a study and found that young Hawaiian surfers out in the sun all day unprotected still didn't manufacture enough vitamin D in their blood to meet the current recommended levels.
  8. People who burn easily are more susceptible to skin cancer.  True.  Fair-skinned people who burn easily are very susceptible to skin damage, skin cancer, and early aging of the skin.  Sun exposure increases a persons risk of all three of the most common skin cancers: basal cell carcinoma, squamous cell carcinoma, and melanoma.
  9. Putting your sunscreen on as soon as you arrive at the beach or golf course is best.  True and False.  You must know what the active ingredient is in your sunscreen to know when you should be applying it.   The mineral sunscreens also known as barrier sunscreens that contain zinc (like EltaMD) or titanium start blocking UV rays as soon as you apply it to your skin.  The chemical sunscreens like oxybenzone, avobenzone, octisalate and octinoxate require a reaction to take place with your skin cells which takes approximately 30 minutes before they start working.  So if you are a redhead, and wait until you are on the beach on a sunny day to apply your the time your sunscreen begins working you would already be burned.  People generally can do a better job of applying their sunscreen before they get dressed, while still indoors.  Too often people don't get close enough to the places the clothing starts and stops and those strips of skin will burn.  Remember no matter what the SPF is (30 or higher is preferred) it will still only last 3-4 hours.  Re-applying sunscreen when you are out all day is very important.  Using clothing with SPF in it, makes this job easier.  Be safe in the sun, and if you are golfing remember to re-apply between the 9th and 10th holes.