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OUR HEALTH: Beware of the Sun

Published On: Jun 17 2013 10:17:42 AM EDT   Updated On: Dec 09 2013 07:02:18 PM EST
Sarah Cox -

First thing:  Anyone can get skin cancer, and they get it from the UV, or ultraviolet rays of the sun as well as sun lamps and tanning booths. Light-skinned, fair-haired and light-eyed people do have a greater risk, but dark-skinned people get it as well. The National Cancer Institute estimates that 76,690 men and women (45,060 men and 31,630 women) will be diagnosed with and 9,480 men and women will die of melanoma of the skin, the most serious type of skin cancer, in 2013. More than 3.5 million cases of basal and squamous cell skin cancer are diagnosed in this country each year.

Cancers are caused by a combination of both environmental and genetic factors, but with skin cancer, environment makes the more significant impact.  So those with a history of skin cancer in their family should be extra diligent when preventing exposure to the sun. Did you know that about 10 percent of all patients with melanoma have family members that also have had the disease?

There are several types of skin cancers, according to the National Cancer Institute. All form in the tissues of the skin. Melanoma is cancer that forms in the melanocytes, or skin cells that make up our pigment. Basal cell carcinoma forms in the lower part of the epidermis, which is the outer layer of the skin. Squamous cell carcinoma forms in squamous cells, and neuroendocrine carcinoma is formed in the neuroendocrine cells.

While most skin cancers are detected after the age of 50, the damage begins far earlier, and that is why everyone should be aggressive in their prevention of exposure to the sun’s UV rays.
Some tips to protect one self are as follows:

•    Research your sunscreen. The SPF, or sun protection factor, of a sunscreen does not indicate how strong it is, but rather how long it will keep you protected. It is calculated by how many minutes it takes a person to burn, multiplied by the number that tells you how long it should last. So if you burn in 10 minutes, multiply that by SPF 30 and that will keep you protected for 300 minutes – theoretically. So, if you burn in 10 minutes of sun exposure without any protection, SPF 30 will keep you protected for 300 minutes (in theory!).

•    Apply one ounce generously to all exposed skin, and reapply often every few hours, or more often. It is suggested that one reapply every two hours, even on cloudy days, and after swimming or sweating, as sunburns significantly increase one's lifetime risk of developing skin cancer, especially for children.

•    Be careful about what is in your sunscreen. Some chemicals are allergens and potential hormone disruptors. Watch for a PABA-free, (one that has no para-aminobenzoic acid) brand. It can cause allergic reactions.

•    Additionally, avoid sunscreens that contain Vitamin A (retinyl palmitate), which the FDA has found may make your skin photocarcinogenic, or at greater risk of turning cancerous when exposed to sunlight.
•    And avoid sunscreens with added insect repellent. Choose a sunscreen because it protects you from the sun.
•    Wear protective clothing in addition to putting on sunscreen. Light layers of clothing are suggested, as light colors reflect heat. To remain comfortable in the heat, try wearing a tank top, and then a light camp shirt open over that. Natural fibers like cotton are coolest. However, be aware that an ordinary t-shirt is only the equivalent of SPF 5. An alternative is to buy clothing designed to block sun, even up to SPF 50.

•    Do not use tanning beds. The UV radiation from tanning beds and the sun causes skin cancer and wrinkling.

•    If your family has a history of cancer, moles, or is fair skinned and fair haired, be more diligent about sun protection.

•    Drink plenty of water, but if one is exercising vigorously, a sports drink can replace electrolytes. Don’t drink too much, and avoid sugary drinks and alcohol, which can dehydrate you.

•    Wear sunglasses. They will protect your eyes from UV rays, the tender skin around your eyes, and reduce the risk of cataracts. Look for those that block both UVA and UVB rays, and consider wrap-around sunglasses.

Jason Givan, MD, board-certified in dermatology, fellowship trained Mohs surgery, and cutaneous oncologist, is associated with Dermatology & Mohs Surgery Consultants. He says that people are just not as aware of the dangers of the sun as they should be, and while the knowledge is much greater than in the past, there are still dangerous misconceptions.

“The biggest is that people have a sense of security in feeling that they are protected when it’s not warm and bright and sunny outside, when in fact some of the most damaging rays come through year round, despite the weather. Another misconception is that a tan is healthy or it’s a sign of health, when in fact a suntan is the skin’s reaction to previous sun damage, and the suntan is the skin’s way of developing a defense to protect against future damage,” he explains.

Melanoma can develop at any age, and in fact very young children can develop it, according to Dr. Givan, but it’s rare. As one ages and increases their lifetime sun exposure, the risks go up. One of the most significant risk factors for melanoma is severe sun damage and sunburns as a young age, and in particular the amount of high intensity, acute sun exposure one gets.

“Blistering sun burns before age 18, with an increasing number of those kinds of sun burns, increases your risk of melanoma,” he says.

Another myth is that dark-skinned races can’t get skin cancer, when in fact anyone can. African Americans do get melanoma and are most likely to get acral lentiginous (a melanoma that develops on hands and feet, typically under fingernails or toe nails). While dark-skinned patients don’t just get this type of melanoma, they are less likely to get other types. But all types can be fatal.

Yes, says Dr. Givan, a diagnosis of melanoma is very upsetting, but if detected early it can be treated. To do so, he suggests regular self-examinations to be aware of what’s normal about your skin. That way, you can detect what is abnormal, if a mile is new, changing or growing. The acral lentiginous type of melanoma appears in an unusual place, so it is often left undetected.

Another factor is genetics. Having a first degree relative (the closer the relative, the higher the risk, so first degree is a patient’s parents, siblings or children) puts one at risk for melanoma, just by virtue of being closely related. Beyond the genetic factor, Dr. Given says to protect yourself with wide-brimmed hats, UV protective clothing, sunscreen worn daily, and do outdoor activities more in morning and evening. He recommends at least SPF 30 for sunscreen, and make sure the sunscreen is broad spectrum or UVA/UVB coverage. Even infants should be wearing sunscreen, and one can look for sunscreens that are not chemical based and not irritating to skin.