Skin Care
Dear Doc,
I love the sun and I spend every possible moment outside during the summer months. My problem is that every summer, I get sunburned. I try to remember to use sunblock but even when I do remember, it seems like I still end up with a sunburn. What is the risk of all these sunburns and what can I do to prevent them without giving up my outdoor lifestyle?
Answer:
Our summers in Upstate New York are so short, that we can easily forget about the dangers of the sun. According to the Skin Cancer Foundation, 42% of people report getting at least one sunburn a year. Also, single blistering sunburn during childhood actually doubles that person’s risk of melanoma. Five or more sunburns in a person’s lifetime also doubles the risk of melanoma. Severe blistering sunburns appear to be linked to melanomas while other less aggressive skin cancers such as basal cell carcinoma and squamous cell carcinoma are associated with repeated chronic sun exposure over many years.
Prevention of sunburns is the key to reducing the risk of future skin cancer. The best way to do this is the actually avoid the sun between the hours of 10 AM to 4 PM, when the sun is most intense. It sounds like this is not a real option for you. Clothing can be an important way to protect you from the sun. Some clothing items have an Ultraviolet Protective Factor (UPF) rating. UPF categories range from 15-50 with 50 being the best protection. In general, tightly woven, dark colored, less stretchy clothing will have the highest rating. Some fabrics are also treated with UV absorbing chemicals. Many retail outlets, particularly stores selling outdoor sporting clothes, sell clothing with the UPF on the label. Wearing long sleeves, pants and a hat are the best way to protect your skin while outside. Unfortunately the heat and humidity sometimes make that unrealistic.
Sunscreen can be an effective way to prevent sunburns but there are some key things to remember about its use. First, sunscreens are rated by their Sun Protection Factor or SPF. The higher the SPF, the higher the level of protection. People with light skin should use a sunscreen with an SPF of 30 or higher when outdoors. It is recommended that they use lotions with an SPF of 15 or higher for daily use. This is frequently found in cosmetic lotions. Second, sunscreen should be applied 15 to 30 minutes before going outside. It should be applied liberally; the average adult should need about 2 tablespoons of sunscreen per application. Lastly, sunscreen should be reapplied every two hours. All sunscreen, even those labeled water resistant, need to be reapplied after swimming or sweating.
A common myth is that using a tanning bed ahead of going on vacation will prevent a sunburn. The use of a tanning bed does change the skin color but it does not increase the melanin in the skin and does not protect the skin against future sun exposure. In fact, the use of tanning beds has been linked to an increase in the risk of melanoma by 74%.
For infants, the American Academy of Pediatrics recommends avoiding sun exposure during those high intensity times (10 AM to 4 PM). If the child is outside, protective clothing, including a hat, is the best option. Sunscreen can be used in any remaining small areas of the skin that are exposed.
I asked Dr. Brett Shulman, a dermatologist with Rochester Regional Health, who is most at risk of skin cancer and how can it be detected? His response, “Fair skinned people, especially those with red or blonde hair, are at increased risk to develop skin cancer. This is because these individuals produce a pigment in their skin that is less likely to protect them from skin cell damage. People who work or play outdoors such as farmers and construction workers, athletes, and frequent sunbathers are at increased risk to develop skin cancer. The early detection and treatment of skin cancer, especially melanoma, can be accomplished with self-examination of the skin. Monthly skin self-examination may reduce melanoma’s death rate by over sixty percent. Both men and women need to set a fixed time each month to examine their skin looking for new or changing growths. This allows them to develop a visual map to use for monthly comparisons. Early detection has been the single most significant factor in reducing the total number of melanoma deaths in the past two decades.”
According to the American Cancer Society, in the U.S., more than 135,000 new cases of melanoma are diagnosed each year and approximately 3.5 million non-melanoma skin cancers are treated annually. Ultimately, everyone is at risk of skin cancer and it is important that we minimize that risk by protecting our skin. It is also our responsibility to protect the skin of our children and to teach them about proper skin protection. Lastly, it is important to examine your own skin on a routine basis and see your doctor if you notice any new lesions.
While the sun can pose a threat to our skin, it is important to get outside and be active. So, please put on your UPF clothing, a wide brimmed hat, sunscreen and ENJOY!
Tara Gellasch, MD, is the Associate Chief of Obstetrics and Gynecology at Newark-Wayne Community Hospital (NWCH) and sees patients at The Women’s Center at NWCH, a Rochester General Medical Group practice. Dr. Gellasch earned her Medical Doctorate from McGill University in Montreal, Quebec and completed her residency in Obstetrics and Gynecology at Emory University. This column is meant to be educational and not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider.
