New Englanders tend to spend as much time out in the sun as possible while it’s warm—often in the middle of the day to avoid mosquitos. Unfortunately, many ignore the general wisdom and medical recommendations about sun protection. Some even wear their tans like a badge of honor (you know who you are).
Ultra Violet (UV) radiation from the sun accounts for most skin cancers, with melanoma killing about 20 people each day in the US. Melanoma is the second most common form of cancer in females age 15-29, with a dramatic increase in recent years. Men over 65 develop twice as many incidences as women their age, partly due to lack of sun protection.
Sometimes we try to rationalize not using sunscreen and a hat or broad-spectrum sunglasses when we head outside, but the following are either misconceptions or myths:
“I want to have a base tan so I don’t burn”
Base tans do almost nothing to protect your skin, providing only about SPF 2. That means if you burn within 10 minutes with no previous sun exposure, a tan would theoretically only give you another 10 minutes. In fact, a 2013 study showed those who got a base tan before spring break actually burned more frequently. But burns are not the only issue; your tan itself is evidence of skin and cellular DNA damage.
A tan forms when your cells produce melanin to protect their DNA from damage by the sun’s radiation. These UVB and UVA rays prevent your cellular DNA from copying correctly when the cells multiply. A single day’s sun exposure could cause up to a million DNA defects in each skin cell, which can then cause cancer.
“I look healthier and prettier with a tan”
Fashion has favored the “a touch of sun” look for almost a century. However, up to 80 percent of visible aging is not caused by age, lack of sleep, or stress, but by exposure to the sun’s rays. Non-burn exposure to UVA radiation causes damage to your skin’s structure as well as DNA. This results in photoaging—wrinkled, leathery skin, dark spots, and white blotches.
If you can’t give up your golden glow there are many self-tanners on the market that use DHA (dihydroxyacetone), a compound that reacts with the amino acids on your skin to darken it. DHA is considered safe, even by stricter EU standards. The caveat is that it can be unhealthy to inhale or ingest it, so stick with lotions rather than sprays and wash your hands well after each application.
“I put SPF 15 lotion on this morning, I’ll be fine”
How much did you put on, and how long ago? Most Americans do not apply enough sunblock to provide the SPF on the label. SPF is calculated using almost a quarter of an 8-oz bottle of sunblock for someone wearing a swimsuit, a shot glass full if you’re wearing a t-shirt and shorts, or a full 1/4 teaspoon for just your face. Either put on the recommended amount or choose a stronger SPF.
The Centers for Disease Control (CDC) also recommends reapplying sunscreen every two hours and immediately after sweating or swimming. If you can, undress and apply it under your clothes so you don’t miss crucial areas while avoiding your clothes.
“It’s a cloudy day so I won’t burn”
If it’s near noon you could still burn on a cloudy day, but once again, burning is not the issue. The UVA rays that penetrate more deeply into your skin also penetrate clouds and windows and are present at an even rate throughout the daylight hours.
Once thought not to cause cancer, these are the same rays that are used in tanning salons. Now we know they are closely linked with the risk of developing at least 3 types of skin cancer, including melanoma.
“If I put sunblock on, I won’t get enough vitamin D”
While vitamin D deficiency is a current health issue in the US, it doesn’t take as much exposure as you think for your body to produce a large dose. There are also plenty of inexpensive and effective D supplements on the market, and a diet rich in fatty fish like sardines and salmon can give you what you need.
Exposing your hands, arms and face 2 to 3 times a week to about 5 minutes of sun, with the strength found here at noon in July, is enough for your body to produce 10,000 IU of vitamin D. This is much more than most doctors recommend patients take as daily supplements, even during winter.
“Most skin cancers aren’t serious anyway”
You may know someone who’s had a skin cancer scare, who just had it removed and has no more than a scar to show for it. Beyond the emotional and financial toll of diagnosis and removal, having any kind of skin cancer increases your risk of developing another or much more serious cancers. There are more skin cancers diagnosed in one year in the US than all other cancers combined over a three-year period, so it is an issue to take seriously.
“I have dark skin and don’t burn so I don’t need sun protection.”
Once again, burning isn’t the only issue. As mentioned above, repeated non-burning UVA radiation exposure over the years also puts you at a significant risk of developing skin cancer, no matter your skin tone. For people of color, skin cancer is often diagnosed at a much later stage when it is harder to treat, so African Americans are more likely to die from melanoma than Caucasians.
How to protect yourself from the sun
The CDC recommends the following for protecting against UV radiation:
- Stay in the shade if possible, particularly when the sun is at its strongest—usually around midday.
- Wear clothing that covers your arms and legs.
- Wear a wide-brimmed hat that provides shade for your head, face, ears, and neck.
- Wear wrap-around sunglasses that protect against both UVA and UVB radiation.
- Use sunscreen with a minimum sun protection factor (SPF) of 15 that is full-spectrum (protects against UVA and UVB radiation), and reapply every 2 hours.
- Avoid indoor tanning altogether.
Protecting your kids from the sun
Children need extra protection from the sun as they can burn easily and childhood burns increase our risk of developing cancer significantly. Babies younger than 6 months should be kept out of direct sunlight and be covered with protective clothing. Sunblock should be used on any exposed areas of skin.
Many are nervous about putting chemical sunscreen on children because some include carcinogens in their ingredients. We are fortunate to live in a community where one of the best natural, full-spectrum, reef-safe line of sunblocks in the world is manufactured. If you don’t already know about W.S. Badger in Gilsum, NH, visit their site or ask them about sun protection when you see them tabling at community events around the Monadnock Region.
When should I see my doctor?
Call to make an appointment with your Primary Care Provider if you find a mole that has irregular borders or is changing shape or size, or if you find a growth that is itchy, bleeds, or doesn’t heal on its own. Your provider may refer you to Cheshire’s Dermatology Team who offer MOHS micrographic surgery for skin cancer in downtown Keene.
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