It’s almost that time of year when people lay out to sizzle in the sun, like so many fillets crisping in the frying pan. Others will be out gardening, working or playing beneath the rays. They slather on their paba-free sunscreen, trusting that their skin, enviously golden-brown today, will remain supple, tan and cancer-free in the years to come. The protection they are getting may not be what they expected. Here are some tips to help you safely enjoy the summer sun season.
Know the Risks According to the American Academy of Dermatology, “Long-term overexposure can cause skin cancer, wrinkles, freckles, age spots, dilated blood vessels, and changes in the texture of the skin that make skin look older.” In fact, much of the visible signs of aging are the result of exposure to sunlight. Ultraviolet light has also been connected with cataracts and suppression of the immune system.
Skin cancer is the most common type of cancer in the United States. Although the mortality rates are relatively low, nearly 10,000 Americans die of skin cancer every year. Most of these are from the least common form, called melanoma. While different forms of skin cancer develop differently and have different risks, they do have one thing in common – the risks are greater with increased exposure to ultraviolet (UV) light, as from the sun and tanning beds.
Things aren’t getting better, despite the common use of sunscreens. According to the National Cancer Institute, it is not clear that using sunscreen reduces the risk of non-melanoma types of cancer, or that avoiding sunburns reduces the risk of melanoma. The incidence of skin cancer continues to rise each year. People with fair skin that tans poorly do seem to have a higher risk of developing any type of skin cancer, and those with many abnormal moles have an increased risk for melanoma. Twenty percent of Americans will develop some form of skin cancer. When diagnosed early, there is a nearly 100% chance of curing it, so have a doctor check out any unusual patches, bumps, scaly areas or moles that change shape, size or color.
Most of us get around 80% of our lifetime exposure to the sun by the time we’re 18. Adopting good habits about sun exposure and the use of sunscreen at an early age may result in significantly reduced incidence of skin cancer over a person’s lifetime. The Skin Cancer Foundation and the American Academy of Pediatrics recommend protecting kids from excessive sun exposure from an early age (but sunscreens should not be used on children under 6 months old).
Since dark-skinned people seem to be somewhat protected from the various kinds of sun damage, it is tempting to assume that staying tanned would give some protective benefit to those with fairer skin. So far, there does not seem to be evidence to support this. In fact, dermatologists consider a tan to be a form of skin damage.
Then again, there might be room for common sense and moderation. Some dermatologists and their professional organizations recommend avoiding sun and getting your vitamin D from a pill or “fortified foods” (generally foods which have had a lot of nutrition processed out of them, then had some chemical form of vitamins added back in). It’s hard to believe that hiding from the sun and taking supplements to replace normal physiological functions is a prescription for optimal health.
Sunscreens Sunscreens may not be proven to be protective against skin cancer, but they can help prevent burns and reduce direct damage from UV radiation. (Possibly, sunscreens encourage additional exposure to UV rays, thus negating any protective effect from skin cancer.) To be effective, sunscreen should be applied at least a half hour before exposure, and reapplied every couple of hours, and after swimming or heavy perspiration.
The Sun Protection Factor or SPF rating of a sunscreen gives you an idea of the degree that UVB radiation is blocked out. An SPF rating of 15 means that, with the sunscreen, you’ll be protected for about 15 times longer than without it. For example, with an SPF 15 sunscreen it would take about 3 hours and 45 minutes to get the same amount of UVB exposure that you’d get in 15 minutes without it. A product with an SPF of 15 blocks 95% of the UVB rays. So, an SPF 30 does not block twice as much; it blocks about 98% of the UVB.
The shorter UVB rays are most responsible for causing sunburn. They are largely blocked by window glass (as well as by a good sunscreen). However, UVA rays also damage the skin, causing wrinkles and loss of elasticity. They are only partly blocked by window glass. There is no rating system for protection against UVA radiation. Choose a wide spectrum sunscreen that blocks both.
There are some concerns about the substances used in sunscreens. Most of the problems are related to skin irritation. Aminobenzoic acid and its esters (paba), oxybenzone and cinnamates can cause a rash or make your skin more sensitive to the sun. Fragrances, alcohol and preservatives can irritate the skin or eyes. The Environmental Working Group recommends avoiding sunscreens containing padimate-O and paba. Instead, use a product made with titanium dioxide or zinc oxide. These substances provide a physical, rather than chemical, radiation block. Unfortunately, both have been connected with environmental pollution related to their production.
To be any good, your sunscreen also has to stay on. Or, at least you have to re-apply frequently enough to get the rated benefit. These labeling guidelines have been recommended to give consumers an idea of a sunscreen’s ability to keep working:
Sweat-resistant: protects up to 30 minutes of continuous heavy perspiration;
Water-resistant: protects up to 40 minutes of continuous water exposure; and
Waterproof: protects for up to 80 minutes of continuous water exposure.
Sunscreens are not to be used on children under six months old. That doesn’t instill a lot of confidence about their safety for adults, but there seems to be little evidence of serious side-effects from long term use in most of the population.
Prevention Guidelines OK, so you’re going to get some fresh air or maybe play a little ball outside. It’s not a bad thing! Just be smart about it.
Stop sunbathing and avoid other long baking sessions in the sun, especially between 10:00 a.m. and 2:00 p.m. when the rays are the strongest. Don’t count on the clouds to protect you – most of the UV light (60-80%) still comes through. Snow, sand and even concrete reflect up to 85% of UV radiation, so you can get more exposure than you bargained for on the beach or around the pool.
Skip the tanning beds and sun lamps – they produce the same damaging rays as the sun, without any redeeming activity such as exercising or at least getting some fresh air.
When you are out, minimize your exposure by seeking shade and covering up. Wear long sleeves and pants, and a broad brimmed hat. Even clothing does not give as much protection as you might think. A white cotton T-shirt has a SPF of only about 3. Tightly woven and darker clothes are the best. Unbleached cotton is a good material because it contains lignins, which do a good job of absorbing UV rays. Some clothing is made of specially treated cloth with protection factors over 40. It’s also possible to buy colorless dyes that you can launder into your own clothing, resulting in an SPF of about 30.
Your sunscreen should have a minimum SPF of 15 and be applied 30 minutes before you go out. Reapply after swimming or heavy sweating, and every couple of hours, regardless.
Be extra careful about sun exposure if you are taking antibiotics, tranquilizers or diuretics. Some of these make your skin more susceptible to sunburn. Check the package inserts or ask your pharmacist if you’re not sure of the precautions for the pharmaceuticals you are taking.
Kids have other things on their minds, and teenagers feel invincible, so it’s our job to give them some guidance about sun protection. Sunscreens, however, are not considered safe for infants under 6 months old. Better to learn some good habits about using shade and protective clothing.
Don’t forget to stay hydrated. If your activities have you worried about sun exposure, you’re probably loosing extra fluids, too.
If You Get Burned Anyway There is no cure for sunburn, but there are some things you can do to ease the discomfort, and possibly speed the healing. Biomedical treatments include topical sprays like Solarcaine, and pain relievers such as aspirin and Advil. Here are some more natural treatments.
A cool shower or bath will give some quick relief. Baking soda or chamomile can be added to the bathwater for a more soothing effect. Avoid warmer water as it strips away even more of the skin’s natural oils. It won’t feel good anyway!
Similarly, cool milk compresses are quite soothing (use gauze or a soft cloth well-moistened with the milk). Use whole milk, as the milk fats contribute to the effect.
Vinegar can be mixed half and half with water and applied as a compress or with a spray bottle. Vinegar is a traditional pain-relieving remedy – it’s good for sore throats and insect bites too. Avoid any broken skin and the eyes.
After any of these treatments, it’s good to apply a moisturizing lotion or aloe vera gel. These may have some direct healing benefit, and act as a barrier that helps your skin stay hydrated.
The Chinese herbal ointment Ching Wan Huang (also spelled Jing Wan Hong) can be used on mild to moderate burns. It helps relieve the pain, reduce inflammation and seems to speed healing of the tissues. It does have a pretty strong odor, and can stain clothes, but the relief it brings may be worth it.
Honey is a traditional treatment for burns (and wounds) with an excellent history of success. It’s probably not very practical for treating a large area, though!
Remember when it didn’t take several manufacturing industries, a couple of government agencies and a watchdog group to prepare us for a walk? Well, perhaps it still doesn’t. But as our longevity increases, we’ll be wearing our skins longer, and the incidence of cancer will trend upward. This article may have armed you with some new information, but basic protection from the sun has been an age-old practice around the world. It has only been in recent times, and in industrialized countries, that a suntan has come to suggest wealth and leisure, rather than poverty and manual labor. Being more aware, you may find new respect for the power of the sun and traditional practices that moderated its effects. It’s not hard to develop habits that will allow you to work and play safely for years to come. So, go ahead and enjoy the summer – but don’t get burned!