For some it has been a long dark Winter (and Spring), so the longer days and increased sunshine are welcome additions to our daily routine. No doubt some of us have already felt the sting of too much sunshine as we either absentmindedly spent an afternoon outside and forgotten the application of sunscreen or misjudged the effects of the sun this early in the season. The long term effects of even one severe sunburn can be life changing. Sometimes these effects can happen decades later.
Nonmelanoma skin cancers are common malignancies comprised mainly of basal cell carcinoma and squamous cell carcinoma. Melanoma, the deadliest form of skin cancer although less common. Both melanoma and nonmelanoma skin cancers can be disfiguring. They can also negatively affect quality of life and create needless economic burden.
Age-adjusted incidence rates of both have recently increased. Different patterns of sun exposure are associated with different types of skin cancer. Squamous cell carcinoma is associated with more continuous, chronic sun exposure (observed among outdoor workers). Melanoma and basal cell carcinoma are more common with intermittent (recreational) exposure. Sunburn will normally occur after intermittent exposure, and the risk for melanoma increases with an increasing number of sunburns during all periods of life. Sunburn is more common among persons aged 18–29 years compared with older adults.
Are there benefits to sun exposure? The most commonly touted benefit is vitamin D creation. Whole body sunlight exposure creates at least 10,000 IU daily. Even with a 5% exposure of body surface area three times weekly for 12 weeks has been shown to result in the same blood levels of 25-hydroxy vitamin D as a 400 IU dose orally in an elderly patient. Younger patients produce even more with the same percentage of skin exposure.
photo credit: Robert S. Donovan via photopin cc
So, how can you stay sun-safe?
- For extended periods of exposure, coverage with wide brimmed hats, UV protective sunglasses that cover the peripheral vision areas, long sleeved shirts and long pants are beneficial in reducing exposure.
- Changing the time of day outdoors to times that the UV index is lower will also benefit (10 am – 4 pm being the worst time).
- Using a broad spectrum sunscreen (UVA/UVB) that has an SPF of 50 or higher on exposed areas will help.
- For extra sensitive areas like the bridge of the nose or the tops of the ears or top of a bald head, a zinc oxide or titanium dioxide ointment or paste (physical block) of 20-40% may be needed as a physical block against the sun’s rays. The higher the percent of these agents, the more the blocking effect that occurs.
- The key is to remember to reapply sunscreen after swimming or excessive sweating and ideally the sunscreen should be applied ahead of going outdoors by about 20 minutes and to apply sufficient sunscreen to each area of the body.
- Sunscreen should be reapplied every two hours otherwise. No one applies too much!
- Infants under six months should be kept out of the sun rather than using sunscreens although the physical blocking agents are ok to use like zinc oxide. Look for PABA free,paraben free and fragrance free. Watch for cloudy days as UV radiation can get through and still cause a burn.