Walter Quan, Jr., MD
Being out in the sun is a reality for many throughout the summer months. The fun of barbeques, swimming and family gatherings should not be hampered by the unnecessary fear of a sun burn or a worry about future skin cancer.
Prolonged sun exposure is never recommended, but there a few tips that can be used during fun summer outings. In addition to sun safety tips, I also want to revisit a few of the most popular questions from our recent #MelanomaMonday Twitterview to make sure that you have all the information you need to protect yourself from the sun and the future risk of cancer.
First, here are the basic tips for sun safety:
- Always use a sunscreen with an SPF 15 or higher and make sure to constantly reapply, especially if you are going to be swimming. Evidence of a tan indicates that the radiation received has overcome the protection afforded by the sunscreen.
- Try to stay inside between the hours of 11 a.m. and 3 p.m.
- Cover up as much as possible if you have to be outdoors during the high intensity hours.
- Watch for moles or marks that are changing in size, color or elevation and reach out to a doctor if you notice those changes.
One of the most asked questions during the Twitterview and covered in media is: “Am I safer in the sun as long as I have a ‘base tan’?” The answer is wholeheartedly no. A sunburn or tan is actually the way that your skin shows that it is damaged. When a tan fades, it’s your body trying to repair radiation damage from sun. Unfortunately, your body never forgets that damage and so every burn or tan increases your risk for skin cancer. Furthermore, a recent study done at Dartmouth Medical School, showed that indoor tanning can produce 10 to 15 times as much ultraviolet (UV) radiation as the midday sun, and that children and young adults who go for indoor tanning “may be especially vulnerable to developing basal cell carcinoma, the most common form of skin cancer, at a young age.”
Another question that I often receive is: “Do people of color have to worry about skin cancer less?” Having melanin in skin does help protect, but not always. There is more than one type of skin cancer and the tendency to have a different type has been reflected in a person’s ethnicity. Basal cell carcinoma, the most common type of skin cancer, is found predominantly in Caucasians, while squamous cell carcinoma and melanoma has been found in people of all ethnicities.
For simplicity, one could imagine human skin as being comprised of three layers: the epidermis, dermis and fat. Cells in the epidermis (the outermost layer of skin) called melanocytes produce melanin, the pigment that gives skin and eyes their color. The more melanin the melanocytes produce, the darker the skin pigmentation. The more melanin that a person has means the more a person is provided with a sun protection factor. Environmental factors, such as increased sun exposure in states like Arizona, can contribute to higher incidences of skin cancer regardless of ethnicity, but to protect yourself from the different types of skin cancer, it is necessary for everybody to apply sunscreen any time they are planning to encounter UV rays.
In my role as a medical oncologist, I am often asked if melanoma is preventable. Only about 10 percent of melanoma runs in families (familial melanoma). Not all cases can be prevented, but there are things you can do to help reduce the chances of getting melanoma, and they all have to do with limiting exposure and protecting against UV rays. Screening is also an important component in identifying melanoma at an early stage. If you follow the ABCDE’s of skin cancer awareness and watch for a change in a pre-existing mole in regards to asymmetry, borders, color, diameter or elevation, and consult a dermatologist, you can potentially discover a treatable melanoma.