Here comes the sun
A summer picnic, a game of tennis, every BBQ or day at the beach is so much more fun in the sunshine. But it has never been more important to stay safe in the sun and develop a skin awareness routine that keeps the whole family protected, says Dr Bahar Schreve.
Every year in Switzerland, some 2,450 people develop malignant melanoma – the most serious form of skin cancer – representing approximately six per cent of all Swiss cancer cases. This dramatic rise in melanoma - here and around the world - is due to increased leisure time for sunbathing and outdoor sports, increased detection of naevi (moles or beauty marks/spots), which are being systematically screened and analysed by pathologists, and also due to a general increase in life expectancy.
However, the main risk factor for melanoma remains exposure to ultraviolet radiation (with main sources being the sun, tanning lamps and solariums). The lighter the skin, the more intense the exposure, the less the skin is protected... the greater the risk of melanoma. The Swiss population - generally fair-skinned – is particularly at risk.
What are the risk factors for developing melanoma skin cancer?
Everyone is at some risk of melanoma, but several factors increase this: the amount and type of sun exposure; the number of moles on the skin; the skin type and family history (genetics); and a weakened immunity as a result of chemotherapy, organ transplant, HIV/AIDS or lymphoma.
UV radiation reaches us in the form of UVA and UVB rays, and both damage the skin, aging it prematurely, and increasing the risk of skin cancer. Blistering sunburn in early childhood especially increases skin cancer risk, but sunburn later in life as well as chronic or cumulative lifetime exposure also play a role. Therefore people who live in locations that have more sunlight develop more skin cancers, but some northern locations with light-skinned populations also have a high incidence. Indeed, people with lighter skin colour, light/fair hair and light green or blue eyes are more at risk, as they have less melanin in their skin to protect them from UV rays. Therefore avoiding exposure to UV rays by following the “Sun Protection Guidelines” set out by the Swiss liguecancer and USA skin cancer organisation, will allow you to lower your risk of developing melanoma and other skin cancers.
Sun Protection Guidelines
See your physician every year for a professional skin examination.
“If a child is severely burned twice as a baby he or she is at increased risk of skin cancer. Even one blistering sunburn can increase the risk for developing skin-cancer over time. The best measure to take is prevention; always try to avoid sunburn.”
Am I protected under the shade? And on a cloudy day?
While shade is a valuable means of protection from the damaging effects of rays, it is not completely protective. This is because indirect or diffuse UV light is scattered by the clouds and other elements in the atmosphere, and/or bounced back from UV-reflective surfaces like dry sand or concrete. Therefore even under the shade of a tree or a large umbrella with high UPF (Ultraviolet Protection Factor which measures protection from UV radiation in fabrics), the protection is limited – with much UV reflected from sand, water and sky. Therefore one may spend time in the shade while still risking sun exposure and skin damage.
Similarly, if it’s cold or cloudy outside, you still need sunscreen since up to 40% of UV rays are present even on a grey day. Indirect or diffuse UV light is radiation scattered by clouds and other elements in the atmosphere, and/or bounced back from UV-reflective surfaces. Therefore serious sunburns can occur during any extended periods outdoors.
How should I choose my sunscreen?
Sunscreens play a pivotal role in UV protection. These are products combining ingredients that prevent the sun’s UV radiation from reaching the skin, and different sunscreens vary in their ability to protect against UVA and UVB. Since your face is almost always exposed, the use of broad- spectrum UVA and UVB protection is recommended daily; ideally a minimum SPF15 – with a SPF 30 for extended periods. SPF refers to the protection against UVB rays, but since UVA rays are also harmful be sure to check the label “broad-spectrum” to ensure both UVA and UVB protection. There are also two types of active ingredients in sunscreens; chemical and physical. Chemical ingredients work by absorbing UV, staying on top of the skin and deflecting UV rays. Physical sunscreens (sometimes called “mineral”) deflect UV rays before the penetrate your skin.Many sunscreenscombine chemical and physical ingredientsand provide broad-spectrum protection.The best product is one you will actually use, so choose a sunscreen with a scent and a feel that’s best for you.
Research suggests that sprays are usually under-applied, so be sure to use liberally, and reapply at least every two hours, plus immediately after swimming or exercising.
What SPF should I use?
Choosing the appropriate SPF depends on your skin type based on the “Fitzpatrick Skin Type Classification System”. This grading system classifies skin type from I to VI, and corresponds to your susceptibility to developing skin cancer. The Fitzpatrick table determines the recommended SPF your skin requires.
Children younger than six months should not be treated with sunscreen as the chemicals may irritate their sensitive skin. Keep them in the shade, make sure they are wearing sun-protective clothing and invest in a sun- protective stroller cover. For children older than six months it is safe to use pediatric and baby sunscreen.
Now you’ve found the best sunscreen for you, don’t rely on it to protect your skin, but include it in a global sun-protective regime. By takingbetter care of your skin and preventing moreUV damage from accumulating, you may notonly avert skin cancer, but also repair yourskin, minimise skin aging - and let your skinheal from past damage. In addition to sun protection, skin self-exams are important in detecting new, suspicious lesions. Check your skin head-to-toe each month and make sure you have an annual professional skin checkup.
The earlier a skin cancer is identified, the easier it is to treat.
Disclaimer: This article is not intended to be a substitute for professional medical diagnosis or treatment. Always seek the advice of your physician or other qualified health providers regarding a medical condition.
References : Facts and information taken from theSwiss statistics published by the Federal StatisticalOffice (FSO): Melanoma: incidence and mortality bylanguage region (chart) 2003-2012 NICER and FSOProtection solaire - L’essentiel en bref - Uneinformation de la Ligue contre le cancer.