'Tis the Season... for Sun

Double-check your cabinet and your knowledge: What do you and your family need to know to be prepared this summer?

Skin cancer is the most common form of cancer in the U.S.
True. More than 1 million skin cancers are diagnosed annually. Skin cancer appears as one of three major types: basal cell and squamous cell carcinoma—the two most common and, if caught early, treatable types—and melanoma, which can be highly aggressive. Skin cancer is ahead of prostate, lung and colon cancer for white men over age 50, and melanoma is the third most common cancer in women aged 20-39. Just over 8,000 of the 60,000 melanomas to be diagnosed this year will be fatal. And while light-eyed, light-skinned people tend to be more at risk, since they have less melanin as a protective shield, any skin tone can be affected.

A base tan gives you SPF (sun protection factor) protection.
False. “It’s hard to generalize what a ‘base tan’ actually means,” says Dr. Elisabeth Shim, assistant clinical professor, Dept. of Dermatology, USC Keck School of Medicine and spokesperson for the Skin Cancer Foundation. Many fair-skinned people, for example, have little to no ability to tan in the first place. But “squamous cell carcinoma is due to chronic accumulation of sun exposure.”

Apply sunscreen at least 30 minutes prior to exposure to the sun for maximum benefit.
True. Sunscreen agents need that much time to bind to your skin. But realistically, Dr. Shim adds, “Any use is better than no use at all, so put it on as soon as you can, when you can.” Also, since SPF indicates protection only against UVB rays, make sure your lotion includes protection against UVA rays—these tend to cause deeper damage, such as weakening of the skin, wrinkling and pigmentation. Recent studies also suggest that UVA rays may initiate and exacerbate the development of skin cancers.

Waterproof sunscreens are better than water-resistant.
False. “‘Water-proof’ is a wastebasket term,” Dr. Shim says. “It implies that water can never dissolve the sunscreen.” This misdirection has led to some controversy and even lawsuits. Look for the words “very water-resistant” on your sunscreen, which will provide 80 minutes of protection under the duress of perspiration or swimming (“water-resistant” will provide 40 minutes under the same conditions). Reapplication is crucial, Dr. Shim says. “If you’re staying out for a long time, you’re better off looking for water-resistant sunscreen. The scary thing is that most sunscreens don’t even meet that standard, which means that they don’t last as long as expected.”

The higher the SPF, the better.
True, but not by much. The minimum recommendation is 15 SPF, which
provides 94% protection. “Anything over 25 SPF provides a minimal difference,” says Dr. Shim.

Sunscreen lotions never expire.
Depends on the lotion. Sunscreens are tested for stability. If the bottle has an expiration date, play it safe and replace when time’s up.

Clothes, hats and sunglasses Provide protection against UV rays.
True, and many experts believe they provide better protection than sunscreen alone. But inspect the item closely:
•    Hats should be broad-brimmed, protecting not just your face but your ears and neck.
•    Sunglasses will specify UVR protection, to help protect against immediate reactions to sunlight such as blurred or watery vision, as well as long-term damage like cataracts. The upper and lower eyelid are one of the most commonly affected areas on the face, and eyelid cancers account for about 10 percent of all skin cancer deaths.
•    Clothing can be tricky. Generally speaking, light-colored, lightweight fabrics do not protect well—about an average SPF of 7—while darker, more tightly woven fabrics can offer up to or more than an SPF of 1,000.
•    Consider your car. “Patients think the glass is protecting them,” Dr. Shim says, “but unless it’s UV tinted or protected, they’re getting a lot of UVA rays. I see it a lot in my patients’ faces.” This includes kids in the back seat. But UV-protective film can be professionally installed. Check the Yellow Pages under “glass tinting” or “glass coatings” for dealers. According to SCF, “laws on auto glass are based on visible light transmission and vary from state-to-state, but UV-blocking window film is clear and legal in all 50 states.”

The chemicals in sunscreens can cause more damage than skin cancer itself.
False. There is no solid evidence for chemical damage, says Dr. Shim, although a couple of studies have shown that some ingredients have the potential to cause free-radical damage. (However, most of the ingredients were tested alone and not in combination with other ingredients, as they are actually used in the product.) There is also minor debate about the recently touted avobenzone, or Parsol 1789; the efficacy of this ingredient beyond one hour is proving controversial. The better blockers have always been physical or mineral based, such as zinc oxide and titanium dioxide. Because they are not absorbed into the skin, they are potentially not as irritating or allergenic. The improved formulas are also much less whitening than they were in the old days. In addition, Mexoryl and Helioplex, more stabilized forms of avobenzone-type ingredients, provide prolonged UVA protection, according to their manufacturers, L’Oreal and Neutrogena respectively.

Sunscreens can create a vitamin D deficiency by blocking the absorption of the sun’s rays.
False. “It’s been shown that elderly people and people of darker skin color already don’t generate as much vitamin D from the sun,” Dr. Shim says. “No one has proven that sunscreen is linked to other types of cancer. Most people, especially in California, get enough vitamin D from the sun within
10-15 minutes—plus through their diet as well.”

Annually, nearly 30 million people tan indoors.
True, and 2.3 million of them are teens. Now consider that regular exposure to tanning beds before one’s mid-30s can increase melanoma risk by 75 percent. Try sunless tanning lotions or tinted moisturizers instead.
   
UV radiation decreases once summer is over.
True, but we didn’t say “vanish”. UVA rays are present during all daylight hours and throughout the winter, giving us a higher dosage than we probably allow.

Remember, monthly self-examinations and annual physician exams are key to early detection and survival. Visit skincancer.org for more information and summer safety tips.

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