You and your children have just arrived at a local beach for a day of fun and relaxation when you realize that you left your sunscreen at home.
The thought of driving to a nearby drugstore to buy a bottle crosses your mind, but that seems like such an inconvenience. Your children are already splashing around in the water. Well, perhaps it’s not a big deal; it’s only a few hours in the sun. Not using sunscreen for one day can’t possibly cause any harm. Think again.
“Sun damage is cumulative, so it’s important to protect your skin from the sun every single day,” says Ali Hendi, M.D., F.A.A.D., a board-certified dermatologist and skin cancer specialist in private practice in Chevy Chase. “One blistering sunburn during childhood more than doubles your risk of developing melanoma later in life. You don’t have to be a hermit; just be smart. Live your life, but live smartly.”
According to the American Cancer Society, skin cancer is the most common type of cancer. More than two million skin cancers are diagnosed each year in the United States, and the number of skin cancer cases is higher than the incidence of cancers of the prostate, breast, lung, colon, uterus, ovaries and pancreas combined. There are two main types of skin cancer: keratinocyte cancers (basal and squamous cell skin cancers) and melanomas.
Although cancer researchers may not know what causes all forms of cancer, they do know the main risk factor for skin cancer: exposure to ultraviolet (UV) radiation. According to the American Academy of Dermatology, two types of rays, ultraviolet A (UVA) and ultraviolet B (UVB), are especially harmful. UVA rays cause premature aging of the skin, such as wrinkles and age spots. They can also suppress your immune system, which may interfere with your body’s ability to protect you from developing skin cancer. UVB rays cause sunburn. However, excessive exposure to both rays can cause skin cancer. The United States Department of Health and Human Services has declared UV radiation—from natural sunlight and artificial sources (such as tanning beds)—as a carcinogen. Although the statistics and facts may be frightening, you can take steps to protect yourself and your children from the sun’s harmful rays.
Sun Protection Guidelines: Sunscreen
Obviously, sunscreen is an integral component of a complete sun protection regimen. To protect your skin, always use a broad-spectrum sunscreen with SPF 15 or higher whenever you’re outdoors. Broad-spectrum sunscreens block UVA and UVB rays, protecting your skin from both damaging rays. If you’re outside for an extended length of time, use a broad-spectrum sunscreen with SPF 30 or higher. And be especially cautious when you’re around sand or water, which reflect the sun’s rays, and can increase the risk of sunburn.
“I’m a big fan of sunscreens that contain zinc oxide or titanium dioxide,” says Sanjiv K. Saini, M.D., F.A.A.D., a board-certified dermatologist in private practice at MD Dermatology of Maryland in Edgewater. “These cream formulas are easily absorbed and vanish into the skin. Technology has improved so much in recent years, and these are really good products.”
Like Saini, Hendi also suggests choosing a sunscreen that contains zinc oxide or titanium dioxide, especially if you have sensitive skin. If your skin isn’t prone to sensitivity, look for the following ingredients: oxybenzone, avobenzone (Parsol 1789) or ecamsule (Mexoryl).
When used properly, sunscreen is perhaps your best defense against skin cancer. Thirty minutes before going outside, apply sunscreen liberally and evenly to your skin. Pay close attention to easily overlooked areas, such as your ears, neck, hands and feet. An average adult should use approximately one ounce of sunscreen—enough to fill a shot glass. Reapply at least every two hours—more often if you’ve been swimming or sweating excessively. Water-resistant sunscreen is ideal, but remember: no sunscreen is waterproof.
Choose a sunscreen that you like and that suits your skin. Sunscreens are available in a variety of formulations to promote ease of use, including lotions, gels, sprays, creams and rub-on sticks.
“I always tell my patients that finding the right sunscreen can take some time,” says Saini. “It depends on what feels good on your skin and what you can tolerate. You may have to try different formulas before you find the right one. It’s very important that you like it. Otherwise, you won’t use it—or reapply it. Many people choose a great sunscreen, but ignore directions about reapplying it. One application can’t protect your skin all day long.”
Recent “scares” reported by the media may have caused concern about the use of sunscreen. If you’re worried about claims that chemicals in sunscreen aren’t safe, rest assured. Confusion about the safety of sunscreen arose in May 2010 when a report by the Environmental Working Group, an advocacy organization that studies chemicals in consumer products, stated that retinyl palmitate, a form of vitamin A and a common ingredient in sunscreen, was linked to skin cancer in laboratory rats.
“Retinyl palmitate is not a carcinogen in humans,” says Hendi. “These studies were conducted on mice that ingested mega doses. Humans apply sunscreen topically, so only trace amounts are absorbed into the skin. Studies such as these are always questionable because you can’t extrapolate research conducted on animals to humans. The bottom line—and I can’t stress this enough—is that sunscreen is safe. And the potential benefits of applying sunscreen outweigh any potential harm of any ingredient. So keep using your sunscreen.”
Other Sun Protection Guidelines
Using sunscreen is only one part of a sun safety regimen; sunscreen alone isn’t enough. The Skin Cancer Foundation recommends that you also incorporate other healthy habits into your lifestyle in order to protect your skin. Wear a long-sleeved shirt, long pants, a wide-brimmed hat and UV-blocking sunglasses. Seek the shade whenever possible, especially between 10 a.m. and 4 p.m. when the sun’s rays are the strongest. Avoid intentional tanning or burning, and never use tanning beds. In addition, examine your skin once a month, and see your dermatologist once a year.
As for the much-debated vitamin D issue, obtain your recommended daily allowance of vitamin D through diet and/or supplements rather than from exposure to the sun. The health risks of the sun’s UV radiation are well documented, so seek vitamin D the safe way; don’t rely on the sun.
Sun Protection Guidelines for Babies and Toddlers
As a parent, you need to be especially vigilant about protecting your child from sun exposure. Babies under six months old require special care because their skin is too sensitive for sunscreen. So keep your baby out of the sun, and take extra precautions when you’re outside. Use removable mesh window shields in your car to keep direct sunlight from coming in through the windows. Walk your baby in his or her stroller before 10 a.m. or after 4 p.m., and use a stroller with a sun-protective cover. Choose lightweight clothing that covers your baby’s arms and legs and a wide-brimmed hat or bonnet to protect his or her face, neck and ears.
When your baby is six months or older, you may begin using a broad-spectrum sunscreen with SPF 15 or higher. Thirty minutes before going outside, apply sunscreen to any areas of your baby’s skin that aren’t covered by clothing, such as his or her hands. And remember to reapply it every two hours.
Like babies, toddlers also require special care to protect them from the sun. Make sure your toddler plays in a shaded area, especially between 10 a.m. and 4 p.m. Choose long-sleeved, unbleached cotton clothing, a wide-brimmed hat and UV-blocking sunglasses. When selecting sunscreen, try a spray-on formula with SPF 15 or higher—a good choice for toddlers who have difficulty sitting still.
Children learn by example, and as a parent, you’re their best role model. So make sure you protect your children, and teach them about sun safety at an early age. If you make sun protection a priority, so will your children.
Skin Cancer Incidence in Maryland
According to Roberta M. Herbst, program manager of the Maryland Skin Cancer Prevention Program at the Center for a Healthy Maryland, an affiliate of MedChi, The Maryland State Medical Society, approximately 1,300 people in Maryland are expected to be diagnosed with melanoma this year.
“Skin cancer is the most common cancer, but it’s preventable because we know what causes it,” says Herbst. “Our organization focuses on helping children become sun aware. It’s so important to begin sun safety education when children are young, so they develop good habits and carry them into adulthood. Parents and teachers play a vital role in accomplishing this. And we are making an impact. It’s a great feeling when parents tell me that their child has never had a single sunburn.”
Maryland is also making strides in deterring minors from using tanning beds. In October 2008, a law went into effect that requires minors to have in-person parental consent in order to use a tanning bed. And in 2009, Howard County banned the use of tanning beds for minors, making it the first location in the nation to implement such a strict restriction on indoor tanning facilities.
Looking Toward the Future
“The number of skin cancer cases has been increasing over the years,” says Hendi. “But that is because we are treating cases caused by sun damage from 10, 20 or 30 years ago. We hope to see fewer cases in the future because of greater awareness of the importance of sun protection and educational outreach. But it’s too soon to see a decline in cases yet. It may take 10 years or more.”
“I think that education and awareness are making an impact,” adds Saini. “But some patients, usually women between the ages of 19 and 30, are still adamant about tanning. Hopefully, with continued education, we’ll see this trend reverse. If we continue to raise awareness about skin cancer and educate patients about sun safety, we can definitely make a difference.”
Lisa Lewis is a freelance writer in Annapolis and regular contributor to Chesapeake Family magazine.
Center for a Healthy Maryland, an affiliate of MedChi, The Maryland State Medical Society
National Council on Skin Cancer Prevention
The Skin Cancer Foundation
American Academy of Dermatology
American Cancer Society
National Cancer Institute