An expert from The Skin Cancer Foundation explained how to read sunscreen labels, sun safety practices, common misconceptions about skin cancer and what cancer survivors should know about their risk.
As the weather heats up during the summer months, people often spend extended periods of time outdoors under the warm – but dangerous – sunrays. This makes it all the more important for people to practice effective sun protection strategies to avoid skin cancer, which is the most common cancer type.
Dr. Maral Skelsey, a dermatologist who is the director of Dermatologic Surgery Center of Washington and a spokesperson for The Skin Cancer Foundation, shared the best ways for people to protect their skin from the sun and described some common misconceptions people have about sun safety in an interview with CURE® for Ultraviolet (UV) Safety Awareness Month.
Choosing the right sunscreen can get confusing when many stores have an entire wall full of choices. What do all of the different labels mean? What number is best? Should you go with a lotion, a spray or a gel?
According to Skelsey, people should look a label that says, “broad spectrum,” because this ensures protection from both UVA and UVB rays – ultraviolet A and ultraviolet B. The sun protection factor (SPF) is a measure of how much sunburn protection you’re getting.
“(UVA) are the long wavelengths of light and (UVB) are the sun burning rays,” she explained.
UVA rays penetrate more deeply and are the cause of wrinkles, sagging and aging, said Skelsey. The SPF refers to protection from UVB rays, which is why you should look for sunscreen with an SPF of at least 30. Both types of sun rays cause skin cancer.
Another key phrase to look out for is “water-resistant,” Skelsey added. Don’t be fooled by “waterproof,” as no sunscreen is technically waterproof. This means that while a water-resistant sunscreen will be helpful, people should still be mindful of reapplying, especially after they’ve gone in the water.
“The longer time period that it’s rated to be water resistant – there’s 40 minutes or 80 minutes – you want to look for an 80-minute water or sweat resistant sunscreen,” said Skelsey.
In terms of the formulation, which could be lotion, spray, gel or stick, the best choice is the one that you’ll actually use, Skelsey stressed.
“If you like to use a lotion or something more moisturizing, choose a sunscreen with that formulation,” she said. “A lot of people don’t want to get sunscreen in their eyes. A stick can be helpful on the face and around the eyes and more hairy areas. For skin that’s (oilier), gels can be helpful. For large surface areas, and sometimes for kids, spray can be really convenient to use.”
When using spray, however, people should make sure they’re covering the entire surface area, Skelsey advised.
Once you find the sunscreen with the most protection, make sure to apply and reapply frequently.
“Even if you use the very highest SPF, you still need to reapply your sunscreen after you've been out for two hours, after you've been swimming or perspiring,” said Skelsey. “Most people don’t use enough sunscreen in terms of the amount – you need to use at least two tablespoons. That’s about a shot glass size to cover your entire body and about a nickel size for your face.”
People also often miss certain hidden areas of the body while applying, such as the tops of the ears, the scalp (especially on any bald patches), the neck and the top of the feet.
When people are out in the sun, they should make an effort to wear long sleeves, if possible, in addition to UV-blocking sunglasses and wide-brimmed hats to stay covered from harmful rays. People should also try to seek shade and avoid outdoor activities between 10 a.m. and 4 p.m., Skelsey explained.
“We know that cumulative sun exposure has an impact on developing skin cancer, so it's not just a sunburn,” she said. “And we know too, that the sun and artificial tanning are known carcinogens. So these are the most common ways that that people develop skin cancer.”
People should get their skin regularly checked for skin cancer at a dermatologist appointment through a full body skin exam. Skelsey also recommends that patients check themselves once a month and look out for any new or changing lesions.
Although many people believe they can get a “base” tan to avoid sunburn and thus protect their skin, this is not true and not safe, Skelsey advised.
“There is no such thing as a safe tan,” she said. “A tan will not protect you from getting sun damage. It doesn't protect you from getting skin cancer. A tan is caused by harmful UV radiation, (whether) from indoor tanning lamps or outdoor (sun), it just is a signal that you have damaged your skin. There's no point in going to get an indoor tan before you're going to go on a beach vacation.”
Another common myth is that only light-skinned people can get skin cancer.
“Darker skin types also get skin cancer, and they're much less likely to be wearing sunscreen,” said Skelsey.
Lastly, many believe that you need to be exposed to direct sunlight without sunscreen to obtain vitamin D. However, according to Skelsey, recent studies have shown that the use of sunscreen does not significantly impact how much vitamin D people receive while in the sun. Additionally, the safest way to get vitamin D is through diet and supplements.
“There are also supplements that have been found to help reduce the risk of non-melanoma skin cancer, including nicotinamide,” said Skelsey. Taking 500 milligrams of nicotinamide twice a day was found to reduce risk of non-melanoma skin cancer by 23%.
Since skin cancer is the most common cancer type in the U.S., many cancer survivors are likely to have had it, regardless of what other types they’ve had, said Skelsey. Having had one type of skin cancer puts survivors at an increased risk of developing a second skin cancer.
“Once you have one skin cancer, we know that in 10 years, you have a 60% chance of getting another one,” she said. “And that means a second skin cancer, not a recurrence of the one that a person already has… and sun protection becomes even more critical.”
Patients who are in active treatment for cancer should be aware that they have an increased risk for skin cancer, due to immunosuppression from treatment.
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