It's Not Always Good On the Sunny Side of the Street

By Deborah Sanborn

Though our skin needs sun to produce Vitamin D, that takes just minutes per day of unprotected exposure. The rest of the time, say experts, you're wise to cover up

If you're 26 and notice a mole below your shoulder, you might not think much of it—even if it wasn’t there a few months ago. But Courtney Rennie did think something of it, because as a doctor she knows that spots, moles or lesions on the skin which appear over time can be a warning sign.

“I didn’t believe someone so young could get skin cancer,”

She says of herself, since it’s the kind of disease that usually affects older people and takes years, even decades, to develop. Even her family doctor “didn’t think anything of it.” But Rennie pushed for a second opinion from a dermatologist, who diagnosed it as basal cell carcinoma—a less virulent form of skin cancer.

As it happens, skin cancer is the most common form of cancer right across the globe, though most cases aren’t life-threatening. Surprisingly, it accounts for up to a third of new cases of the disease every year in Canada, according to the Canadian Cancer Society. And experts seem to agree it’s almost always caused by too much time in the sun—extensive or repeat sun damage can actually alter the skin’s DNA.

sunburn is never harmless just because it fades, a tan is never healthy despite perception to the contrary. 

As for Rennie, a triathlete and traveller, her cancer was easily treated, and three years later she’s as fit as ever. But when in India in February of this year, she says, she sure slathered on the sunscreen.

Dr. Courtney Rennie points to where she discovered a mole that turned out to be skin cancer sign of skin damage. So how did someone as young as Rennie get skin cancer? “Probably from wearing swimsuits in the summer,” she says, recounting the hours spent hanging out with friends at the local pool. Her story is typical—most sun damage you will do to your skin happens before the age of 20, when you’re more apt to get blistering sunburns or spend hours in the bright light of day at the park, camp, cottage, beach or pool, not to mention the slopes.

Travellers have this in common with kids—being out and about for long periods of time without giving the sun much thought. Whether in the city exploring, at the flea market grazing or on the highway cruising—the sun’s ultraviolet (UV) rays can penetrate car windows—being outside more than usual while travelling is a big change for most of us. And it’s this casual exposure that has dermatologists worried, since it too can lead to permanent skin damage and cancer.

Though hard to believe, the sun’s rays are now considered carcinogenic to humans, with the sun to skin what cigarettes are to lungs.

Common Skin Cancers 

  • Basal cell and squamous cell carcinoma: less virulent, can be cut out and treated but leave tissue damage, scarring and disfigurement if left too long.
  • Malignant melanoma: can be fatal if not treated in early stages; more easily metastasizes (spreads through tissue and organs). 
  • Do self-examination, look for new spots or patches on skin, pre- existing moles that start to change, sores on skin that don’t heal.
  • If any change over time in colour (to dark brown, red, purple or black), shape (from round to asymmetrical or lumpy), size (gets bigger, has misshapen borders) or tone (has white rim or border around it), go to doctor immediately.
  • Risk factors include: too much time in the sun; history of severe sunburns and intense sun exposure, especially in childhood; family history; multiple moles on body; tendency to burn easily rather than tan; Caucasian (darker-skinned people at low risk); people with fair hair (blonde or red), fair/pale/freckled skin, blue or green eyes.

Other Sun Damages Issues 

  • Can damage eye tissue, cause cataracts, snow blindness.
  • Can cause 1st, 2nd and 3rd degree burns with permanent damage and scarring.
  • Causes premature skin aging and wrinkling.
  • Can undermine immune system, increase susceptibility to other diseases.

Sun Myths Exposed

Fiction

  • A tan protects skin from getting sunburned.
  • Don’t have to worry about sun damage in winter.
  • Since sunscreen absorbs UV rays, it’s all I need to be protected.
  • Since I don’t feel the heat from the sun I’m not getting burned.
  • Men are at less risk since they don’t sunbathe as often.
  • Sunscreen with SPF 30 blocks twice as much as SPF 15.
  • Fact. Tan offers SPF of about 4; damage outweighs any protection.

Fact

  • UV level is lower in winter but still an issue; reflection of snow makes it more potent. FICTION Clouds and water act as shields from sun.
  • UV rays can penetrate clouds, and clouds can make you feel safe when you’re not; water reflects UV rays.
  • Sunscreens never offer total protection. It’s never smart to stay in the sun for too long. 
  • Sunburn and skin damage are caused by UV radiation, which can’t be felt.
  • Men are less prone to wearing sunscreen, more prone to getting occasional severe burns. American Cancer Society says this increases risk of getting melanoma, the most serious form of skin cancer.
  • SPF tells how long—not how much—it protects skin in general. SPF 15 prevents sunburn for almost four hours. Formula = 15 minutes x SPF 15 = 225 minutes.

“When you think of a triathlon, it’s hard to keep sun lotion on, [to] waste time to slather some on. But I definitely [used sunscreen] after I got skin cancer. I did a half-Ironman last year and spent three minutes putting lots of lotion on every time I transitioned.” Rennie, triathlete and skin cancer victim. Many races now assign people to put sunscreen on competitors.

Travel Tips 

  • During summer avoid sun from 10 am to 4 pm, when UV rays profusely (even for water-resistant and sweat-proof brands), or are most intense; if your shadow is short, get out of the sun.
  • Wear sunscreen everyday, with minimum Sun Protection Factor (SPF) of 15.
  • Use lip balm with SPF.
  • Seek shade when possible, but beware—sun can sneak through trees or awnings.
  • Wear wide-brimmed hat that protects face, ears, front and back of neck.
  • Follow 10-minute rule: 10 unprotected (no SPF) minutes of sun every day is good, as skin produces vitamin D for strong bones using UV rays from the sun.

Sunscreen 

What it does: absorbs UV rays as they hit skin. SPF: no higher than 30 is usually needed; more important to use as directed. On the label look for: “broad-spectrum” protection against UVA and B rays; water-resistant, sweat-proof; para-aminobenzoic acid-free (PABA-free), vitamin-enriched, non-oily formulas promote better usage. 

Sun Smart Travelling 

  • Beware the “urban sunburn” from walking in a foreign city or country wearing no SPF.
  • Wear sunglasses with 100 percent UV protection and wrap- around design (think Bono) to prevent sun from getting in through corners.
  • Lightweight, long-sleeved, tight-weaved, dark-coloured clothes are best (dark colours absorb rays).
  • For hot-climate countries, outdoor & water adventures, take UV-protected clothing and bathing suits found at outdoor/sports stores.
  • Check UV Index daily if possible: Index measures intensity of sun’s UV rays on a scale from 0 to 16+: higher the number, the more harmful.
  • Beware: higher altitudes have thinner atmospheres that filter out less UV radiation; snow, water, sea foam, sand and concrete reflect rays, making them more potent; closer a country is to the equator, higher UV radiation level.
  • Apply on all exposed skin but especially face, ears, front and back

Sunburn Treatment Do's and Don'ts 

  • Do: take cool bath, use wet towel to cool skin. • Don’t: over-itch peeling skin as nails spread germs.
  • Do: use calamine/after-sun lotions or gels with aloe vera to ease itching.
  • Don’t: use petroleum jelly, oils.
  • Do: drink lots of water to avoid dehydration, use common painkillers for relief.
  • Do: be aware that travellers’ medications such as doxycycline for malaria and ciprofloxacin for diarrhea, as well as skin creams with alpha hydroxy acids (AHA), make skin more sensitive to sun and burning.

Travel Health, www.dermatology.ca (Canadian Dermatology Association), and Environment Canada. F&F adapted from the American Cancer Society’s “Sun-Safety IQ” at www.cancer.org. The information in this article is intended as a guideline only, and in no way should replace a proper consultation with a doctor or at a travel clinic. Always get individualized medical advice before travelling.

 


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