Summer sun safety

[Editor-in-Chief]

Summer sun safety
By Ben Aaronson/ TRI-TOWN@CNC.COM
Friday, July 22, 2005

For many people, the hot summer months are the perfect time to lie out by the pool or on the beach and soak up some sunshine. In a culture obsessed with bronzed skin, a dark complexion is often viewed as a sign of beauty and good health. But according to North Andover dermatologist Dr. Owen Reynolds, there is no such a thing as a "healthy tan."
"'Healthy tan' to me is a term that the tanning salon industry promoted. I wouldn't call a tan healthy," said Reynolds, who has been in practice since 1982. "Tanning is the skin's attempt to protect itself from ultraviolet exposure," he explained.
Prolonged or unprotected exposure to the sun's ultraviolet rays can put a person at high risk for developing skin cancer, Reynolds said. There are three types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. Non-melanoma cancers are generally treatable and thus rarely fatal, he explained, but melanoma is often difficult to treat, carrying a disproportionately high mortality rate. Out of an estimated one million cases of skin cancer each year (in the U.S.), approximately 8,000-9,000 are terminal and about 7,500 of those fatalities are from melanoma, he said.
Aside from the serious health risks associated with exposure to the sun's ultraviolet rays, there are also cosmetic reasons to avoid excessive sunshine, Reynolds said. Like smoking, exposure to the sun promotes photo aging or premature aging of the skin, including wrinkles and brown spots, he explained.
Risk factors
People with certain risk factors may be more susceptible to developing skin cancer, Reynolds said. First and foremost, people with fair skin are at a higher risk. Skin is categorized into six types, with Types 1 and 2 - people who tan slowly and burn easily - being at the highest risk for skin cancer, he explained.
Genetics also play a role, as individuals with a family history of skin cancer may be genetically predisposed to develop skin cancer themselves. Research to determine genetic markers for melanoma is ongoing, Reynolds said, but it is not as far along as similar research for breast cancer.
"Some day, there will be genetic markers so that people with fair skin and the genetic marker would know to be more careful," he said.
Finally, aging increases one's susceptibility to skin cancer. This is due in part to cumulative exposure to the sun, but it is also a result of a weakened immune response, particularly in individuals over the age of 80, Reynolds explained. Without strong immune surveillance to attack and destroy abnormal cells, cancers of any kind tend to spread more quickly in elderly patients, he said.
It is important to be aware of the warning signs of skin cancer, particularly for people with high risk factors, Reynolds said. The classic warning signs are a mole or a spot on the skin that bleeds easily or doesn't heal, or a mole that changes appearance. Contrary to popular belief, a raised mole is not necessarily a bad sign, Reynolds added, emphasizing that most spots are benign.
"I reassure my patients that the vast majority of things that people go in to see their dermatologist about are perfectly okay," he said.
Reynolds said regular mole-checks with a dermatologist might not be necessary for all patients. However, he does recommend annual check-ups for patients who have a family history of skin cancer, those who burn easily, and those who have an inordinate number of moles or large, oddly shaped moles.
Taking precautions
While the specter of skin cancer is a very serious health issue, it does not mean that people should be afraid to go out and enjoy the summer. There are a number of precautions one can take to protect oneself and one's family when spending time in the sun.
According to Dr. Reynolds, the most important thing you can do to protect yourself from the sun, even more important than using sunscreen, is wearing a hat and a shirt. While he said he does strongly recommend always using sunscreen on exposed skin, preferably SPF 30 or higher, Reynolds maintained that a hat and any shirt are more effective than any sunscreen.
"Eighty percent of non-melanoma skin cancer occurs on the upper trunk, the head and the neck," he said.
A shirt and a hat, the wider the brim the better, can add an extra layer of protection to these high-risk areas, he explained.
If you are already wearing your hat and your shirt and you have applied strong sunscreen to all your exposed skin, your last defense is to simply find some shade whenever possible, Reynolds said.
In most cases, Reynolds recommends that parents take the same precautions with their children as they take themselves.
"If [children] are in the pool, they're obviously not going to get any shade. But I don't think it's far fetched to tell a kid at the beach to leave his shirt on," he explained.
The one special precaution Reynolds said he recommends to parents with small children, especially infants under six months old, is to use chemical-free sunscreen. Chemical-free sunscreens, such as Neutrogena's Sensitive Skin Sunblock Lotion, are safe even for babies, he said.
"It's non-toxic so if the kid licks it or puts his fingers in his mouth, it won't hurt him," he explained.
There has been some controversy recently over some studies that seem to indicate that sunscreen may actually promote skin cancer. Reynolds said that the results are likely a function of the fact that people who use sunscreen tend to stay out in the sun longer. He cautioned against prolonged exposure to the sun, even when wearing sunscreen.
"The classic beachgoers wear a skimpy bathing suit and put on a strong sunscreen and they think they're all set. Then they are out there for hours and hours baking in the sun. I don't consider that healthy," Reynolds said.
"The best way the consumers can protect themselves is to do those other three things: wear a hat, wear a shirt, and find some shade if they can," he added.

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