Take Care in the Sun
Diana Clarke

Protect your skin from aging and skin cancer with this simple guide.
Fun and Sun. The two are synonymous. And it's about time-after months of dreary gray skies and drab, rainy weather. We can hardly wait to head for the beach, lie out by the pool, show off that new swimsuit and suntan.

But before you go, keep this in mind:

This year more than 1 million Americans will discover they have basal cell and squamous cell carcinoma-mild, usually benign forms of skin cancer. And it is estimated that in 2002, 54,200 Americans will be told they have malignant melanoma, the more serious and often fatal form of skin cancer. In addition, 7,600 are expected to die from melanoma.

The number of Americans with malignant melanoma-primarily Caucasians-- had doubled from 1973 to 1995. And experts expect this rate to increase unless we take great precautions and forego that summer tan.

"Most people know that the sun is dangerous, but that does not always translate into recognizable protective actions," stated dermatologist June K. Robinson, M.D., Professor of Medicine (Dermatology) and director of the division of dermatology, Loyola University Medical Center, Maywood, at an American Academy of Dermatology's Melanoma/Skin Cancer Detection and Prevention Month Press Conference.

Malignant Melanoma

Melanoma lesions are ragged, blotchy moles that appear on the skin. If left untreated, they can metastasize (spread) throughout the body, sometimes killing people within months. The average five-year cure rate is 88 percent, and the five-year cure rate for early, superficial melanoma is 96 percent. (In contrast, basal cell and squamous cell carcinoma are less dangerous. Overall, they 're 95 percent curable.)

Who is at risk, and what can you do about it?

Genetics and the immune system play a role, but solar radiation is more likely the major cause of this disease.

And solar radiation is just that-radiation, the most dangerous cancer-causing agent. When solar radiation burns the skin, injured cells can mutate. These abnormal cells in turn can divide and spread just as overexposure to radiation from X-rays or a leaking nuclear power plant (such as Chernobyl) can cause cancer.

If you're Caucasian, you are more susceptible to sun damage because your light skin makes less melanin, the pigment that colors your skin. Melanin acts as a barrier to UV rays by absorbing them and converting them to heat before they penetrate the skin.

So the lighter your skin and the faster you sunburn, the greater your risk. Equally important, melanoma is not only caused by years of sun exposure, but also by at least one incident of a severe sunburn during childhood. And most people get 50 to 80 percent of their lifetime exposure while they are children, under age 18. So you can protect your children from cancer in adulthood by carefully shielding them from solar radiation now.

Shielding our bodies from solar radiation begins with knowing "the sun is bathed in light," says Michael J. Martin, M.D., Attending Physician, Department of Medicine, University of California, San Francisco. That light scatters and bounces off surfaces. So even if you're under an umbrella at the beach all afternoon, the sun can reflect solar radiation back to you.

Here's a simple guide to let you know your personal risk, and prevention measures you can take:

Your risk

You are at greater risk of malignant melanoma if you have fair skin, burn within 10 to 20 minutes of sun exposure, have had a severe sunburn as a child, and have a family history of melanoma and atypical moles. If you're Chinese, Filipino or Hispanic, you're still at risk because compared with blacks, whose risk is negligible, your skin produces less melanin. However, even blacks, who have the most melanin in their skin, can get melanoma on their lips, soles of their feet and palms of their hands. To give you an idea of your risk according to your race, in California in 1998, the total number of new cases per 100,000 by race is as follows:

Whites (non-Hispanic) 2,314 Hispanic 84 Black 5 Asian/Pacific Islander 23

Total 2,818 Protecting yourself

To lower your risk of malignant melanoma, determine your skin type by how fast you burn in the sun, and how poorly you tan. Then, determine when and where to avoid intense solar radiation, take measures to protect your skin from too much sun, and examine your skin for signs of precancerous lesions and skin cancer.

Specifically:

Watch or read the weather report, looking for the UV index. The index shows on a scale from 1 to 10 how intense solar radiation is at a given time of day.

Limit sun exposure between 10 a.m. and 4 p.m., particularly during the summer. What's more, be cautious if you are in areas near the equator such as Florida, or at high altitudes such as Colorado, where UV radiation is more intense. Use your shadow as a guide. The shorter your shadow-as when the sun is overhead-the greater your exposure to UV radiation.

Wear a sunscreen that has at least a Sun Protection Factor (SPF) of 15 with broad-spectrum protection (blocks both UVA and UVB radiation). Better yet, if you are at greater risk of melanoma, wear a sunscreen that offers an SPF of 30. The SPF is the number of minutes you can stay in the sun without burning, multiplied by the sunscreen lotion's SPF number (For example, 10 minutes-times-SPF equals a period of 2.5 hours in the sun without burning.)

Pay particular attention to areas of the skin that tend to receive more direct sunlight such as the nose and shoulders. And since solar radiation can penetrate three feet into the water, if you swim in pools or surf in the ocean, wear waterproof, sweat-proof sunscreen.

Cover up with clothing that has dark, tightly woven fabric, and wear a wide-brimmed hat and sunglasses that filter UVA and UVB rays.

Detecting the cancer

It's simple as ABCD. Look at the mole. Is it Asymmetrical, where two sides don't match up? Is the Border irregular? Does a Color vary on the same mole? Is the Diameter greater than six millimeters or one-quarter inch? Likewise, look for changes in color, shape, size, texture, elevation. When performing a self-exam, use a mirror if necessary, and don't forget to check hidden areas such as between the toes and on the scalp.

If you have symptoms of skin cancer, consult a physician before subjecting yourself to more sun damage. Otherwise, play in the sun, but play it safe.

About the Author

Diana Clarke is a California credentialed teacher and freelance writer. Her sun protection articles have appeared in publications, such as the San Jose Mercury News, Saratoga News and a high school health magazine, Listen Magazine.