Don’t Soak Up The Sun

Sun exposure is more hazardous than you think, especially when hunting at high altitudes or in tropical climates.

What is the Greatest Health Threat under the Sun?

For those who spend lots of time outdoors, the biggest health threat is the sun, according to many doctors. The incidence of melanoma–the deadliest form of skin cancer, usually caused by sun exposure–has increased 80 percent in the last twenty-five years. The less lethal but still serious carcinomas are also on the rise. In 2007 more than one million cases of skin cancer were diagnosed in America alone. The importance of the problem is evident, but self-protection against damaging sun rays can be more complex and subtle than many realize. Even those who think they are taking the right safety measures often are endangering themselves in unsuspecting ways.

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Dermatologists warn that most of us underestimate just how dangerous solar ultraviolet (UV) waves are to the human skin. Within seconds of exposure, intense rays can begin to damage unprotected skin. Shorter UVB rays mostly burn surface areas. The damaged cells release chemicals that irritate surrounding blood vessels, creating the redness and inflammation we know as sunburn. However, the sun also shoots out longer UVA rays, which penetrate deeper and cause permanent damage. UVAs break down collagen and elastin fibers, which results in sagging skin and visible, broken veins. Worse, UV radiation also produces acid molecules called free radicals, which damage cellular DNA in a way that can lead to skin cancer.

The crucial point to remember is that any burning or tanning of the skin is visible evidence of damaged DNA, which is why dermatologists repeatedly warn that there is no such thing as a “safe tan.” After the tan fades, the skin damage remains. Moreover, it accumulates over the years. Thus the real danger of too much sun is not so much that you will burn yourself to a crisp, but that you are unknowingly building toward a dangerous and potentially deadly eventual outcome. The more burns and tans you experience over the course of your life, the higher your risk of getting skin cancer. Most dangerous of all are repeated sunburns in the first 10 to 15 years of life; burns that triple the risk of developing melanoma. (Parents take note!)

Other factors that increase skin cancer risk include having fair skin, blond of red hair, and blue, green, of gray eyes. Those who freckle or burn rather than tan are at higher risk, as are those having more than a usual number of moles. Spending copious time in high-UV environments (tropic regions, on and around water, high altitudes, and snowfields), is another high-risk factor.

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Using of Sunscreens

The first key to effective sun protection is the proper selection and use of sunscreens. “Everyone” knows this by now, of course, yet studies show that a significant percentage of outdoor recreationists either choose a defective sunscreen product or use a good product improperly. (Or both.) A kind of sad irony has resulted from these mistakes, leading to an overall increase in sun damage and incidences of cancer.

A sunscreen’s Sun Protection Factor (SPF) rating is a measure of how long that product will theoretically protect you from UVB burning. Without protection human skin, on average, begins to burn after twenty minutes of direct sun exposure. An SPF 15 sunscreen–again, theoretically–should give you 15 times more protection. (15 x 20 minutes = 300 minutes, or five hours.) However, this is an ideal, laboratory number and does not take into account such real-life factors as perspiration and water immersion, which will dilute even those products touted as “waterproof.” Also, according to several studies, most people are getting only half of the rated SPF protection simply because they aren’t slathering enough sunscreen onto their skin.

Another important and often overlooked concern is that many sunscreens, even those with high SPFs, offer little or no protection against the deep-penetrating and dangerous UVA rays. It’s important to choose a product that protects against both types of solar radiation. The standard advice is to use only those sunscreens labeled “broad spectrum.” Unfortunately, advertising being what it is, such labels aren’t always backed up by fact. The only safe approach is to carefully read the ingredients list, which for UVA protection should include some of the following: avobenzone, capsule, dioxybenzone, oxybenzone, sulisobenzone, titanium dioxide, and zinc oxide.

Whenever possible, apply sunscreens twenty minutes or more before heading out into the sun. This gives them a chance to absorb into the skin for fuller protection. Be sure to layer the sunscreen liberally, erring on the side of stopping on more than you think you need. If you’re also using insect repellents, be sure to put the sunscreen on first, giving it time to absorb before applying the repellent. Add more sunscreen throughout the day, especially to highly exposed areas of skin (ear tops, hand and wrist backs, nose bridge, neck, and don’t forget your lips, which are a prime site for developing cancers and precancers). Err on the side of “too much” sunscreen rather than too little throughout the day, especially if you’re perspiring heavily.

No sunscreen by itself offers 100 percent protection from burning rays, so it’s wise to dress with the sun in mind. Wide-brimmed hats, where feasible; neck protection (bandanas or caps with neck drapes); long-sleeved shirts (especially the newer designs that ate SPF rated), and long pants. UV-filtering sunglasses also ate importantly, especially (though not only) in high-glare conditions; since UV rays can cause retinal burns and longer-term damage that can lead to pterygium (a non-cancerous growth over the white part of the eye, which requires surgical removal) and cataracts. Buy glasses that have a 99 to 100 percent UV protection rating. Polarizing is also valuable since it cuts down on irritating and vision-diminishing glare. Keep using sunscreen and sunglasses even on cloudy days. UVA rays penetrate through clouds (and even through transparent glass windows), even though you can’t feel them.

Lastly, give yourself periodic skin cancer exams a few times a year. A very common precancerous growth to watch for is actinic keratosis (AK), which typically occurs on the face, lips, ears, scalp, back, neck, hand-backs, and forearms. AKs usually appear as small, crusty scales or bumps. Coloration can be dark of skin-colored at the base, with red, pink, or tan blotching. AK on the lips can appear as chapping, with cracks and whitish coloring. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common skin cancers (more than a million cases each year in America). Although skin cancer is associated with older individuals, carcinomas are increasingly being found in twenty- to forty-year-olds. Most BCCs show in one of these forms: a shiny red, pink, or white bump; an open sore that bleeds or oozes for three or more weeks; a pink growth with an elevated border; a white, yellow, of waxy scar-like area with poorly defined borders, of a reddish patch that won’t heal. SCCs appear as thick, scaly patches, sometimes elevated, that might crust or bleed. The good news: according to The Skin Cancer Foundation, both types of carcinomas had a nearly 100 percent cure rate when detected and treated early.

The most dangerous and deadly skin cancer is melanoma, which afflicts more than 40,000 people and kills more than 7,000 annually in America. The acronym for self-exams is ABCDE. If you find a suspect mole of growth, look for A for Asymmetry. If you draw a line through the middle, the halves don’t match. B for Border Irregularity. Common moles have smooth, even borders; melanomas often ate uneven, scalloped and notched. C for Color Variability. Common moles are usually a single shade of brown. Melanomas contain different shades and color tones, possibly including black. As they progress, they may turn white, red, and blue. D for Diameter. Melanomas are larger than ordinary moles. Any growth the size of a pencil eraser or larger should be suspect. E for Evolving. Change or evolution in shape, size, color, elevation or “behavior” (bleeding, crusting, itching) indicates an abnormality.

See a dermatologist at the first sign of any of these cancers and precancers. Putting off diagnosis and treatment only increases the danger. For more information on the diseases, and to view images of various skin growths, visit The Skin Cancer Foundation at www.skincancer.org.

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