How to Save Yourself from Skin Cancer
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How to Save Yourself from Skin Cancer

The latest news on sunscreen ingredients, SPFs, melanoma warning signs, and more.

How Sun Damage Happens

If you're using sunscreen every day, congratulations -- you're doing your skin a huge favor. But if you're like the vast majority of us who haven't quite been able to make slathering it on a regular habit, consider putting a bottle of the stuff in the medicine cabinet right next to your toothpaste. "Applying sunscreen should be as automatic as brushing your teeth," says Sandra Read, MD, an instructor of dermatology at Georgetown University and spokesperson for the American Academy of Dermatology (AAD).

Here's why: More than 1 million new skin-cancer cases will be diagnosed in the United States this year, 90 percent of them sun-related. Using sunscreen only when you go to the beach or work in the garden leaves you vulnerable to a huge amount of day-to-day sun exposure. "The good news is that wearing sunscreen every day and taking other sun-protective measures helps prevent both skin cancer and cosmetic changes -- dryness, wrinkles, and irregular pigmentation," notes Dr. Read. Protect your skin, starting today.

Sunlight contains two types of harmful rays -- ultra violet A (UVA) and ultraviolet B (UVB). UVA rays cause wrinkling and premature aging; UVB rays are responsible for sunburn. (Remember: "A" for aging, "B" for burning.) Both cause skin cancer, but damage from UVA is sneaky. "Even when these rays have severely harmed the skin, signs don't show up right away," says Dr. Read.

When UVA and UVB rays penetrate the skin, they alter the DNA that controls cell growth and division. Too much damage can cause cancer. UVA rays also weaken the elastic fibers and harm the collagen that keeps skin smooth and youthful, says Dr. Read . It's UVA that causes dark-pigmented "age" spots.

The newest generation of sunscreens guards against both types of UV rays, not just UVB, as used to be the case. Look for UVA-blocking chemicals, such as Mexoryl (in L'Oreal and La Roche-Posay sunscreens) and Helioplex (from Neutrogena). It's never too late to start. "The skin has a natural repair process," explains dermatologist David J. Leffell, MD, professor of dermatology and surgery at Yale University. "If you keep it protected, you'll repair some of the damage."

8 Burning Questions

1. Am I using enough sunscreen?
Typically, people don't use the sunscreen amount they need to get the SPF protection promised on the label, according to a study in the Archives of Dermatology. One ounce -- enough to fill a shot glass -- is the minimum amount you supposedly need to cover your face and body at the beach. "But unless you're a very petite woman, you should use two ounces," says Dr. Read. Be sure to reapply at least every two hours and right after you swim or perspire heavily.

2. Should I apply sunscreen even if I'm just running errands?
Yes. Little bursts of sun can add up to big-time damage. "Think of sun exposure as cumulative," says Amanda Jacobs, MD, a dermatologist at the Mayo Clinic.

3. Do I need sunscreen on a cloudy day?
Yes. Up to 80 percent of the sun's UVA and UVB rays can pass through clouds.

4. Does an SPF 30 sunscreen protect much better than a 15?
It doesn't provide twice the screening power. "You'll get 3 to 4 percent more protection with SPF 30 compared to SPF 15," says Dr. Leffell. Above 30, higher numbers will give you even less additional benefit. However, if you skimped on how much you applied, a higher SPF may add a little extra insurance.

5. Which is better -- a spray or a cream?
Used correctly, they're about equal. "It's best to spray on one coat and then respray," says Allan C. Halpern, MD, chief of dermatology at the Memorial Sloan-Kettering Cancer Center. It's easier to cover hard-to-reach places with a spray, and sprays have a lighter feel. Creams are often greasier, so it's easier to tell if you've skipped a spot.

6. My moisturizer has SPF 15. Do I need to wear sunscreen, too?
Experts don't agree. "If you're just going back and forth to your car, your moisturizer should be sufficient," says Dr. Leffell. But Dr. Jacobs thinks using sunscreen under moisturizer is a better daily habit. "You'd have to really slather on your moisturizer to get adequate SPF protection," she says. And if you're at the beach or pool, you definitely need to use sunscreen.

7. Do some ingredients work better?
Two of the most effective ingredients are zinc oxide and titanium dioxide, compounds that physically block UVA and UVB radiation from penetrating your skin. They sometimes last longer than two hours -- what you get from a typical sunscreen -- but older formulas leave a chalky residue on the skin (if you were a lifeguard growing up, you may remember covering your nose with white zinc oxide cream). Most sunscreens rely on lighter-weight chemicals that act by absorbing and dissipating harmful radiation.

Is it considered safe to use sunscreen around my eyes?
Yes, says Dr. Halpern, but if it gets into your eyes it will burn. Products for babies or kids may sting less; washing your fingers after applying sunscreen will help if you accidentally rub your eyes.

Detecting Skin Cancer

In the past 30 years, the incidence of basal cell carcinoma tripled in women under age 40; squamous cell carcinomas have quadrupled and melanoma has doubled. All are highly treatable if found early. Check your skin monthly.

What basal cell carcinoma looks like: Pink or red patch; or shiny pink, red, or white bump.




What squamous cell carcinoma looks like: A scaly pink or red patch or raised warty growth.




What melanoma looks like: Tan, brown, black, or multicolored patch, often with an irregular edge.

IS IT A MOLE OR MELANOMA?
Doctors use the following guidelines for diagnosis:
A - ASYMMETRY Half of mole does not match other half.
B - BORDER Edges are irregular or scalloped.
C - COLOR Entire mole is not the same color.
D - DIAMETER Mole is over 1/4 inch in diameter.
E - EVOLVING Look of mole changed over time.

I Can Get Sun Damage There?

You've taken all the right precautions. You think you're safe. Here are some instances in which that may not be true.

Sitting in or near a sunny window. While UVB rays usually can't penetrate glass, UVA rays (the wrinkle-causing ones) can sail right through. "If your furniture and carpet are getting bleached by the sun, UVA rays are the culprit," says Dr. Halpern.
Fix: Wear SPF 30 or block the sun with opaque drapes, shades, or blinds.

Having a picnic under a shady tree. If a tree screens out 90 percent of the sky, its shade is only equivalent to wearing an SPF 10 sunscreen, according to Purdue University researchers.
Fix: Find a totally shady spot in the shadow of a wall or under a tree where no sun seeps through.

Driving, even with car windows closed. A 2007 Saint Louis University study found that drivers who spent a lot of time in their car without wearing sunscreen had higher rates of skin cancer on sun-exposed areas, such as the left side of their face and neck and their left arm and hand. While front windows are made of glass that filters out UVB and most UVA rays, typically side and rear windows (except some tinted ones) aren't.
Fix: Keep broad-spectrum sunscreen in your glove compartment and apply it before you drive.

Lounging under a beach umbrella. Beach sand reflects 25 percent of the sun that hits it. "UV rays can bounce off the sand and find you under the umbrella," says Dr. Halpern.
Fix: You still need SPF 30+ sunscreen.

Watching a softball game protected by a long-sleeve shirt. A lightweight white T-shirt gives you protection equivalent to SPF 4; a dark, tightly woven one raises the coverage to 10.
Fix: Invest in clothing that's been pretreated with sun blockers or save money (sunscreen garments can be pricey) by washing several long-sleeve shirts and long pants in an SPF laundry additive. Or just apply sunscreen to your arms before dressing. And remember to wear a hat.

More Sun-Savvy Tips

May Is National Melanoma/Skin Cancer Detection and Prevention Month
The American Academy of Dermatology is partnering with dermatologists across the country to offer free skin-cancer screenings. To find one near you, log on to aad.org/public/exams/screenings.

Sight Savers
Long hours in the sun sans protection may contribute to cataracts and macular degeneration, according to the American Academy of Ophthalmology (AAO). "A hat with a brim will prevent up to 50 percent of UV rays from reaching the eyes," says AAO spokes man Stuart R. Dankner, MD, assistant clinical professor of ophthalmology at Johns Hopkins Medical Center. Use sunglasses rated to block at least 99 percent of UVA and UVB rays (both types penetrate some plastic lenses).

Don't Go There
Research shows that the UVA rays you get at a tanning salon are three times more powerful than rays from natural summer sunshine.

Chemical Controversy
A recent report produced by the Environmental Working Group questioned the safety of the sunscreen ingredient oxybenzone. Some dermatologists dispute the research behind it. "While laboratory studies of individual chemicals have raised some concerns, it's important that we rely on solid science and clinical testing," says Sloan-Kettering's Dr. Halpern. Translation? Nothing we know yet is solid enough to challenge the pluses of using sunscreen. The new label guidelines being prepared by the FDA should give consumers more information about the safety and effectiveness of each product.

 

Originally published in Ladies' Home Journal, May 2009.

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