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Sun Sense

Nothing tempts people like a bright, sunny day. How often have you looked outside your window and wished you were at the park or at the beach? Despite all the good things that the sun does for people and the earth, being too “friendly” with the sun has its hazards too. This brochure covers some “SunSense” tips to help you enjoy the sun without contributing to health problems in the future.

The Sun
The sun can be good for you. It helps your body produce Vitamin D, which in turn, helps your body absorb calcium from the foods you eat and the vitamins you take. The sun can also help boost your mood — studies have shown that people living in areas that do not get a lot of sunlight (like Alaska during their winter season), have higher rates of depression.

In Hawaii, where there are mostly sunny skies, it’s tough to avoid the sun. Because of its proximity to the equator, its good weather, and outdoor activities, Hawaii residents are in the sun more than people in other states. People flock to the beach and to the park when skies are clear, often exposing themselves to the sun when the invisible ultraviolet (UV) rays are harshest and brightest.

UV, UVA and UVB Rays
The sun is brightest between 10 a.m. and 4 p.m. in Hawaii. During those hours, ultraviolet (UV) rays from the sun can do more damage than an earlier or later time of the day.

There are three types of UV rays – UVA, UVB and UVC; however, UVA and UVB rays are the types that can damage your skin. These rays stimulate your body’s production of melanin so that you have a tan, but they also penetrate the skin and cause short-term and long-term damage. A tan may fade, but the damage to your skin by UV rays doesn’t go away.

UVA rays can cause tanning, wrinkling and premature aging of your skin. Damage may not be as immediate as UVB rays, but the UVA rays can damage blood vessels and make you more susceptible to skin cancer.
UVB rays causes the skin to tan or turn red and burn. Exposure to UVB rays can result in sunburns and lead to skin cancer. Damage is immediate.
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Your Skin and How it Protects You
Your skin is your body’s armor. It protects you from infection and injury. It keeps blood and other life-giving fluids inside of your body. The skin regulates your body temperature — how hot or cold you are. When you jog or bike, for example, your skin perspires and your body loses heat from exercise so you feel cooler. Your skin stretches so you can bend and twist different parts of your body. The skin also serves as a warning system. Because it’s sensitive to touch, it lets your brain know how your body should respond to sensations. That’s why when something tickles you, you laugh. When something hurts, you instinctively back away from it.

You have two layers of skin. The top, or the thinner layer, is the epidermis. The lower, or thicker layer, is the dermis. Melanin, a pigment found in the epidermis, determines the color of your hair and your skin. The more melanin you have, the darker your skin and your ability to tan. People with small quantities of melanin will have fair skin and sunburn easily.

The effects of aging start becoming visible in your skin when you are in your 20s. Biochemical changes take place in collagen and elastin, the connective tissues that give skin its firmness and elasticity. Each person is genetically different so the loss of skin firmness and elasticity occurs at a different rate and time in each individual. As the skin becomes less elastic, it also becomes drier and underlying fat begins to disappear. Skin begins to sag, wrinkle and look less supple.

At the same time, the effect of chronic and excessive sun exposure on your skin will hasten the aging appearance of your skin. Cigarette smoking also contributes to aging effects because of the biochemical changes it causes in skin tissues.

More damaging to the skin than aging, however, are the ultraviolet (UV) rays of the sun. The more you expose your skin to the sun, the more rapidly your skin ages. If you are constantly in the sun and haven’t protected your skin, it’s a good bet your skin has aged prematurely — possibly as much as 15 to 20 years!

How the Sun Can Damage Your Skin
When the sun’s ultraviolet rays penetrate the skin’s inner layer, the skin produces more melanin as a response to the injury. A suntan is the result of an injury to the skin. Every time you tan, the damage to your skin accumulates. Skin cancer is the most common form of cancer in the United States. It is caused by too much sun exposure. Roughly one in seven people will develop skin cancer in his or her lifetime. In Hawaii, just about everyone is at risk whether you love to bask in the sun or not. The good news is that skin cancer is treatable and curable if caught in its early stages. That’s why it’s important to do regular self-exams. Your face, neck, ears forearms and hands are the most common areas where most cancers are found.

Basal cell carcinoma is the most common type of skin cancer. It seldom occurs in dark-skinned people, and it grows slowly and rarely spreads. Most of these skin cancers are found on the head and the neck. This type of cancer is curable when treated promptly.

Squamous cell carcinoma is generally found on fair-skinned people, especially on the ears, lips, mouth and face as small, round or irregular lumps or red scaly patches. This type of skin cancer rarely spreads but it can — unlike basal cell carcinoma. If treated early, there is a cure rate of 95 percent.

Malignant melanoma is the most dangerous type of skin cancer. Sunburn and, to some extent, heredity are contributing factors. It is most commonly found on the upper backs of men and women and the lower legs and chest of women.

Melanoma begins in melanocytes, the cells that produce melanin, and can spread to other parts of the body. It may begin suddenly in or near a mole and be dark brown or black with irregular edges. Sometimes the mole may turn red, blue or white. That’s why it is important to check the moles on your body for changes. If detected early and treated promptly, melanoma is always almost curable. If left untreated, melanoma can spread. The death rate from melanoma is declining because of early detection.

Precancerous Spots
If you’ve been in the sun a lot, and especially if you’re fair skinned, you may develop actinic keratosis. These are small, precancerous scaly spots on your face and hands. Left untreated, these spots could develop into skin cancer. If diagnosed early, a dermatologist can treat the precancerous spots in the office with cryosurgery, using liquid nitrogen to “freeze” and kill the abnormal cells.

Take a Self-Exam
Eighty percent of skin cancers are found on the face, head and neck. But skin cancers can also be found in places we forget are exposed to the sun — like between your toes or on the soles of your feet. Here’s how to do a monthly self-exam:

   • Do a monthly self-exam after a bath.
   • In a well-lighted room, use a full-length mirror and a hand mirror to examine the front, back and left and right sides of your body.
   • Look under arms, on forearms, on the backs of hands and on palms.
   • Check the backs of your legs and your buttocks. Examine feet, including toes and soles.
   • Part your hair and examine your scalp, also the back of your neck.
   • Look for red patches on your skin and sores that don’t heal.
   • Check moles and note any changes in color, shape, border, sensation, surface or size. If you notice any change, see your doctor or dermatologist immediately.

How We Burn
Several factors, including skin type and how much time you spend in the sun, affect how you burn or tan. Generally, how quickly your skin burns follows this scale:

Type I: Extremely sensitive, always burns, never tans.
Type II: Very sensitive, burns easily, tans very little.
Type III: Sensitive, burns moderately, tans gradually.
Type IV: Minimally sensitive, rarely burns, tans easily.
Type V: Not sensitive, never burns.

The risk that you’ll develop skin cancer is higher if:

   • You are fair skinned, have red or blond hair, and blue, green or gray eyes.
   • You sunburn easily and you don’t usually tan.
   • You had severe sunburns when you were young.
   • One of your immediate family members had skin cancer.
   • You’re regularly in the sun because of work or play.
   • You live where there is year-round sunshine like Hawaii or the southwestern areas of the United States.

Protect Your Skin
There is no known safe way to tan. If possible, avoid exposure to the sun between 10 a.m. and 4 p.m. Schedule outdoor activities for the early morning or evening, e.g. jog first thing in the morning instead of the early afternoon.

Avoid tanning booths. Exposure in these booths can cause eye damage, sunburns, skin cancer and premature aging of the skin.

The Skin Cancer Foundation recommends that you use a sunscreen of SPF 15 or higher whenever you are outdoors – including times when you go shopping, do gardening or even waiting for a bus.

Sunscreen and Sunblock Lotions
Sunscreens chemically absorb UV rays. Sunblocks physically deflect UV rays. These lotions do not offer total protection from the sun. However, sunscreens can decrease the damage ultraviolet light does to your skin. Use a waterproof sunscreen (gel, cream or lotion) with the proper skin protection factor (SPF) for your skin type. The Food and Drug Administration suggests that you buy a broad spectrum sunscreen with an SPF up to 30. After that, the extra benefit is quite small and provides a false sense of security. The SPF is a rating that measures the amount of extra time your skin can be in the sun before it starts getting red. It’s based on your own skin type, so if you get red after 10 minutes without sunscreen in the tropical sun, a sunscreen with an SPF of 15 means you can stay in the sun for 150 minutes, or 15 times your usual sun exposure, before you start to burn. Keep in mind that applying a second dose of sunscreen won’t enable you to stay out an extra minute — the dose isn’t cumulative.

SPF provides protection from UVB rays but not UVA rays. Make sure the label says the lotion is designed to protect against both UVA and UVB rays. Look for zinc oxide or titanium dioxide among the ingredients. These are inert, opaque compounds that block almost the entire spectrum of damaging rays without exposing you to the irritating effects of chemicals such as PABA (para-aminobenzoic acid) or oxybenzone.

Most people don’t use enough sunscreen. Slather on the equivalent of a shot glass full over the exposed parts of your body. About a half teaspoon of sunscreen should do for your face and neck. Be sure to put sunscreen on your ears, around your eyes, hands, feet and even on your scalp if your hair is thinning. Also remember to put the sunblock on a half hour before you go out. It takes about that long before it will protect you fully. Even if your sunscreen is waterproof, reapply it after being in the water or if you have been perspiring a lot.

Go Undercover
If you are at the park or the beach, one of the easiest things you can do to protect yourself from the sun is to stay in the shade of a nice big tree. The sun’s rays can still reach you if you are in the shade because it can reflect off surfaces such as sand and water, so it is still important to wear sunscreen.

In addition to wearing sunscreen, wear a hat with a large brim when you are going to be out in the sun. The brim of the hat will help to shade your face and your shoulders. Baseball caps and visors only shade your face and leave your neck, lower face and ears exposed to the sun. Clothing does protect you from the sun somewhat, and there are companies that make clothing to specifically block out UV rays and gives you an SPF of about 30.

Your eyes also need protection too, no matter what color they are. Studies have shown that in regions with mostly sunny skies, people are more likely to develop cataracts. To protect your eyes, get in the habit of wearing dark glasses. Select a pair that protects against UV rays. And if you surf, don’t paddle out without a pair of goggles that screen out UV rays.

Don’t forget about your lips. Wear a lip balm with SPF to help protect your lips.

Babies and young children have tender skin that’s more sensitive to the sun than adult skin. They need sunscreen protection at the playground, in the stroller and at the beach. Severe sunburn at a young age contributes to the possibility of skin cancer occurring before you’re 20 years old. Sunglasses are available for children.

A creamier sunscreen may be gentler on young skin or a sunscreen that comes in stick form might be easier to apply.

Are You Allergic to Sunscreen?
Some people are allergic to PABA-based sunscreen. PABA is a chemical commonly found in sunscreens. If sunscreens irritate your skin, ask your doctor or dermatologist to recommend a sunscreen that uses a PABA substitute.

Did You Know?
   • You can get a sunburn on a cloudy day or by being in the water.
   • UV rays penetrate clouds.
   • UV rays penetrate water.
   • Some medications - such as antibiotics and acne medication - may make your skin more sensitive to the sun.
   • It’s easier to get a sunburn at the beach because fewer buildings and trees block out the sun, the atmosphere overhead is clearer and the sand reflects UV rays.
   • Your skin is the largest organ in your body.
   • The skin of the average adult weights about six to 10 pounds.
   • Your skin is thinnest on your eyelids. It is thickest on the palm of your hands and soles of your feet.

What to Do for a Sunburn
   • Take a cool bath or shower.
   • Drink lots of liquids, especially water and juice.
   • Apply cool compresses.
   • If you develop nausea, fever, pain, or blistering, call your doctor.

At the Beach
   • Evenly apply waterproof sunscreen with an SPF of 30, especially when you are unable to avoid the sun.
   • Apply a waterproof sunblock like zinc oxide to your nose and lips.
   • Re-apply sunscreen and sunblock after being in the water or doing strenuous exercise that causes you to perspire.
   • Wear dark glasses that screen out UV rays if you read or sit in the sun.
   • Avoid the sun between 10 a.m. and 4 p.m. when the UV rays are most intense.
   • Remember that wearing sunscreen in not an excuse for staying out in the sun for a long time.

For more information about protecting yourself from the sun, talk to your physician or dermatologist

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