Sun Safe:

An­swers to your burn­ing ques­tions about sun safety, with ex­pert tips on UV ex­po­sure and re­duc­ing the risk of skin can­cer, plus sun­screen mis­takes to avoid.

Expat Living (Singapore) - - Contents - BY AMY GREEN­BURG

The right way to pro­tect your skin

Sure, we love the golden glow achieved from bak­ing by the pool, but is it re­ally worth the long-term risks? Wrin­kles aside, sun dam­age can rear its ugly head in the form of skin can­cer, in­clud­ing non-me­lanoma and me­lanoma. The World Health Or­ga­ni­za­tion (WHO) es­ti­mates that be­tween two and three mil­lion cases of non-me­lanoma skin can­cer and 132,000 cases of me­lanoma oc­cur glob­ally each year. The Skin Can­cer Foun­da­tion (SCF), mean­while, as­serts that the num­ber of peo­ple who de­velop can­cer be­cause of tan­ning is greater than the num­ber of peo­ple who de­velop lung can­cer be­cause of smok­ing. One is­sue is ozone de­ple­tion; when the at­mos­phere loses more of its pro­tec­tive fil­ter func­tion, it causes more so­lar UV ra­di­a­tion to reach the Earth’s sur­face, ac­cord­ing to WHO.

So, how can we help pro­tect our­selves? Der­ma­tol­o­gist DR LIM KAR SENG sheds some light on the risk fac­tors of skin can­cer and shares his top tips on safe sun ex­po­sure.

Is there a safe way to get a tan?

Not quite. But lim­it­ing one’s sun ex­po­sure time, as well as us­ing a good broad-spec­trum sun­block, can help pre­vent skin can­cer for­ma­tion.

Which sunscreens would you rec­om­mend?

A broad-spec­trum sun­block that is at least SPF30 and above. It’s even more im­por­tant to en­sure that ad­e­quate amounts are ap­plied. In in­di­vid­u­als with sen­si­tive skin, opt for the “phys­i­cal sun­blocks” (as op­posed to “chem­i­cal sun­blocks”), as this will min­imise skin ir­ri­ta­tion. Most phar­ma­cists will be able to point you to the ones with the least amount of chem­i­cal sun pro­tec­tion in­gre­di­ents. When in doubt, the kids range of sun­block is usu­ally “phys­i­cal sun­block.”

Is it pos­si­ble to de­velop skin can­cer if your skin doesn’t burn?

Yes, a skin can­cer can most def­i­nitely oc­cur even on skin that isn’t exposed to the sun.

What are the key risk fac­tors for skin can­cer?

The main fac­tors are sun ex­po­sure and ul­tra­vi­o­let light. Ul­tra­vi­o­let ra­di­a­tion is di­vided into three cat­e­gories: UVA, UVB and UVC; both UVB and UVC are more car­cino­genic and put peo­ple at a higher risk of skin can­cer. For­tu­nately, UVC is fil­tered out by the ozone layer and min­i­mal amounts reach the earth’s sur­face.

A weak im­mune sys­tem, and med­i­ca­tions that sup­press the im­mune sys­tem, can also in­crease the risk of skin can­cer. Ad­di­tion­ally, fam­ily his­tory plays a role, as does skin colour and fair­ness of com­plex­ion, along with the area of the world, or lat­i­tude, in which an in­di­vid­ual lives.

What are some of the most com­mon types of skin can­cer?

Non-me­lanoma skin can­cers are those that arise from the skin, but not from melanocytes – cells that give us our pig­ment. The most com­mon type is basal cell car­ci­noma, while other non-me­lanoma skin can­cers in­clude squa­mous cell car­ci­noma and Bowen’s dis­ease. Me­lanoma, a type of a skin can­cer de­rived from melanocytes, is the most ag­gres­sive of skin can­cers, and may be lethal. For­tu­nately, me­lanoma is not as com­mon as other forms of skin can­cer.

What pre­ven­ta­tive mea­sures can be taken to re­duce the risk of skin can­cer?

I’d sug­gest avoid­ing ex­ces­sive sun­light as much as pos­si­ble; in fact, I’d limit di­rect sun ex­po­sure to no more than 30 min­utes. And, avoid the “dan­ger times”, from 9am un­til about 5pm when the UV in­dex is the high­est.

The most com­mon ar­eas on the body that de­velop skin can­cers are the head and neck re­gion, the back of the hands, the legs and the scalp – par­tic­u­larly in bald or bald­ing in­di­vid­u­als; that be­ing said, min­imis­ing sun ex­po­sure to these ar­eas is im­por­tant. Broad-spec­trum sun­block of at least SPF30 should be used, and, if wa­ter ac­tiv­i­ties or ex­ces­sive sweat­ing are in­volved, then re-applying af­ter 1.5 hours would be ad­vised.

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#1 You only wear sun­screen at the pool

Lim­it­ing your ap­pli­ca­tion to the pool is a no-no; it’s im­por­tant to wear sun­block on a daily ba­sis, no mat­ter where you are or what you’re do­ing – even on a cloudy day! Tip: If you drive, put ex­tra cream on your exposed arm.

#2 You only ap­ply it once

Many peo­ple ap­ply sun­screen just once and con­sider it done for the day. How­ever, even the sweat-proof, so-called “wa­ter­proof” and lon­glast­ing sunscreens wear off from per­spir­ing and swimming. It’s best to ap­ply the first batch at least 30 min­utes prior to go­ing out­side, so it can ab­sorb into your skin. Then, reap­ply ev­ery one to two hours, or im­me­di­ately af­ter you swim or sweat ex­ces­sively.

#3 You don’t wear enough

Ac­cord­ing to SCF, applying one ounce (two ta­ble­spoons) of sun­screen will en­sure that you’re prop­erly cov­ered for one to two hours.

#4 You for­get about your lips

The skin on your lips is thin, which means they’re par­tic­u­larly vul­ner­a­ble to sun dam­age. In fact, the lower lip is one of the most com­mon sites for squa­mous-cell car­ci­noma to set in, ac­cord­ing to the SCF. Al­ways use lip balm with an SPF of 30 or higher, and keep reap­ply­ing through­out the day.

#5 You only rely on sun­screen for pro­tec­tion

No sun­screen com­pletely blocks UV ra­di­a­tion, so it’s vi­tal to dress de­fen­sively, in ad­di­tion to wear­ing sun­block. Tightly wo­ven, loose fit­ting clothes can pro­vide some pro­tec­tion, while a wide-brim hat can help shield your face and neck.

And, don’t for­get sun­glasses! It’s im­por­tant to choose sun­glasses la­belled with a UVA/UVB rat­ing of 100 per­cent to get the most pro­tec­tion. Also, ac­cord­ing to the US Food and Drug Ad­min­is­tra­tion (FDA), the dark­ness of the lens doesn’t in­di­cate its abil­ity to shield your eyes from UV rays.

Ev­i­dence sug­gests that child­hood sun ex­po­sure con­trib­utes sig­nif­i­cantly to one’s life­time risk of skin can­cer. Thus, Can­cer Coun­cil Aus­tralia rec­om­mends keep­ing ba­bies out of the sun as much as pos­si­ble for the first 12 months.

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