Sun Damage

If you are a sun worshiper, you probably share several characteristics with other sun worshipers. You like to look healthy. You like the outdoors. You have sun-damaged skin. You may also share an increased risk of skin cancer, the most common type of cancer. In order to avoid these risks, you do not have to give up the sun. But you do need to avoid overexposing your skin to the sun.

Over time, sun exposure causes skin to lose resilience, and develop blotches and “freckles” (solar lentigines), wrinkles, spider vessels, blackheads, coarse texture and yellow discoloration. Sun exposure also increases your risk of several types of skin cancer. For some people, the outer layer (or lens) of the eye also thickens in response to sun exposure and forms a cataract.

Sunlight consists of two types of harmful UV rays – UVA and UVB. The UVB rays are (which are blocked by window glass) are the primary cause of sunburn and skin cancer. UVA rays (which pass through window glass) penetrate deeper into the dermis, or base layer of the skin.

SUNSCREEN
The Sun Protection Factor (SPF) on a sunscreen measures its ability to block UVB rays, and help prevent sunburn. But a sunscreen’s SPF does not measure the amount of protection it provides from UVA rays, which can cause immunosuppression – or the weakening of the body’s ability to protect itself from cancer and other diseases. It is possible that even though a person is getting adequate UVB protection to prevent sunburn the UVA rays can still cause unseen damage that could cause immunosuppression and skin cancer. This may explain why some skin cancers, including melanoma, appear anywhere on the body – even places that are not directly exposed to the sun. Although “broad-spectrum” sunscreens offer some protection against UVA rays, it is seldom adequate to protect from immunosuppression. To supplement sunscreen, people should follow a sun protection program.

SUN DAMAGE AND SKIN CANCER
Too much sun at any one time can lead to sunburn, (a radiation burn). The redness, pain and swelling from sunburn are comparable to any other type of burn. In most cases, your discomfort (or pain) will be temporary. However, the long-term effects of multiple sunburns are cumulative. Even one, extensive sunburn after the age of 20 doubles a person’s risk of melanoma.

Another problem some sunbathers develop is sun poisoning, an allergic reaction to the UV light called polymorphous light eruption. Redness, bumps or blisters, itching, and burning on exposed skin develops two to five hours after exposure. Other symptoms may include; chills, headache, nausea, and aches. If this happens, the best thing you can do is avoid the sun. If you are using any type of skin product, taking medication or exposing yourself to the sun for long periods, altering your habits should lead to an improvement in your condition and allow you to continue to enjoy some sun exposure.

SUN TIPS YOU CAN COUNT ON

• To protect your skin from blotches, wrinkles and cancer, always use a sunscreen with a sun protection factor (SPF) of 15 or greater (the number will be on the label).
• If you have oily skin, choose an oil-free sunscreen.
• If you burn easily, freckle or have light hair and eyes, use a sunscreen with a higher SPF factor and reapply every hour if perspiring or swimming.
• Choose a PABA-free sunscreen if you are allergic to PABA (words like "PABA-free" will be on the label).
• Ask your care provider if any of your medications increase your skin's sensitivity to the sun. Some medications make you less tolerant of heat, as well.
• Your tan won't protect you from burning! Even if you already have a tan, use sunscreen to keep your skin even-toned, young-looking and safe.
• If you go swimming or perspire heavily, use a waterproof sunscreen. Don't forget to reapply sunscreen after swimming or perspiring heavily.
• Don't be fooled by cloudy skies - you should still apply sunscreen if you're outside. The sun can damage your skin even if it's not sunny out.
• For the best results, apply your sunscreen 20 minutes before going outside. You'll need to use about one ounce to cover your whole body.
• If possible, avoid being out in the sun between 10:00 a.m. and 4:00 p.m. Follow the “Shadow Rule” – if your shadow is shorter than you are, the sun’s damaging rays are at their strongest and you are most likely to sunburn.
• Drink plenty of fluids, particularly water, to help prevent heat exhaustion.
• When you're out in the sun, especially midday, wear light, protective clothing: wide-brimmed hats, jeans or pants and long-sleeved tops.
• Pre-tan accelerators, which stimulate your skin's tanning rate, are not sunscreens. There's no proof that they're safe.
• Tanning pills are definitely not safe. Some can turn your skin a sickly shade of yellow and damage your internal organs.
• Forget tanning booths! They can give you first- and second-degree burns - not to mention premature wrinkles, eye damage, harm to the immune system and cancer. Like natural sunlight, tanning salons can cause “polymorphous light eruption.” Fungal and other infection of the skin can be spread by tanning booths.
• Remember: It's never too late to help your skin stay healthy. No matter how many times you've been sunburned or tanned before, you can start fighting blotches, wrinkles and skin cancer by using a sunscreen now.
• Protect your eyes too: wear sunglasses with EPF 10+ (100% UV blockage).

TREATMENT FOR SUNBURN
If this information is too late to help you prevent sunburn, there are some strategies for helping you survive the crisis:

• If your burn hurts, soak it for five minutes in cold (not ice) water or apply cold compresses. This will provide immediate relief and lessen swelling.
• Avoid greasy substances. They "seal" in the heat and cause further damage.
• Avoid cooling lotions with menthol or camphor. They feel good, but can cause allergic reactions. First aid sprays with benzocaine can cause similar reactions and are not advised.
• If your entire body is tender, a cup of dry instant oatmeal in a tub of water can provide a soothing bath.
• If your sunburn causes blisters, swelling and oozing of fluid, it is a second degree burn. See a practitioner. Do not use lotions or creams on the burn. To avoid infection, do not break blisters or peel skin.
• Take a pain reliever of your choice, such as acetaminophen (Tylenol), for discomfort.
• Drink plenty of fluids. Your body will lose moisture due to your burn. Cool fluids will also help you feel more comfortable.
• If you are in need of evaluation for sunburn, call the Dial-A-Nurse at 333-2700 for an appointment.

References
American Academy of Family Physicians (1996). Revised January 2000
Clinical Guidelines in Family Practice, 3rd Ed. Uphold & Graham 1998.
American Cancer Society "Definitely a 15" brochure.
Anders, J.E. & Leach, E.E., (1983). Sun Versus Skin. American Journal of Nursing 83 (7) 1015-1020.
Warshauer, D.M. & Steinbaugh, J.R., (1983). Sunlight and Protection of the Skin. American Family Physician 27 96) 109-114.

You may also visit the American Academy of Family Physicians at: www.familydoctor.org

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