It’s Skin Cancer Awareness Month, and I thought it best to highlight this topic here on the blog. Whether you’re looking at it from a preventative side or know someone who’s survived it, this is dedicated entirely to you. I’ve included quotes from various dermatologists as well as links to reputable sources, including skincancer.org and the American Cancer Society, so please know that I take this very seriously. My intention is to give you quality, trustworthy information. And on that note, let’s just dive into it. Shall we?

The Sun Factor

Many people are downright terrified of the sun. There’s a growing disdain for it, that, in my opinion, needs to be reevaluated. According to Dr. Robert S. Stern, chair of the Department of Dermatology from Harvard-affiliated Beth Israel Deaconess Medical Center, these are “solar-phobes”, further elaborating that, “They cover up like they were going out into the Arabian Desert.” [1] Clearly, there’s a growing mistrust of the sun. But why is it so? Aside from being a major contributor to skin cancer, it’s also been known to cause premature aging (i.e., wrinkles), sun spots, and moles. This is all due to its Ultra Violet (UV) rays that come in two forms: UVA, , and UVB, which have long, penetrating wavelengths that age the skin by damaging cell membranes and DNA, and UVB, which have shorter wavelengths that burn the skin while damaging DNA and suppressing skin cell immunity. [1] No matter which one is strongest, we still lose in end, since both UVs are known to cause skin cancer.
Before we throw the baby out with the bathwater and turn into hermits, we must give sunlight a fair chance. There are known benefits to sunlight:

• Seasonal Affective Disorder: Ever noticed a shift in your mood once the weather starts cooling down? They don’t call it the winter blues for nothing. Seasonal Affective Disorder (SAD) is a known type of depression that is triggered by the onset of weather changes, particularly whenever sunlight exposure starts to wane. The solution? A little bit of morning sun exposure whenever possible usually does the trick. With the alternative being artificial light boxes. In Canada, this “light therapy” has 60-90% effectiveness in most SAD cases. [2] Real or fake, it goes to show that light plays a role in our mood.
• Vitamin D: It should be common knowledge that outside a limited number of animal foods and supplements, the best “source” of Vitamin D comes from direct exposure to the sun. Vitamin D is important for a number of reasons, from immune to hormone health. Furthermore, we need adequate Vitamin D in order to maintain healthy, strong bones. Low levels of this essential vitamin have been linked to bone-deteriorating conditions, such as osteoporosis and osteomalacia. [3] Researchers estimate that 10-20 minutes of direct exposure is sufficient, at least during the spring and summer seasons, with the winter months demanding nearly two hours (in this case, supplementation would be a necessity). [4]
• Circadian Rhythm: Our circadian rhythm (or internal alarm clock) runs on a 24-hour cycle that is highly responsive to our habits, sleep, hormones, and level of exercise. Jet lag is notorious for disrupting our circadian rhythm as it puts us off our normal sleeping and waking times. Luckily though, there is a way to maintain or reset circadian rhythm, and it has to do with our good friend the sun. In the evening, you should start dimming the lights in your house and avoid going outside. But in the morning, it’s very important that you get as much sun as you can. These light cues help to accumulate your body to whatever location you’re in, helping you to optimize sleep, energy, and hormone production. [5]

Without a doubt, there is a benefit to sunlight. The problem is that we’re focused on extremes: excessive exposure and ignoring to use common sense with proper protection is definitely going to lead to serious problems, skin cancer being one of them. However, there are other causes of it:

• UV Tanning Beds
• Genetics
• Age
• Chemical exposure
• Repeated X-Ray use

The risk of developing skin cancer is even greater in these instances:

• Familial history of skin cancer or melanoma
• Fair skin, more so if there are freckles and several moles
• Blue or green eyes and natural blonde, red or light brown hair
• Living in tropical or subtropical climates or high altitudes, which is where UV strength increases
• Frequent time spent outdoors
• Medical conditions associated with low immunity or autoimmune disease (HIV, lupus, etc.)
• Organ transplant
• Medications that increase skin sensitivity
• Using exfoliating skin care products (retinol, peels, acids, etc.)
• Having a past skin cancer diagnosis
[6] [7]

Another overlooked risk of skin cancer development? Driving. By which I mean ignoring to load up on sunscreen even though you’re on the road. Research published by the Journal of the American Academy of Dermatology found that over 82% of skin cancers were discovered on the necks and backs of patients; 53% of which occurred on the left (or driver’s) side of the body. [8] Yet another misconception is believing that you don’t need protection even when it’s cloudy or overcast. That couldn’t be further from the truth! In fact, most UV rays can pass through clouds- nearly 80%. [9] So, rain or shine, be ready to arm yourself!

A Note on UV Rays and Darker Skin Types

I must also share another aspect of sunlight protection that has to do with darker skin. Research (as recent as 2016) published in the Journal of the American Academy of Dermatology shows that skin cancer is actually deadlier in people of color. These patients are the most likely to receive a diagnosis of later-stage melanoma while simultaneously having the worst prognosis and lowest overall rate of survival. As cautioned by senior vice president of the Skin Cancer Foundation Maritza I. Perez, MD, “Remember, ethnicity does not define skin type. It can represent a wide range of skin tones with a wide range of risks.” [10] No matter the color of your skin, please remember to exercise caution and use your sunscreen! Additionally, it would be prudent to stay on top of regular skin check-ups, particularly if you have a familial history of skin cancer or have an assortment of moles or sunspots.

What About Tanning Beds?

You might have noticed that tanning beds were mentioned earlier as a potential cause of skin cancer. Despite staying out of the sun, you’re ironically receiving an intimate dose of harmful UVA rays. Dermatologist Lisa Chipps, MD, further elaborates, stating, “First, ultraviolet radiation, whether from the sun or from a tanning bed, is a carcinogen, just like cigarettes are a carcinogen. And just as there’s no safe amount of smoking, you can’t get a little safe suntan. The damage it does, even if it’s just a bit here and there, adds up over time and contributes to overall aging as well as skin cancer.
Tanning beds are not safer than lying out in the sun. In fact, people who have ever used a tanning bed have a 67% increased risk of developing squamous cell carcinoma and a 29% increased risk of developing basal cell carcinoma. People who first use a tanning bed before age 35 increase their risk off melanoma by 75%. Melanoma is very prevalent in women in their early 220s, and a lot of that is attributed to tanning bed use. That’s one of the reasons many states have restricted their use for minors.” [11] [12]
A safer alternative would be investing in self-tanning products. I know there’s nothing like a good tan, however, the risks far outweigh any benefits.

Sun Protection 101

We’re at the tail end of the post guys- hang in there! I’m going to offer a list of measures that can be taken for optimizing your sun protection in bullet format; hopefully, all of this information is enough for you to take away!

• Use sunscreen with an SPF of 15 or higher and reapply every two hours (if your skin is sensitive, mineral based is often better)
• If you’re sweating or swimming, go for one with an SPF of 30 or higher and reapply either after swimming or every two hours
• Be sure to read the expiration date on your sunscreen; it loses its effectiveness over time, so if it’s already expired, toss it and get a new one
• Cover up your neck, décolleté, and arms, especially when driving
• Be cautious near water, snow, and sand; all reflect the sun’s rays
• Stick to shady areas, especially between 10 AM and 4 PMs
• Invest in transparent window film for your car
• Use UVA protective sunglasses
• Wear a wide-brimmed sunhat
• Cover up with loose fitting clothing
• Get a yearly examination by a dermatologist to check for any suspicious bumps, marks, and discolorations

Sources:

[1] https://www.health.harvard.edu/diseases-and-conditions/benefits-of-moderate-sun-exposure
[2] https://www.webmd.com/depression/features/sunshine-for-sad-sufferers#1
[3] https://www.healthline.com/health/osteoporosis
[4] https://www.sciencedaily.com/releases/2017/03/170308083938.htm
[5] https://www.sleepfoundation.org/articles/can-you-change-your-circadian-rhythm
[6] https://www.cancer.org/cancer/skin-cancer/prevention-and-early-detection/sun-damage.html
[7] https://www.wellandgood.com/good-looks/sun-sensitizing-ingredients-increase-sun-burn/
[8] https://www.skincancer.org/prevention/sun-protection/shade/sun-safety-cars
[9] https://www.nrcs.usda.gov/wps/portal/nrcs/detail/ks/people/employees/?cid=nrcs142p2_033306
[10] https://www.skincancer.org/prevention/skin-cancer-and-skin-of-color
[11] https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent
[12] https://blog.skincancer.org/2017/06/02/ask-expert-just-little-tan/?utm_source=skincancer.org&utm_campaign=blog
[13] https://www.skincancer.org/prevention/sun-protection/prevention-guidelines
[14] – https://blog.skincancer.org/2018/06/06/sunscreen-safety/