By Gino C. Bottino, M.D.Although it’s winter, I’d rather talk about the sunny boating season to come.
At the turn of the 20th century, people endeavored never to be exposed to the sun (especially women), and doctors recommended sunbathing for good health. After World War II, sunbathing and deep tanning became popular and remain so today.
Medically speaking, although some sun exposure is required for good health, getting a suntan is not. Anyone who spends time on or near the water gets plenty of sun without sunbathing. As a doctor, I believe sunbathing is almost as bad for you as smoking and should be totally avoided.
Sunburn and its after-effects
Let’s look at the damage caused by the sun’s radiant energy (radiation). Sunburn is a radiation, not heat, burn. It’s the acute (rapid) damage caused by the sun’s rays striking the skin. Sunburn isn’t the most dangerous aspect of the sun’s energy or the one that most concerns doctors, but it can be serious, and precautions are in order.
Long-term effects of the sun’s radiation include rapid skin aging with loss of elasticity and wrinkle formation, sun-induced skin diseases (non-tumorous) such as multiple nevi (moles), and keratotic lesions (sunspots) and rashes, including malignant and non-malignant skin cancers.
Assessing your risk
Although everyone is susceptible to sun damage, not everyone is equally susceptible. The Skin Cancer Foundation and Harvard Medical School classify resistance to sun exposure into six basic skin types. Check the table below to determine your skin type and level of risk.
According to the American Academy of Dermatology Association, more than 3.4 million Americans will be diagnosed with some form of skin cancer in 2019. The number of skin cancer cases doubled from 1982 to 2011 and continues to rise.
If you want to avoid being one of the millions afflicted by skin cancer, act now. Reduce Earth’s exposure to ozone-depleting materials and practice good sunscreen techniques, including using sunscreen every day and wearing protective clothing when prolonged sun exposure is likely. By taking these simple precautions, you can reduce or even eliminate your risk of skin cancer.
Different sunscreens for different folks
The most important recent change in sunscreen is the formulation of products to block ultraviolet radiation type A. Since UVA rays do not cause sunburn, most older sunscreen formulations only blocked sunburn causing UVB rays. Now, we know that UVA contributes significantly to skin damage and skin cancer.
A sunscreen’s sun protection factor (SPF) refers only to the product’s ability to block UVB radiation. The SPF number on the sunscreen’s label tells you only how much longer you can remain in the sun with the sunscreen on than you could without it. For example, an SPF of 15 will allow you to be in the sun without turning red 15 times longer than your normal unprotected “MED,” or minimal erythemal dose, the measure of the sun’s energy it takes for your skin to turn red. Refer to the chart to determine your MED.
To achieve UVA protection, you must check that your sunscreen contains one or more of the following additives: benzophenone, oxybenzone, sulisobenzone, titanium dioxide, zinc oxide or avobenzone, a sunscreen chemical recently approved by the Food and Drug Administration and sold under the brand name Parsol 1789.
In the past, the government recommended an SPF of 15, which would allow a fair-skinned American five hours of protection between the hours of 10 a.m. and 3 p.m. With the depletion of the ozone layer, it’s probably advisable to use an even higher SPF. If you are fair-skinned, use a SPF of 30 that includes one of the UVA protectants.
It’s important to note that sunscreen use can cause side effects such as skin irritation and rash. Para-aminobenzoic acid (PABA) can be very irritating, especially to children. You may need to carry one sunscreen for adults and one for children and others with sensitive skin. Sunscreen washes off with sweating and swimming, so try a waterproof formulation and remember to apply frequently.
Once the damage has been done
Once skin damage has occurred, you can treat the skin with Retin-A cream to minimize wrinkles, age spots and keratotic lesions. It can also treat and help prevent recurrent skin cancers. However, the standard treatment for limited skin cancers and lesions is removal, either by surgery or freezing.
Doctors may prescribe a chemotherapy cream called 5-fluorouracil (5-fu). All treatments require a doctor’s prescription and supervision.
Other over-the-counter treatments with fruit acids and the like may be beneficial for decreasing skin damage. Products like Solarcaine will help with the sting of the burn, as will the old folk remedy of a vinegar and salt solution applied to the burn. If the burn blisters or the skin is broken, do not use either of these treatments as they will greatly irritate the burned skin. Burns that blister should be considered a medical problem and should be treated as such.
A little color is certainly not worth all the medical risks involved. Remember, sun exposure is cumulative. Should you develop a skin cancer or sun-damaged skin, the risks of any further sun exposure could be deadly, which would really put a damper on your recreational pursuits. So, play it safe, and put on sun protection.
Gino Bottino, M.D., has had wide experience in medical practice and emergency medical matters. A member of United States Power Squadrons First Aid Support Team (FAST) and the Safety Committee, Gino also has a background in competitive sail racing and is familiar with health-related problems afloat.
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