Preventing Skin Cancer

Everyday Steps to Sun Safety

Published on December 2, 2011

Most people like to get a little sun. Its warmth and light can relax us and boost our spirits. But the benefits come with a dangerous tradeoff. Each year more than 3.5 million cases of skin cancer are diagnosed in the US, over 90 percent of which are caused by the sun's ultraviolet rays (UVR). Similarly, most of the skin damage we associate with aging - wrinkles, sagging, leathering, and discoloration - is UVR-related. This damage is cumulative. So, whenever you venture out in the sun, be smart about it. To enjoy what the sun has to offer without risking your health, follow these simple rules:

Seek the shade, especially between 10 AM and 4 PM

That is when the sun's rays are usually strongest. If you're outside, head under a pavilion roof or leafy tree - or carry a sun umbrella. And take advantage of early morning and late afternoon to indulge in your favorite outdoor activities - try the beach at sunset, for example, rather than midday.

Do not burn

Even a single sunburn increases your risk of developing melanoma, the deadliest form of skin cancer; suffering five or more sunburns doubles your lifetime risk. Avoid spending long periods in the sun, and when you see or feel your skin redden, take cover.

Avoid tanning and UV tanning booths

A tan is never safe, whether you acquire it on the beach or in a salon. Although tanning salon operators may say that their new bulbs are safe and that some UV exposure is necessary for vitamin D, neither statement is true. In general, it is far safer to obtain vitamin D through D-rich foods (such as salmon, fortified milk or orange juice) and/or dietary supplements. New high-pressure sunlamps used in tanning salons actually emit UVR doses as much as 12 times that of the sun. When unprotected skin is overexposed to UVR, DNA is damaged; a tan is the skin's attempt to prevent further damage by creating a wall of darker pigment. Damage that has already occurred can lead to changes (mutations) in skin cell DNA.

People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma (SCC) and 1.5 times more likely to develop basal cell carcinoma (BCC). Even occasional sunbed use almost triples your chances of developing melanoma. Young people - including teenagers - are especially sensitive to the UVR emitted from tanning booths.

Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses

Clothing can be your most effective form of sun protection, so make the most of it with densely woven and bright- or dark- colored fabrics, which offer the best defense. For instance, a thin white T-shirt provides a UPF, or Ultraviolet Protection Factor, of about 5, meaning the shirt lets in about 1/5 of the sun's rays. In contrast, blue jeans have a UPF of approximately 1700. The more skin you cover, the better, so choose long sleeves and long pants whenever possible. For extra safety, seek specially designed clothes that come with a UPF label; a UPF rating of 30 and up indicates substantial protection.

Wraparound sunglasses that block 99-100 percent of the sun's UV rays effectively shield both eyes and the surrounding skin, helping prevent serious conditions from cataracts to melanomas of the eye and eyelid. And, hats with a brim of 3" or greater offer significant protection for the face and back of the neck.

Use a sunscreen with an SPF of 15 or higher every day

A sunscreen's SPF, or Sun Protection Factor, measures how long unprotected skin can be exposed to the sun's shortwave, ultraviolet B (UVB), rays before burning, compared with how long it takes to burn without protection. If used correctly, sunscreen with an SPF of 15 would prevent sunburn 15 times longer than if the product weren't used. Sunscreen with an SPF of 15 effectively filters out about 93 percent of all incoming UVB rays, while SPF 30 keeps out 97 percent and SPF 50, 98 percent. These higher SPFs can make a difference for people with skin that always burns rather than tans, people with photosensitive conditions such as lupus, those taking medications that increase photosensitivity, and outdoor sports enthusiasts who spend a lot of time in the sun.

However, a high SPF alone is not enough. SPF measures protection against UVB, but not against the sun's long-wave, ultraviolet A (UVA) rays, and new research shows that UVA penetrates the skin more deeply than UVB, causing as much or even more damage. UVA is also the key cause of sun-induced skin aging (photoaging). So look for products that offer "broad spectrum" or "UVA/ UVB" protection, and make sure your sunscreen has one or more of these UVA-filtering ingredients: titanium dioxide, zinc oxide, stabilized avobenzone, or ecamsule (a.k.a. MexorylTM). Remember, use sunscreen every day, year-round, in every kind of weather. Here's why:

  • sunlight reflects off snow, ice, sand and water, intensifying UVR effects by up to 80 percent. So in winter, be sure that your hands, neck, and as much as possible of your face are covered. If your skin gets dry, moisturizing sunscreen formulas are a great idea.
  • even on overcast days, 70-80 percent of UVR travels through clouds.
  • at high altitudes, for example when you're skiing, the thinner atmosphere filters out less UVR.

Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside

Reapply every two hours, or after swimming or excessive sweating.

For adequate protection, you have to apply enough sunscreen. And after two hours in the sun, sunscreen loses effectiveness, so it's vital to reapply. Furthermore, no sunscreen is completely waterproof, so if you've been swimming or exercising heavily, reapply immediately.

Keep young infants out of direct sunlight to prevent sunburn

An infant's skin possesses little melanin, the pigment that gives color to skin, hair and eyes and provides some sun protection. Therefore, babies are especially susceptible to the sun's damaging effects. If you go out with your baby in the first six months, make sure he or she is covered up with clothes (long-sleeved cotton clothing is cool and comfortable), wearing a sunbonnet and shielded by an umbrella or stroller hood. Sunscreen may be applied to small areas of a baby's skin not covered by clothing and hats.

Just one severe burn in childhood doubles the chances of developing melanoma later in life. Remember, sunburns can be dangerous for babies and toddlers, possibly leading to dehydration and heat stroke.

Getting out to exercise is good for everyone. So teach your children early about the importance of protecting their skin and eyes from the sun. When they go outside to play, make sure they are well protected with clothing, hats, sunscreen, and sunglasses.

Examine your skin head-to-toe once every month

Here's how:

  • In a full-length mirror, inspect your skin. Start with your head and face, using a blow dryer to check your scalp.
  • Check hands, including nails. Examine elbows, arms, underarms, torso and trunk.
  • With your back to the mirror, use a hand mirror to check your back, the back of your neck, and other hard-to-see places.
  • Sitting down, check legs and feet, including soles, heels, toes, and nails. Use the hand mirror to examine genitals.

Look for skin changes of any kind. Cancer warning signs include:

  • a spot or sore that continues to itch, hurt, crust, scab, erode or bleed
  • an open sore that does not heal within two weeks a skin growth, mole, beauty mark or brown spot that:
    • changes color or appears pearly, translucent, tan, brown, black or multicolored
    • changes in texture
    • increases in size or thickness
    • is asymmetrical
    • is irregular in outline or border
    • is bigger than 6mm, the size of a pencil eraser
    • appears after age 21

See your physician every year for a professional skin cancer exam.

And ask your child's pediatrician to examine his or her skin thoroughly as part of a yearly check-up. This is especially important for children and teens at high risk for sun damage, such as those with fair skin, light eyes and hair, and those with a personal or family history of skin cancer.

Regular total-body checkups are the best way to make sure your skin is healthy and stays that way.

Follow these tips and you can enjoy yourself safely outdoors, minimizing the sun's dangers while maximizing your health.

The Seal of Recommendation

One good way to select quality sun protection products is to look for The Skin Cancer Foundation's Seal of Recommendation. The Foundation's Photobiology Committee grants the seal to products that meet the highest standards for safety and effectiveness. Learn more about The Seal of Recommendation.

Medical Reviewers:
Sophie J. Balk, MD
Doris Day, MD
Bruce E. Katz, MD