Safety in the Sunshine - Sun Awareness Week
Published: 14 May 2018
As part of Sun Awareness Week, we asked Dr. Claire Fletcher, a Consultant Dermatologist at New Victoria Hospital with a special interest in skin cancer, to provide some advice on how to stay safe in the sun.
Most people would agree that sunny weather has a mood enhancing effect. In addition, the infrared radiation from the sun warms our bodies and eases aches and pains. Sensible exposure to ultraviolet light can help to reduce facial spots in those with acne and ease inflammatory skin diseases such as psoriasis and eczema. Prescribed ultraviolet light treatment, given in a specially designed cabinet, is used for the treatment of selected patients in hospital Dermatology Departments.
There is a perception that the appearance of individuals, particularly those with lighter hair and eye colouring, is naturally enhanced by the acquisition of a tan. Tanned skin temporarily covers red areas and imperfections; transiently giving the appearance of improved skin tone. The desirability of a tan has led to the increased use of sunbeds. UV radiation from sunbeds, like excess exposure to sunshine, increases the risk of skin cancer and should be avoided. The safest way to achieve a tanned appearance is with the use of self-tanning products.
Perhaps because warm sunny weather cannot be guaranteed in the UK, many light-skinned individuals strip off surplus clothing and bare their pale winter flesh at the first sign of warm spring sunshine. The recent unseasonably hot weather has caught many unaware of the sunburn risk at this time of year.
Sunburn is particularly damaging to the skin and is recognised to increase the risk of the deadliest form of skin cancer, malignant melanoma. However, even the acquisition of a tan, which is the holy grail for many, signifies DNA damage. Recreational time spent outdoors can be enjoyed by the whole family but some precautions need to be taken:
- Babies and young children should be kept out of direct sunlight completely. A parasol or UV shielding mesh cover should be affixed to prams/ pushchairs and they should be kept in the shade at other times. It is often overlooked that babies in parent slings or carriers are directly exposed to the sun. Ideally, such carriers should not be used during the summer. If unavoidable the baby’s head should be covered with a brimmed sun hat and long loose clothing should be worn to protect exposed limbs.
- It is preferable to avoid sun exposure between 11am and 3pm when the sunburn- inducing UVB radiation is at its strongest. Outside of these hours, a high factor sunscreen should be applied to all exposed areas that cannot be covered with closely woven clothing. If you can see through your clothing when it is held up to the light, it will not be sufficient to protect you from sunburn. Light skinned people, with a tendency to burn, should apply the highest sun protection factor that they can obtain. This should be at least SPF 30 and be broad spectrum, that is, protective against UVA radiation too - often expressed as a star rating (4 stars and above being preferable). UVA is responsible for deeper damage to the skin resulting in wrinkles and dark spots and can trigger sun-sensitive rashes such as polymorphic light eruption, colloquially known as ‘prickly heat’. A brimmed hat should also be worn. Manufactured UV protective clothing is available on the high street and online and is particularly useful for children and those enjoying outdoor sports and swimming.
- Beware of cloudy days; the risk of sunburn is still present, particularly in the summer months when the UV index is higher. Reflected UV radiation from water, sand and hard surfaces can also lead to unexpected burning. A typical cautionary tale would be a case of unexpected sunburn following a boat ride on a cloudy day.
- Weather reports, broadcast or online or within Apps, can provide the UV index both in the UK and when travelling further afield. The higher the index, the greater the chance of burning and the more care you need to take.
- There is currently some controversy regarding the role of sunlight and Vitamin D optimisation. Most people living in the UK have low Vitamin D levels. Vitamin D is stored in the body in small amounts and therefore needs to be consumed in the diet (from oily fish, eggs and fortified foods such as cereals) or in the form of supplements. It is likely that only 10-15 minutes of sun exposure to the face and forearms twice weekly is sufficient to maintain Vitamin D levels. Vitamin D is synthesised in the skin, even in very fair individuals, before the sunburn threshold is reached.
Further information regarding sun protection and the use of sunscreens can be obtained from the British Association of Dermatologists website. www.bad.org.uk
If you are concerned about changing moles or other types of skin cancer, make an appointment with your GP to discuss referral to a Consultant Dermatologist on the GMC Specialist Register.
Cancer Research UK provides detailed information regarding skin cancer. www.cancerresearchuk.org
Dr Claire Fletcher has clinical interests in: pigmented lesions (moles) and dermoscopy, skin cancer, infectious dermatology and phototherapy. She set up the multidisciplinary Skin Cancer Service at Kingston Hospital, along with Mr Soldin, Consultant Plastic Surgeon, in 2003. She was elected a Fellow of the Royal College of Physicians in 2007 and has a level 2 Clinical Excellence Award. For further information about Dr Fletcher click here