True or false?
- Sunscreens contribute to skin cancer.
- Most skin "aging" is caused by the sun.
- Skin cancer is increasing dramatically.
- One sunburn can lead to skin cancer.
- One version of skin cancer, melanoma, is very deadly if not caught early.
- Sunbathing is about as smart as smoking or living on Big Macs.
- The body organ most likely to get cancer is the skin.
- One in five of us will get skin cancer.
- There is no such thing as a healthy tan.
Easy: all true.
Sunscreens and their promotional hype lead us to think we can safely do something as dumb and risky as sun bathing, or ... gulp ... windsurfing. In fact, we can't. A tan ... any tan ... is clinical, medical, physical evidence and proof that our skin has been damaged. In fact, melanin production -- a tan -- is our body's response to injury, not a protective response to prevent burning. Even a dark tan has an SPF of only 2 to 4, which is pretty useless. The damage is cumulative: each tan, each day outdoors, and especially each sunburn pushes us closer to looking like the haggard, withered, leathery prunes we see on Miami beaches or the Las Vegas strip. Age didn't do that to them; the sun did. Old hooded monks' faces look like babies' bottoms, not like raisins. (Those old monks also have a child's hearing, but that's another column.)
Skin cancer used to take decades to develop, but is now showing up in teen-agers. Its deadly version, melanoma, has doubled in incidence since 1980. What has changed to make the sun so much more dangerous? Nothing astronomical, except maybe some ozone depletion. What has changed is human attitudes and behavior, aided by commercial hype. The new attitude is that tans are now healthy signs of affluence and leisure time, rather than a price outdoor laborers pay. The new behavior is increased outdoor sports, plus one of the most harmful "healthy "new fads we know of: sunbathing. (That includes tanning booths, of course. A tan is a tan is a tan.)
Commercial hype is nothing new, but we've just learned in the past few years that sunscreens promote skin cancer, in the sense that we watch the ads, smear some on, and lie or play in the sun as though the stuff actually worked.
There are two problems with that belief. One is that many of them wash or wear off much sooner than their labels claim. Consumer Reports testing can help you distinguish which ones hold up as claimed.
The other problem with sunscreens is that they have been made to combat burning, not aging. Until recently, most of them reflected and/or absorbed only uvB rays -- the ones that Burn the surface of our skin. They provided little protection against the uvA rays that age our skin and its underlying support structures. Good sunscreens (again, consult labels and/or Consumer Reports) are including uvA protection more commonly and are holding up longer to water and wear.
On the other hand, many of us were doomed to getting skin cancer years, even decades, ago by a genetic susceptibility to it and a really bad sunburn as a child. No one can yet say which sunburn gave which person skin cancer, but many people with skin cancer got one bad sunburn as a kid and have demonstrated skin behavior implicating a high natural susceptibility to skin cancer.
But even if one has the gene and got that sunburn, further uv exposure still accelerates the aging and cancer process, making prudence and shade still important.
You know the drill. Stay out of the sun within hours of noon. Cover your skin with dense clothing if you must go outdoors between mid-morning and mid-afternoon. (Light cotton clothing stops only a small percentage of uv; wet cotton stops much less.) Use gobs of a good broad spectrum uvA/uvB sunscreen, at least SPF 15, on skin you can't cover with clothes. Synthetic fibers stop much more uv than natural fibers, and there are lightweight stylish clothes made that stop virtually all the uv. uv fries our eyes and causes many kinds of blindness (as though one weren't enough); wear sunglasses. Not those foo-foo designer shades you can see through indoors; we're talking major Secret Service sunglasses.
Oops ... I see the finish line approaching. Time to sprint:
- Sunscreen doesn't work on babies under 6 months old, and they can't cope with uv. Keep them out of the sun.
- Ages 10-24 years -- the "formative" years of skin cancer -- are the worst ages to spend in the sun. Even one blistering burn then doubles one's risk of the very deadly melanoma. A steady diet of sun causes some wrinkles before 30, many wrinkles by 40, and precancerous lesions before 50.
- Tans ... natural or from booths ... do not heal acne.
- Clouds block the sun's heat, but not its uv, letting us feel comfortable while we burn.
- uvA, the aging rays, are strongest morning and evening, are strong all year, zip right through most window glass, and are not blocked by all sunscreens.
- Even if a young woman's melanoma is cured, she should not get pregnant. Prenatal hormones can trigger a reoccurrence, and it is quickly fatal if it spreads.
- Skin cancer repeats so often that once we've had any skin cancer, we should be examined professionally two to four times per year. And pray, because melanoma is a fast, sure killer if it escapes our notice too long.
- Protecting a whole body in a swim suit requires about three teaspoons of sunscreen.
- Psychologists found that the people who sunbathe are, as a group, more concerned with the appearance of health than with health itself.
- Sunglasses help prevent the many blinding, disfiguring eye problems caused by uv. Excellent sunglasses start under $15. The rest is for show.
When windsurfing, I wear lycra or a wet suit, a helmet and visor, and sunglasses. I use lots of expensive, broad-spectrum, all-day-waterproof sunscreen. When I come ashore, I get the heck out of the sun. I last deliberately sat out in the sun 30 years ago.
Why? For the same reason I don't smoke, eat bacon or Big Macs, or drive drunk: none of them is worth dying for. Go look at your dermatologist's book of skin cancer photographs, and you'll never sunbathe again, either.