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In the Summertime, When the Weather is Hot...

You and your children should wear suntan lotion. A new study shows that sun exposure in youth may be associated with the greatest risk of melanoma.

It's not exactly groundbreaking news to say that excessive sun exposure is linked to skin cancer, but this study is one of the first to identify a connection between age of exposure and type of skin cancer, specifically melanoma. It is a prospective study based on data that followed more than 100,000 Caucasian women over 20 years. Participants provided information about their medical histories and specific information about tanning bed use, sun exposure, moles, and other risk factors.


Women who reported at least five blistering sunburns as teenagers were found to have a greater likelihood of developing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. This risk was particularly high for melanoma, the most lethal form of skin cancer. Women exposed to sun as adults had double the risk of developing BCC and SCC, but no increased risk for melanoma. BCC and SCC are less invasive forms of cancer with a lower mortality rate but a risk of disfigurement if allowed to progress.

The takeaway, not surprisingly, is that you should limit direct sun exposure and wear sun tan lotion. You should also slather kids with high SPF lotion and try to keep short sighted teenagers from spending hours trying to achieve that perfect sun kissed skin. Short sighted adults too, come to think of it. At least we've moved away from those reflective mirror things though!


Skin cancer is the most common cancer in the United States. 1 in 5 Americans will develop it in their lifetime. This study is noteworthy because it indicates that early sun exposure is a very important factor in the development of melanoma in particular. This is all unfortunate news for me because in 90% of my childhood summer time photographs I am red as a lobster.

Researchers here specifically looked at caucasian women, a group in which skin cancer is the most common cancer. Although rates of skin cancer are highest in white men and women, there are significant rates of the disease in people of color of both genders.


Why the different rates? Melanin, the pigment responsible for variation in skin tones, helps protect the skin against the effects of the sun. If you think in terms of SPF, the melanin in Black skin is roughly equivalent to an SPF of 13 as compared to an SPF of 3 in white skin.* Skin cancer is most prevalent in individuals with light skin color (low percentage of Melanin) but does affect people of all races. Due to the incorrect impression that non-caucasians are immune to skin cancer, people of color are typically diagnosed at a later stage with more advanced cases (Bob Marley, for example, died at age 36 when his aggressive melanoma was misdiagnosed). Mortality rates for the disease are significantly higher for people of color. There are many factors involved in different health outcomes, but a clear element in this is a misguided belief that skin cancer does not affect people with darker skin tones. Further studies must look at development of cancer across races and genders.

How to stay sun safe:

We often talk about wearing sunscreen (of SPF 30+) to protect against harmful UV and UVA rays, but there are additional ways to protect yourself. Avoid direct sun exposure between 10 am and 4 pm. Stay in the shade when possible, but especially between those hours. Make sure you cover up with protective clothing, a hat, and sunglasses. It probably goes without saying at this point that tanning beds are inadvisable.


Keep in mind that the Skin Protection Factor (SPF) number reflects how long one coating will protect you for. SPF 50 will last longer than SPF 10, it's not a 5 fold increase in protection. If you burn after 10 minutes in the sun, SPF 15 sunblock will protect you for 150 minutes (the formula is time to burn x SPF - the number will be different for every individual). How long lotion stays affective is obviously also influenced by sweating, swimming, and dousing your head with water because it is feels like you are living on the sun. Don't put on SPF 70 once in the morning and assume you're protected for the rest of the day.

How to check yourself:

Skin checks should be a regular part of your medical exams but you can also do your part to check yourself for signs of skin cancer. Skin cancer is treatable - the sooner you identify it, the better your outcome will be. Do a thorough body check and keep an eye out for the ABCDE's


A: Asymmetry - If you draw a line through the mole, do the two halves match? Asymmetric moles can be indicative of skin cancer.

B: Border - The borders of cancerous moles tend to be uneven.

C: Color - Another warning sign can be freckles or moles with a variety of colors (multiple shades). Melanomas may become red, blue, or other colors.


D: Diameter - Melanomas are usually larger than 6 mm (the eraser on a pencil) but may start smaller.

E: Evolving. Any change in size, color, or shape, or development of a new symptom (bleeding, itching, crusting, or an unheeding ulcer) may also be a warning sign.

Illustration for article titled In the Summertime, When the Weather is Hot...

(Title is part of the lyrics of In the Summertime by Mungo Jerry, an excellent song despite some questionable life lessons)


Image from terawallpaper.com because I very much wish I was there right now. Wherever there is.

*There is obviously a huge variation in the skin tone within each race. These are rough numbers taking from the Skin Cancer Foundation.

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