Sun Exposure

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The sun gives benefits but also can damage the skin if exposed excessively for example skin cancer.

The sun gives benefits but also can damage the skin if exposed excessively for example skin cancer.

The sun is essential for life on earth and it provides thousands of us with great enjoyment especially on holiday during the summer months; unfortunately it can also cause burning, wrinkling, leathery thickening and aging of the skin; sometimes even skin cancer.

The aims of this message are to advise you about safer sunshine exposure and also to advise you on how to inspect your own skin for potential problems.

We now understand that sun exposure accumulated during the childhood years is important in the later development of skin changes; and therefore all the information applies especially to your children.

We now understand that a certain amount of sunshine exposure is absolutely essential for correct vitamin balance in the body. I think a sensible approach is to be reasonable and certainly never to let your skin burn bright red in the sunshine. Children are particularly vulnerable and require protection for example in the school playground etc.

As British residents we are not accustomed to strong sunshine and we tend to get our sun exposure in short bursts e.g. on a summer holiday, or on a bank holiday weekend. Our climate does not provide regular exposure and therefore our skin does not develop much natural protection. All racial groups in Britain can suffer from sunburn but those with very fair skin, multiple frecides and moles, blue eyes and ginger or fair hair are most at risk.

Sunscreens should be applied generously (and I stress generously); they should be applied at least 5 minutes before you go out into the sun; some sunscreens particularly the ones which are water-resistant should be applied at least 30 minutes before going out into the sun and you will need to follow the manufacturer's instructions carefully to achieve the best protection. Please remember that sunscreens are washed off the skin by any moisture including perspiration for example whilst playing tennis; under these circumstances you will need to reapply your protection frequently throughout the day - I would recommend applications about once every 2 hours.

The sun's intensity is greatest between the hours of 11 in the morning and 3 in the afternoon and this rule applies both at home and overseas. During these hours you are at greatly increased risk of suffering a severe sunburn which could ruin the rest of your holiday. You need to limit your exposure during these hours for at least the first few days of the holiday. My rough and ready rule is that you should limit your bare skin exposure during these hours to 15 - 30 minutes maximum per day until you have achieved a reasonable tan after the first few days holiday.

During these first few days, more prolonged bare skin exposure must only occur during those hours of the morning before 11 a. m. and those hours of the afternoon later than 3 p.m., but even then you should wear a sun block.

During these danger hours it is not advisable to rely only upon sun creams which can rapidly rub or wash off; you should also wear some light clothing e.g. a baseball cap to protect the face, a T-shirt to protect the shoulders and Bermuda-style shorts to protect the thighs. Wearing a T-shirt whilst swimming or enjoying other water sports is essential especially for young children.

Certain areas of the body are especially prone to sunburn and deserve a special mention; these areas include bald heads, shoulders, thighs, the nose and forehead, the tops of your feet and bare breasts; in other words those areas pointing up towards the sky and those areas which are usually covered. For these areas I strongly recommend a sun block of factor 20 or higher during the first 7 days of sunshine exposure and apply it at least 3 times per day; more often if you get wet or sweaty. Even during the second week of sunshine exposure I would recommend a sun protection factor of at least 15 to these areas at all times.

Other areas of skin on the arms and body do not bum quite so easily but nevertheless need high-level protection for at least a week. To these areas I recommend the use of a protection factor of at least 10-15 for 7 days and at least factor 4 thereafter.

Sensible exposure will enable you to enjoy the sun without looking silly on the beach or during the evening. If you do burn red you should immediately go indoors until the sun goes down. You must keep warm and drink plenty of water. 1% hydrocortisone cream should be generously applied to all burnt sites twice per day for 2 days; you can buy 1% hydrocortisone at any dispensing pharmacy in the UK without a Doctor's prescription so take some if you go abroad. At all costs you must avoid further sun exposure whilst the skin remains red.

As dermatologists, we are very concerned about the sun causing skin cancer. Particularly disturbing (as highlighted earlier) is the fact that sunshine exposure in childhood may cause skin cancer in later life. The number of skin cancers we see is increasing every year and the main reason is people's increased exposure to sunshine. It is important that you know what skin cancer can look like so that you can arrange to see your doctor for a check- up if you are worried.

The most dangerous type of skin cancer is the type called malignant melanoma where a brown, black or purple growth appears on the skin. This can look like a mole or sometimes can arise from within a mole perhaps even a mole which has been on the skin for years. If you see a new mole on the skin or if you notice a change in an existing mole then you might have a problem. If in doubt, it is always best to get your skin checked by your doctor rather than ignore a pigmented skin lesion which might later turn out to be something serious. It is important for you to have an accurate idea of what your moles look like at all times so that you will rapidly be alerted to any changes in their appearance. It might even be helpful for you to take a photo of any troublesome moles. Do not die wondering about your irregular mole, have a consultation here and get it checked today.

by Dr John Ashworh

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