Use your head to protect your skin all summer long

GRAND FORKS, N.D. -- As summer heats up, people are flocking to parks and lakes, playgrounds and pools to enjoy the great outdoors.

Trouble is, all that sun exposure can cause long-lasting damage to your skin, said Amy Suda, a nurse practitioner in dermatology with Truyu, part of Altru Health System in Grand Forks.  Not only can it age skin faster, it can lead to skin cancer.

“Sun is the biggest ager,” Suda said. “A tan is sun damage.

“Be aware that - depending on your skin type especially - you should avoid exposure to the sun when it’s the strongest: from 10 to 2,” she said. “If you go out and your skin is not protected, you’re setting your skin up for problems down the line.”

Fair-skinned people or anyone with red hair should be particularly careful, she said.   

“The more sunburns you have, the greater your chances are for getting skin cancer.”

A person’s risk for melanoma - the most serious form of skin cancer - doubles if he or she has had five or more sunburns, according to the Skin Cancer Foundation.

One blistering sunburn in childhood or adolescence more than doubles a person’s chances of developing melanoma later in life.

Getting a sunburn is fairly common, the foundation reported. In a recent survey, it found that 42 percent of people polled get a sunburn at least once a year.

When you’re at the beach on a clear summer day, bear in mind that the water and sand reflect the sun’s UV rays, allowing them to hit your skin and eyes twice, Suda said. Sand reflects an extra 15 percent of UV light, and water up to 10 percent.

“You don’t have to be baking in the sun to enjoy the summer,” she said. “Sit in the shade.”

When choosing a sunscreen product, “look for one that’s ‘broad spectrum,’ with an SPF (sun protection factor) of 15 or higher,” Suda said. “The higher the better.

“Apply it 15 to 30 minutes before you go out, and reapply it every two to three hours.”

Common skin cancers       

Skin cancer is the most common form of cancer in the country, according to the foundation. Nearly 3.7 million skin cancers are diagnosed in the U.S. annually, and the vast majority of them are caused by solar UV radiation (UVR), according to the Skin Cancer Foundation.

The two most common non-melanoma skin cancers, basal cell carcinoma and squamous cell carcinoma, are caused by accumulation of sun exposure over many years, Suda said.

“We have farmers (as patients) who say ‘but I’m not in the sun much anymore.’ That doesn’t matter, because (skin cancer results from) the accumulation of sun exposure over years.”

The most common locations for these cancers are the face, ears and hands, the foundation reports. But they can appear in an area of the body that is not exposed to the sun.

Melanoma, on the other hand, is believed to be the result of brief, intense exposure - a blistering sunburn - rather than years of tanning, Suda said. Other risk factors include family history, skin type and having a large number of sizable moles on the body.

Melanoma can appear on any area of the body, regardless of whether or not a sunburn occurred in that location.

Also, “melanoma can come from no sun exposure,” she said. “It can pop up anywhere.”

Clothing as protection  

Clothing is our first line of defense against the sun’s harmful ultraviolet rays and protects the skin by absorbing or blocking much of this radiation, Suda said. The more skin you cover, the better.

Dark or bright colors, like red or black, absorb more UV rays than white or pastel shades, according to the Skin Cancer Foundation. The more intense the hue, the better the UV defense.

The foundation also recommends:

•  Shirts with a high collar give added protection for the back of the neck.
•  Check for clothing tags that indicate the level of sun protection with an Ultraviolet Protection Factor number. A shirt with a UPF of 50, for example, allows just 1/50th of the sun’s UV radiation to reach the skin. The higher the UPF, the greater the protection.
•  Increase your clothes’ UPF by washing a laundry additive like SunGuard’s RIT into them.  A laundry additive can raise the UPF of an everyday white cotton T-shirt from a UPF of about 5 to 30.
•  Consider wearing scarves and wraps to shield the neck, upper chest and shoulder area.
•  Suda and her colleagues at Truyu recommend a line of clothing and hats called Coolibar -- made from materials that provide added skin protection, which is endorsed by the American College of Dermatology, she said.

Don’t forget hat, sunglasses  

Hats are the head’s first line of defense, Suda said. They provide protection to the scalp, where it’s difficult to apply sunscreen, and areas where people forget to apply sunscreen such as the top of the ears and back of neck.

Baseball caps don’t cut it, she said. “The hat needs to be broad-brimmed to cover the ears, face and neck.”

Hats are especially important for men who have thinning hair and are at risk for developing skin cancer on the top of their heads, according to the Skin Cancer Foundation.

The face and neck receive the most sun exposure and are particularly susceptible to basal and squamous cell carcinoma.

People with melanomas of the head and neck are almost twice as likely to die from the disease as patients with melanomas on other parts of the body, the foundation reports.

Sunglasses are also essential, according to Suda. “Choose a pair that wraps completely around the face and eyes.”

Watch for labeling that verifies the glasses block 99 to 100 percent of all UV radiation.  

Over time, solar UVR can cause or contribute to conditions ranging from cataract and macular degeneration to ocular melanomas and other skin cancers, the foundation said. Five to 10 percent of all skin cancers arise on the eyelids.

Treatment

Any burn draws fluid to the skin surface and away from the rest of the body, the foundation states. In case of sunburn, drink extra water, juice and sports drinks for a couple of days and watch for signs of dehydration, such as dry mouth, thirst, reduced urination, headache, dizziness and sleepiness.

Take a dose of ibuprofen, such as Advil, as soon as you see signs of sunburn and keep it up for the next 48 hours, the foundation recommends. It reduces swelling and redness that is going to occur and may prevent some long-term skin damage.

Acetaminophen, such as Tylenol, will treat the pain, but does not have the same anti-inflammatory effect.

After a cool shower or bath, slather on moisturizing lotion, the foundation states.

“A cool compress can help too,” Suda said.

If you get a sunburn, let it be a lesson to take necessary steps to protect your skin, she said.

Treating sunburn in kids Getting a sunburn is a very bad idea, a Sanford Health pediatrician said, but it’s particularly bad for babies and children.

Even one blistering burn in childhood or adolescence more than doubles their lifetime risk of developing melanoma, a serious skin cancer, later in life, according to the Skin Cancer Foundation.

Sunburn can sneak up on us, with symptoms developing “six to 12 hours after exposure, and greatest discomfort 24 hours later,” said Dr. Tracie Newman of Sanford Children’s Southwest Clinic in Fargo.  

“Parents need to be vigilant about the time their children spend in the sun, especially during peak times from 10 a.m. to 4 p.m. - which is very hard to do since that’s when kids want to go to the water park.”

Babies under 6 months of age should avoid direct sunlight, Newman said.

Sunscreen for these babies is not recommended, she said.

She advises parents with babies younger than six months to dress them in long-sleeved tops, pants, hats with wide brims, and UV-blocking sunglasses “for any child that will tolerate it.”

For babies older than 6 months, parents should apply sunscreen that is UVA and UVB protective every two hours or so, she said. “It’s very important to reapply sunscreen. Families get busy and parents sometimes forget.”  

If your child is sunburned, here are suggestions from the Skin Cancer Foundation:

•  For a baby under 1 year old, sunburn should be treated as an emergency. Call your doctor immediately.
•  For a child 1 year or older, call your doctor if there is severe pain, blistering, lethargy or fever over 101 degrees.
•  Sunburn can cause dehydration. Give your child water or juice to replace body fluids, especially if your child is not urinating regularly.
•  Give your child a dose of ibuprofen (such as Advil) as soon as you see signs of sunburn and keep it up for the next 48 hours. It helps to reduce swelling, redness and may prevent some long-term skin damage.
•  Give acetaminophen (Tylenol) if your child’s temperature is above 101 degrees.
•  Baths in clear, tepid water may cool the skin.
•  Light moisturizing lotion may soothe the skin, but do not rub it in. If touching the skin is painful, don’t use lotion.
•  Dabbing on plain calamine lotion may help, but don’t use one with an added antihistamine.
•  Do not apply alcohol, which can overcool the skin.
•  Do not use any medicated cream - containing hydrocortisone or benzocaine - unless your baby’s doctor tells you to.
•  Keep your child out of the sun entirely until the sunburn heals.
•  Familiarize yourself with the rules of sun protection, and make sure that no matter where your child goes - day care, play dates, nursery school - sun safety is taken into account.  
•  Most sunburns, even those that cause a few blisters, can be treated at home. But if a blistering burn covers 20 percent or more of the body (a child’s whole back), seek medical attention.

 
A severe sunburn, which causes blistering, fevers or headaches, should be treated by a medical professional, Newman said, because symptoms could lead to heat stroke or dehydration.