Skin Cancer and Sun Safety

I know it’s a little early for this but since the weather has been so warm in most parts of the county and it is getting closer to summer, I thought I’d share some links on skin cancer and sun safety.  It’s never too early to start protecting yourself.

So you think a tanning bed is safer than being out in the sun?

For information on tanning equipment, visit the EPA website:

http://www.epa.gov/radtown/tanning-equipment.html#resources

Skin cancer treatment: sources of authoritative information

There are many kinds of treatments available depending on the type of cancer.  For melanoma, the options are surgery, chemotherapy, radiation therapy, and biologic therapy.  For more information on all aspects of melanoma, visit http://www.cancer.gov/cancertopics/pdq/treatment/skin/patient/

For basal cell carcinoma information, visit http://www.cap.org/apps/docs/reference/myBiopsy/SkinBasalCellCarcinoma.pdf

 For treatment information on Merkel cell carcinoma, visit http://www.cancer.gov/cancertopics/factsheet/Sites-Types/merkel-cell

Squamous cell carcinoma treatment information can be found at http://www.cap.org/apps/docs/reference/myBiopsy/squamous_cell_skin_cancer.pdf

Treatment options vary widely depending on the type of cancer and the stage of the cancer.  It is important to ask your doctor proper questions in order to make an informed decision about your treatment.  The previous links provide authoritative information on the various types of cancer.

For more information on all aspects of skin cancer, visit the MedlinePlus skin cancer page at http://www.nlm.nih.gov/medlineplus/skincancer.html#cat3

Types of Skin Cancer

To see what Basal Cell Carcinoma looks like, please visit the following website from the American Academy of Dermatology:

http://www.skincarephysicians.com/skincancernet/basal_cell_carcinoma.html

To see what squamous  cell carcinoma looks like, please visit the following website from the American Academy of Dermatology:  http://www.skincarephysicians.com/skincancernet/squamous_cell_carcinoma.html

To see what melanoma looks like, please visit the following website from the American Academy of Dermatology: http://www.skincarephysicians.com/skincancernet/melanoma.html

To see what Merkel cell carcinoma looks like and for more information, visit the following web site from the American Academy of Dermatology:  http://www.skincarephysicians.com/skincancernet/whatis_merkel_cell.html

Skin Cancer Self-Examination and Prevention

It is important to protect yourself in order to prevent skin cancer or to find it early.  For a great sheet with instructions for skin cancer self-examination, check out:  http://www.melanomamonday.org/documents/08_96%20Melanoma%20Monday%20Mole%20Map.pdf

For more information on protecting kids from the sun, visit http://kidshealth.org/parent/firstaid_safe/outdoor/sun_safety.html

With the overwhelming amount of sun protection products, it’s important to understand what all those claims mean.  The FDA is in the process of finalizing its long-awaited label changes to sunscreens.  One of those changes would be that no sunscreen would have higher than a 50 SPF.  All those claims of high SPF numbers and all the other claims can be very confusing.  To find out more information on sun protection and sunscreens, visit http://www.medicinenet.com/sun_protection_and_sunscreens/article.htm

Have you seen all those ads for special sun-protective clothing and wondered if it’s worth it?  Here’s a great article from the Mayo Clinic answering that very question:  http://www.mayoclinic.com/health/sun-protective-clothing/AN01975

The CDC has some great information on skin cancer and covering up when out in the hot summer sun.  Although the campaign has officially ended, they still have a lot of great information available online.  Check out these sites:

Choose Your Cover Campaign Materials

Brochures

Sunscreen for Your Sun Day [PDF-248KB]

Play It Safe in the Sun: A Guide for Parents [PDF-147KB]

Choose Your Cover [PDF-85KB]

FDA Ruling on Sunscreens

The Food and Drug Administration (FDA) just released new guidelines for the labeling of sunscreen products. I thought I'd post a summary of the requirements of the ruling so you can be aware of what changes are coming to sunscreens. These products contain so many claims that this ruling should help clear up a lot of confusion consumers face when choosing a sunscreen product.

The new final rule includes the following requirements:

Broad Spectrum designation. Sunscreens that pass FDA's broad spectrum test procedure, which measures a product's UVA protection relative to its UVB protection, may be labeled as "Broad Spectrum SPF [value]" on the front label. For Broad Spectrum sunscreens, SPF values also indicate the amount or magnitude of overall protection. Broad Spectrum SPF products with SPF values higher than 15 provide greater protection and may claim additional uses, as described in the next bullet.

Use claims. Only Broad Spectrum sunscreens with an SPF value of 15 or higher can claim to reduce the risk of skin cancer and early skin aging if used as directed with other sun protection measures. Non-Broad Spectrum sunscreens and Broad Spectrum sunscreens with an SPF value between 2 and 14 can only claim to help prevent sunburn.

"Waterproof, "sweatproof" or "sunblock" claims. Manufacturers cannot label sunscreens as "waterproof" or "sweatproof," or identify their products as "sunblocks," because these claims overstate their effectiveness. Sunscreens also cannot claim to provide sun protection for more than 2 hours without reapplication or to provide protection immediately after application (for example-- "instant protection") without submitting data to support these claims and obtaining FDA approval.

Water resistance claims. Water resistance claims on the front label must indicate whether the sunscreen remains effective for 40 minutes or 80 minutes while swimming or sweating, based on standard testing. Sunscreens that are not water resistant must include a direction instructing consumers to use a water resistant sunscreen if swimming or sweating.

Drug Facts. All sunscreens must include standard "Drug Facts" information on the back and/or side of the container.

Use a sunscreen with a Sun Protection Factor (SPF) of 15 or higher. Sunscreens come in many forms, including ointments, creams, gels, lotions, wax sticks, and sprays.

If you do happen to get a sunburn, here are some tips from the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health:

First Aid

- Take aspirin, acetaminophen, or ibuprofen to relieve pain, headache, and fever.

- Drink plenty of water to help replace fluid losses.

- Comfort burns with cool baths or the gentle application of cool wet cloths.

- Avoid further exposure until the burn has resolved.

- Use of a topical moisturizing cream, aloe, or 1% hydrocortisone cream may provide additional relief.

If blistering occurs:

- Lightly bandage or cover the area with gauze to prevent infection.

- Do not break blisters. (This slows healing and increases risk of infection.)

- When the blisters break and the skin peels, dried skin fragments may be removed and an antiseptic ointment or hydrocortisone cream may be applied.

Protect Yourself from the Sun: UV Index

Since I posted some information last week on melanoma/skin cancer awareness and prevention, I thought a good follow-up would be to post some information on the ultraviolet (UV) index. This index is used to describe the intensity of ultraviolet rays on any given day. The higher the number, the quicker you will get sunburn if you don't take precautions.

The United States Environmental Protection Agency (EPA) has a great description of what each level of the UV index means. Here is the information from their UV index scale page:

2 or less: Low
A UV Index reading of 2 or less means low danger from the sun's UV rays for the average person:
• Wear sunglasses on bright days. In winter, reflection off snow can nearly double UV strength.
• If you burn easily, cover up and use sunscreen.

Look Out Below
Snow and water can reflect the sun's rays. Skiers and swimmers should take special care. Wear sunglasses or goggles, and apply sunscreen with an SPF of at least 15. Remember to protect areas that could be exposed to UV rays by the sun's reflection, including under the chin and nose.

3 - 5: Moderate
A UV Index reading of 3 to 5 means moderate risk of harm from unprotected sun exposure.
• Take precautions, such as covering up, if you will be outside.
• Stay in shade near midday when the sun is strongest.

Me and My Shadow
An easy way to tell how much UV exposure you are getting is to look for your shadow:
• If your shadow is taller than you are (in the early morning and late afternoon), your UV exposure is likely to be low.
• If your shadow is shorter than you are (around midday), you are being exposed to high levels of UV radiation. Seek shade and protect your skin and eyes.

6 - 7: High
A UV Index reading of 6 to 7 means high risk of harm from unprotected sun exposure. Apply a sunscreen with a SPF of at least 15. Wear a wide-brim hat and sunglasses to protect your eyes.
• Protection against sunburn is needed.
• Reduce time in the sun between 10 a.m. and 4 p.m.
• Cover up, wear a hat and sunglasses, and use sunscreen.

Made in the Shades
Wearing sunglasses protects the lids of your eyes as well as the lens.

8 - 10: Very High
A UV Index reading of 8 to 10 means very high risk of harm from unprotected sun exposure. Minimize sun exposure during midday hours, from 10 a.m. to 4 p.m. Protect yourself by liberally applying a sunscreen with an SPF of at least 15. Wear protective clothing and sunglasses to protect the eyes.
• Take extra precautions. Unprotected skin will be damaged and can burn quickly.
• Minimize sun exposure between 10 a.m. and 4 p.m. Otherwise, seek shade, cover up, wear a hat and sunglasses, and use sunscreen.

Stay in the Game
Be careful during routine outdoor activities such as gardening or playing sports. Remember that UV exposure is especially strong if you are working or playing between the peak hours of 10 a.m. and 4 p.m. Don't forget that spectators, as well as participants, need to wear sunscreen and eye protection to avoid too much sun.

11+: Extreme
A UV Index reading of 11 or higher means extreme risk of harm from unprotected sun exposure. Try to avoid sun exposure during midday hours, from 10 a.m. to 4 p.m. Apply sunscreen with an SPF of at least 15 liberally every 2 hours.
• Take all precautions. Unprotected skin can burn in minutes. Beachgoers should know that white sand and other bright surfaces reflect UV and will increase UV exposure.
• Try to avoid sun exposure between 10 a.m. and 4 p.m.
• Seek shade, cover up, wear a hat and sunglasses, and use sunscreen.

Beat the Heat
It is possible to go outside when the UV Index is 11 or higher. Make sure you always seek shade, wear a hat, cover up, wear 99-100% UV-blocking sunglasses, and use sunscreen. Or you can opt to stay indoors and take the opportunity to relax with a good book rather than risk dangerous levels of sun exposure.

If you want to check out the UV index in your area, the EPA has a web page where you can enter your city or Zip Code to find out the UV index. Check it out at UV Index Forecast.

The Ultraviolet (UV) Index

June is Cancer from the Sun month, but the sun can harm more than just your skin. Below is a chart with the UV index with descriptions of each level and precautions to take when the index reaches a particlular level.

(Click on chart to enlarge)

Cautionary notes

Be aware when interpreting the UV index and recommendations that:

The intensity of UV radiation reaching the surface of the earth varies greatly depending on how high the angle of the sun is in the sky. The sun reaches its highest angle at solar noon, which rarely corresponds to 12:00 on clocks. This is because of the differences between solar time and local time in a given time zone

The recommendations given are for adults with pale to lightly tan skin. Children and particularly fair-skinned people or those who have sun sensitivity for medical reasons need to take extra precautions.

Damage from sun exposure is cumulative over one's lifetime. Cumulative exposure to the sun imparts damage to the epidermis (outer layer and the dermis (the deeper layer where the skin's framework exists). Damage to the dermal layer changes the structural components, causing Elastin fibers to thicken and become more numerous. Collagen is damaged and degraded and reticulin fibers appear throughout the dermis rather than outlining the specific dermal-epidermal junction.

Sun Exposure (Sunburn)

Ultraviolet (UV) rays are an invisible form of radiation. They can penetrate your skin and damage your skin cells. Sunburns are a sign of skin damage. Suntans aren't healthy, either. They appear after the sun's rays have already killed some cells and damaged others. UV rays can cause skin damage during any season or at any temperature. They can also cause eye problems, wrinkles, skin spots, and skin cancer.

To protect yourself :

Stay out of the sun when it is strongest (between 10 a.m. and 4 p.m.)

Use sunscreen with an SPF of 15 or higher

Wear protective clothing

Wear wraparound sunglasses that provide 100 percent UV ray protection

Avoid sunlamps and tanning beds

Check your skin regularly for changes in the size, shape, color or feel of birthmarks, moles and spots. Such changes are a sign of skin cancer.


(From the Centers for Disease Control and Prevention)