Docs warn sunworshippers to protect skin
Too much of a good thing can be painful, even deadly, when it comes to sunshine. So with summer just about in full swing, dermatologists and skin cancer researchers say people should limit their time in the sun and take other steps to protect themselves from the sun.
"Enjoy it, but enjoy it in moderation and with common sense," said Dr. Warren Heymann, head of the division of dermatology at Cooper University Hospital in Camden.
With skin cancer on the rise, doctors have been issuing such warnings for years, but many people don't heed them — or wrongly think slapping on a little sunscreen once before a full day at the beach or pool is all they need. That's the biggest mistake people make, Heymann said.
"It's not enough. If you're going to be outside, try to stay out of the midday sun, stay in the shade, wear appropriate clothing," use sunscreen and reapply it every two to three hours and after swimming or heavy sweating, Heymann said.
Appropriate clothing includes a hat that covers the scalp, long sleeves if it's not too hot and fabrics that aren't open-weaved or too thin.
A thin, white T-shirt allows the ultraviolet rays that cause skin cancer and sunburn to penetrate, so sunscreen should be applied underneath, said Dr. Jonathan Lee, a melanoma specialist at the Cancer Institute of New Jersey in New Brunswick, part of the University of Medicine and Dentistry of New Jersey.
People should also check sunscreen labels to see exactly what the product does; the SPF, or sun protection factor, listed on the bottle only refers to protection against ultraviolet B rays, which primarily cause sunburn. UVA rays penetrate the skin more deeply and are the main cause of skin cancer and premature aging, so sunscreens that provide broad UVA and UVB protection are best.
Older sunscreens block UVB rays well, but are less effective against UVA. Newer products do a better job against UVA rays but are much more expensive, Heymann said.
Products with the ingredients Helioplex or Mexoryl are "photo stable," so they aren't broken down quickly by UVA rays and work for a few hours. Chemical-free blockers containing titanium oxide or zinc oxide, which also protect well against both UVA and UVB rays, are a particularly good choice for anyone experiencing rashes from other sunscreens, Heymann added.
Lee said New Jersey has a high incidence of melanoma, which causes about 3 percent of skin cancer cases but roughly 80 percent of skin cancer deaths nationally. He's not sure why it's so common here, but noted that about 90 percent of skin cancer cases are directly related to sun exposure, with the rest related to genes.
"Some people are a lot more prone to developing skin cancer," Lee said.
Those include fair-skinned people who burn rather than tan, people who have previously had melanoma or have a family history of it, and people with "atypical" moles: ones that are asymmetrical, have jagged borders or varying colors, and are about one-quarter inch in diameter or larger. Those moles and any showing signs of changes should be checked, because skin cancer usually is curable if treated early.
This year, the American Cancer Society estimates about 59,000 Americans will be diagnosed with melanoma, and about 8,110 will die of it. That's up from about 48,250 new melanoma cases in 2002, when deaths were slightly higher at about 9,900, according to the U.S. Centers for Disease Control and Prevention.
In New Jersey, new melanoma cases rose by about 50 percent from 1999 through 2002, then dipped slightly in 2003, the latest year for which data are available.
Including less dangerous skin cancers such as basal cell and squamous cell carcinoma, there are more than 1 million new U.S. cases a year, almost as many as all other cancers combined, said Alan Conney, director of the Laboratory for Cancer Research at Rutgers University.
Reasons for the increase in cases include the thinning of the ozone layer, use of tanning salons and people going outside more — and wearing less clothing compared to decades ago when attire covered more skin, said Conney.
He's been doing tests in mice on two substances that appear to prevent cells whose DNA has been damaged by ultraviolet light from turning cancerous. He's about to start testing them in people to try to develop a protective cream or oral medicine, but that could be years away
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