Did you know that half of all children in the US experience a sunburn annually and that this incidence has not improved in decades? Dermatologists know that sunburns in childhood are associated with an increased risk of skin cancer in adulthood. With over 5 million new cases of skin cancer each year in the U.S. it is extremely important to teach all patients and their families the facts about sun protection and skin cancer prevention. Here are some important facts that we think you need to know.
First, ultraviolet radiation cannot be seen or felt but must be measured. The US Weather Service developed the UV Index, a scale of UV intensity from 1 to 11+, that correlates with risk of sun damage. The UV Index increases as days become longer and peaks on the longest day of the year, June 21st or the Summer Solstice. Some teachers, parents, and even healthcare providers do not always realize that on a cool beautiful day in May the UV Index may be the highest it will be all year. Free UV apps are available to alert us to changes in UV intensity throughout the day and the year. They include a GPS monitoring system that incorporates data related to altitude and ground cover. Another fun way to measure UV intensity is to use the Shadow Rule. This rule states that the sun’s rays are strongest when your shadow is shortest. Remember to seek shade when your shadow is shorter than you are in the middle of the day.
Second, your skin’s response to UV radiation exposure is directly correlated with your risk of developing skin cancer. There are two types of UV radiation that penetrate the ozone layer and cause skin damage. First, UVA radiation (tanning/aging rays) are the longest rays. They completely pierce the ozone layer and penetrate deep into our skin. These rays can stimulate pigment producing cells, called melanocytes, to release pigment. This temporary increase in pigment creates what is commonly known as a tan but is actually our skin’s first line of defense against sun damage. UV B radiation (sunburn rays) are much shorter and 90% are blocked by the ozone layer. Excessive exposure to UVB radiation causes redness, swelling and sometimes blistering in the top layer of the skin. Both UVA and UVB radiation are known to cause genetic damage and are both linked to skin cancer. Dermatologists classify patients into 5 different skin types based on how their skin typically reacts to UV exposure. For example, Skin Type 1 are patients that “always burns and never tan” while Skin Type 5 are patients that “rarely burn and pigment deeply.” Take a look at the Skin Type Chart included to determine your skin type. Remember that families may have some members with varying skin types; some requiring extreme protection while others may be less sun sensitive and safer in the sun.
Third, we are not born with freckles and only 1% of babies are born with a mole. We develop these skin changes secondary to sun exposure. Freckles are an inherited genetic trait and indicates sun sensitivity. Freckles will never hurt you but do indicate where you have had the most sun exposure or sun damage. Because UV intensity peaks midday when the sun is directly overhead freckles develop most commonly on sites in direct line with the midday sun. Locations that have the greatest degree of freckling or cumulative sun damage are at greatest risk for the development of basal cell and squamous cell skin cancer. Moles, on the other hand, start to develop around the age of two and cease to develop by around age forty. Moles develop most commonly at sites where we have had sporadic sun exposure or sunburns. The tendency to make moles is also an inherited trait. Most of our moles are similar in characteristic or the same garden variety. It is therefore important to check your moles to see if any of them stand out because of a larger size, varying color, or irregular shape. Having a lot of moles is an independent risk factor for developing melanoma. Because 30% of melanomas develop in a mole the more moles you have the greater the risk of the disease. You should check your moles and your entire skin surface regularly for any new, different or changing growths that persist and report concerns to your dermatologist.
Fourth, use the five easy action steps included in the SunAWARE acronym to promote sun protection and prevent skin cancer.
Enjoy our rap song and remember, “Don’t be scared, be prepared, tell them all around the world to be SunAWARE!”
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