When it comes to your skin, it pays to play it safe.
SUN AWARENESS
In Canada’s often chilly climate, nothing is more welcome than sunshine. But when it comes to preventing skin cancer and premature aging, it is vital to remember that the sun’s radiation is dangerous, particularly at higher levels of exposure.
“When we talk about sun awareness, what we’re really talking about is skin cancer and sunburn prevention,” says Dr. Cheryl Rosen, head of dermatology at Toronto Western Hospital and University Health Network Hospitals, and national director of the Canadian Dermatology Association’s Sun Awareness Program. “We’re also talking about wrinkle prevention and ‘looking old before you have to’ prevention, but most important is skin cancer prevention.”
Dr. Rosen says that ultraviolet radiation from sunlight is involved in the development of basal cell and squamous cell carcinoma and melanoma.
“With squamous cell carcinoma, it seems to be cumulative exposure that is most important – but for basal cell cancers and for melanoma, it seems that intermittent hits of intense exposure are very important,” she says.
Research conducted on the development of skin cancers looks at mutations that have ultimately led to the cancer, says Dr. Rosen. “There is a certain kind of mutation in the DNA that is only caused by ultraviolet radiation, and so if that mutation is there, it’s been caused by sun exposure. Like tobacco, ultraviolet radiation is a cancer-causing substance. The difference is that it is ubiquitous – and it is also nice to go outside every day. We have to find a balance between living an enjoyable, active life out in the sun and being careful.”
For most people, says Dr. Rosen, that balance can be achieved reasonably easily. “Be physically active, have a good time, and enjoy the Canadian summer, because it’s too short. Enjoy your southern holidays. But protect yourself as best as you can.”
Some of the strategies she recommends require only sound planning and a bit of thoughtfulness. “If you’re going to play tennis, play it early in the morning rather than at noon. If you’re going to sit outside and read, sit under a tree. If you’re going to go for a long walk, wear protective clothing if you can.”
When protective clothing is impractical, she says, because it’s just too hot, use sunscreen, sunglasses and a hat. “It certainly isn’t necessary to stay indoors all the time. Let the UV index that is part of the weather forecast in spring, summer and fall be your guide in terms of how stringent your sun protection is, or how much protection you use.”
For the many Canadians who spend a lot of time outdoors working or playing, sun protection is even more essential.
Dr. Elizabeth O’Brien, CDA regional director for Quebec, says, “For people who spend more than an average amount of time outdoors, it’s important to recognize that sun damage is cumulative. You don’t have to be out for long periods – people who are just in and out also accumulate damage. That’s particularly important for people such as golfers who spend hours outside. Added to day-to-day exposure, it certainly increases the danger of skin cancer.”
To minimize the dangers, says Dr. O’Brien, people who are in the sun for longer periods need to minimize exposure.
“Cover up whatever areas you can with clothing, and use sunscreen on areas that aren’t covered. Time activities, if possible, so you are not out midday when the sun is stronger. If you can play golf or go for a walk or a bike ride early in the morning or in the evening, it is going to take longer to accumulate the same amount of damage.”
In Canada, the sun is strong enough to damage skin from the beginning of April to the end of October, and the importance of sun protection can’t be overestimated. (In winter, sunlight reflected by snow can also be damaging.) “Many people seem to think the sun is only harmful if you’re sunbathing or vacationing – they don’t realize they’re exposed to the sun anytime they step out the door. Parents of children in sports may put sunscreen on their kids, but forget to put it on themselves when they’re on the sidelines watching.
“We know that sunscreens do prevent precancerous changes. As I often say to my patients, we don’t have any control over the factors that cause breast cancer or prostate cancer: if you had a cream you could put on once a day to reduce your risks, wouldn’t you use it? We know that sunscreens are both safe and beneficial, so there is absolutely no reason not to use them,” says Dr. O’Brien.
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