Mole on woman’s back as doctor checks for skin cancer

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Skin cancer is the most common cancer in the United States. According to the American Academy of Dermatology, the condition affects more than 3 million people annually. About 99 percent of the cases are caused by damage from the ultraviolet rays of the sun. Skin cancer is virtually 100 percent preventable, because you control your sun exposure.

One in five Americans will develop skin cancer by age 70. Non-melanoma skin cancer, however, is often excluded from cancer statistics, and is not reported in global statistics because it is so very common and under-diagnosed. It is also frequently managed within primary care (e.g., family medicine) without being reported, according to the World Cancer Research Fund International. Melanoma cases are rapidly rising across the U.S., however, and this very dangerous type of skin cancer on its own is expected to become the second most common cancer in the coming years.

Test your knowledge about sun damage and learn how to minimize your risk of developing skin cancer. Do you think the common beliefs about sun damage and skin health listed below are fact or fiction?

1. 80 percent of sun damage to skin occurs before the age of 18.

Fiction: A study conducted by the United States Food and Drug Administration (FDA) determined that less than 25 percent of sun damage occurs before the age of 18. After that, 10 percent more accrues for every decade of life. However, one blistering sunburn before the age of 18 can double your chance of developing melanoma. The 80 percent figure was based on incorrect information and miscalculations.

Intervention at any age is beneficial for starting protection and repairing some damage. A broad-spectrum sunscreen (covers both UVA and UVB rays) with a sun protection factor (SPF) of 30 should be used daily on your face and any other exposed areas of skin. Limit getting direct sun exposure, and use barrier antioxidant products (e.g., zinc oxide.) Here’s a list of the best sunscreens, according to experts.

2. You can get a sunburn even in the shade.

Fact: You can burn in the shade, from UV radiation reflected off nearby surfaces. According to the World Health Organization (WHO), surfaces you’d never suspect of reflecting UV rays can increase your risk of burning. Sea foam reflects 25 percent of UV radiation and sand reflects 15 percent.  Grass, soil, and water reflect less than 10 percent. Fresh snow doubles your UV exposure. Take care when outdoors to protect yourself from burning. And by the way, it’s important to use sunscreen for your pets too.

Man sitting with dog under tree
Sitting in the shade might be a nice escape from the hot sun, but it won’t protect you or your pet from sunburn. (Photo by Forsaken Films on Unsplash)

3. Tanning is safe. It’s burning that’s dangerous.

Fiction: The bronzing of the skin with tanning is the result of DNA damage. UV light damages skin cell DNA and the body tries to repair the damage. The process produces melanin, which darkens the skin.

4. You don’t need sunscreen on a cloudy day.

Fiction: You can get a more serious sunburn on cloudy days than in direct sunlight. According to the World Health Organization, 80 percent of the sun’s ultraviolet rays pass through a light cloud cover. There’s also an interesting phenomenon called the broken-cloud effect.

Partly cloudy days can intensify surface UV radiation by 25 percent and make the UV rays associated with skin damage 40 percent greater. Scientists speculate that the effect may occur when UV rays are reflected off the sides of dense clouds or are redirected when passing through thin clouds.

5. People with naturally dark skin don’t need to use sunscreen.

Fiction: Naturally dark skin can burn and suffer the damage that is associated with developing skin cancer. A study conducted by the American Academy of Dermatology revealed that African Americans are the most likely to die from melanoma, because they are least likely to be diagnosed early in the course of the disease. There is some protection associated with a naturally elevated level of melanin, but some sun damage is still occurring.

Dr. Erin Boh, chair and professor of dermatology at Tulane University School of Medicine, tells The Healthy: “Remember that children can get sunburned despite their skin color. I advise all patients to use at least an SPF 30 sunscreen or a physical barrier such as zinc or titanium oxide.” 

Woman rubbing sunscreen on her shoulder to prevent skin cancer and sun damage
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6. One of the first signs of a sunburn is itching.

Fact: “You can have a sunburn long before your skin becomes visibly pink,” says Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. “In fact, the first sign you may be getting a sunburn is that your skin will start to itch and feel hot, in an interview with The Healthy.” Other signs include thirst, skin tightness, and pain with touch. The skin may turn white when you apply pressure to it. 

7.  A tanning bed can be more dangerous than natural sunlight.

Fact: According to the American Academy of Dermatology, a single session in a tanning bed can increase your risk of melanoma by 20 percent, squamous cell carcinoma by 67 percent, and basal cell carcinoma by 29 percent. Women younger than 30 are six times more likely to develop melanoma by using tanning beds. Some states prohibit their use by children. Here’s a list of the best self-tanning lotions for individuals who want to avoid the harms from using tanning beds.

8. Eating tomatoes and strawberries protects skin from burning.

Fact:Strawberries contain vitamin C and tannins, which are beneficial for sun protection, and tomatoes contain lycopene, which is known to protect the skin from UV damage,” Dr. Green adds. “But while eating them may offer some natural sun protection, it shouldn’t be a reason to skip the sunscreen.” 

Bonus knowledge: Prior research also shows that eating grapes can protect you from sunburn. Adding them to your fruit salad alongside strawberries and tomatoes can give you a nice “edible sunscreen,” scientists say.

9. Black and darker-colored clothing provide full blocking of UV radiation.

Fiction: Clothing yields an SPF of 4 to 8, with darker colors and tighter weaves of fabric being more protective, according to the Skin Cancer Foundation. 

What about so-called sun-protective clothing? UPF (ultraviolet protection factor) clothing and hats provide more protection and block more UV radiation than do untreated clothes. The protection decreases with repeated washes. Rit Sun Guard is a powdered product which can be washed into clothing to provide UV protection. It increases the UPF of the clothing to 30 and lasts for up to 20 washes.

10. A sunburn has to run its course; there is no quicker-healing treatment.

Fact: You can’t make a sunburn heal faster, but you can get some relief from the symptoms.

“If you catch a sunburn early—as soon as you feel the tingle—you can slow it down and reduce the severity with a non-steroidal anti-inflammatory drug like Aleve or Advil,” says Dr. Christopher Huerter, associate professor of medicine and chief of dermatology at Creighton University School of Medicine in Omaha, in an interview with The Healthy. Cold compresses and aloe can also be helpful. You should see a doctor if you get a fever and chills. In that case, says Dr. Huerter, “we would give [patients] a dose of oral corticosteroid, like prednisone.”

As always, if you are concerned about your skin health, don’t hesitate to reach out to your doctor with your questions.

About Dr. Faith Coleman

Dr. Coleman is a graduate of the University of New Mexico School of Medicine and holds a BA in journalism from UNM. She completed her family practice residency at Wm. Beaumont Hospital, Troy and Royal Oak, MI, consistently ranked among the United States Top 100 Hospitals by US News and World Report. Dr. Coleman writes on health, medicine, family, and parenting for online information services and educational materials for health care providers.

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1 Comment

  1. Tesla Destroyer says:

    Why don’t you show photos of basal cell carcinoma?