Paying the Price for A Day at the Beach

How today’s sunburn risks tomorrow’s melanoma.

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I was stupid, really.  We were enjoying a weekend on the Florida Gulf Coast, where it’s been summer for several weeks.  I had started out smart, reserving a large beach umbrella to shade our two lounge chairs and slathering the SPF (Sun Protective Factor) 50 sunblock all over my arms, legs, feet, and face (including my ears and the almost hairless central area of my head).  Finally, my wife made sure that my back was also sunblock protected.

  My wife and daughter did the same, and we were off.  It was a comfortably overcast day (meaning that the Florida heat was not overwhelming), and the Gulf water was wonderful.  Still, I only stood waist deep, occasionally swimming, for about an hour.

By that evening, it was clear that I had indeed been stupid.  Blessed (or cursed) with a thick layer of chest hair, decades of beach experience had told me that sunblock wasn’t necessary (as well as difficult to apply) over my front.  But experience is fickle, and it was clear that my fur coat had failed to save me this time.  And failed miserably, based on the fluorescent pink chest and flank skin radiating back at me in my hotel bathroom mirror.

Yep, it’s summertime again.  Time to briefly again review the danger that the sun poses to your skin cells and to your future health.

Our wonderful sun gives off a spectrum of light wavelengths.  Infrared (IR) sunlight gives us heat.

  Ultraviolet (UV) gives us sunburns.  Two types of UV can reach our vulnerable skin:  UVB (the more common source of sunburn) and UVA.  And UV rays can reach you even on cloudy days, which is why summer protection is important regardless of the sky and even during non-summer days when you are going out-of-doors long periods of time.

Skin cancers are the most common human malignancies, but fortunately, the most common types (basal and squamous cell carcinoma, both of which are believed to be related to cumulative sun exposure rather than to intermittent sunburns) are often curable.  Melanomas, however, are linked to repeated sunburns and are much less treatable, accounting for the vast majority of deaths while only representing 2% of all skin malignancies.  Melanomas are more common in Caucasians than in Hispanics or African Americans and, while most common in people in their sixties and older, are also among the most common cancers diagnosed in young adults.

Thus intermittent sunburns throughout your life (especially starting in childhood) are linked to dangerous melanoma formation.  In fact, your lifetime risk of melanoma doubles if you’ve had only five or more past sunburns.  That’s because the damage done to the DNA (genetic material) within your skin cells is cumulative.  The UV causing each sunburn damages your DNA, creating genetic mutations (errors).

  These genetic errors are passed on to the next generations of skin cells when the sun-damaged cells divide.  Already-abnormal skin cells are then damaged further with each subsequent sunburn (even if they are years apart), creating additional genetic mutations.  Finally, enough critical mutations are created that a single melanoma cell is born.  And a single melanoma cancer cell is all it takes.

As many as 80% of people who develop melanoma could have avoided their cancer by protecting their skin from the sun.  (Thus, not all melanomas are related to sunburns, such as those that develop on the soles of your feet, your palms, inside of your mouth, under your fingernails, and other sun-hidden sites).  But the majority of melanomas are UV associated (and preventable), forming on your legs, your back, and your chest as a result of repeated sunburns.

So, what did I do wrong last weekend?  Well, first of all, I should never have assumed that any area of skin that might be exposed to the sun (even briefly) didn’t need the protection of a good sunblock.  So spread that lotion all over, including your arms, legs, neck, back, flanks, face and ears, and top of your feet.  And make sure that you select a block with a SPF of at least 15 (which blocks out 93% of UVB) or greater (higher SPF numbers indicate greater UV blocking).  And remember to reapply the sunblock frequently between swims and other activities.  Also don’t forget clothing, like a T-shirt (which I wore at the beach and in the pool after that first day) and a brimmed hat.

And most of all, be aware.  Don’t forget that even under cloudy skies, and even in seasons other than summer, your skin needs protection and time out under the shade.  It’s up to you to remember that a fun day at the beach today can mean a future day at the doctor’s that’s anything but fun.

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