Robert Young MD, dermatologist, Rocky Mountain Dermatology
Well, first, some statistics. There are roughly 3.5 million cases of skin cancer this year in America and Utah has one of the highest rates in the nation. One person dies from melanoma every 52 minutes and melanoma is the most common cancer in young adults ages 25-29. Beyond cancer risk, excessive sunshine clearly accelerates signs of aging. Yes, sunscreen is still relevant!
To effectively protect the skin, use a broad-spectrum sunscreen rated 30 SPF or higher. Both chemical and physical sunscreens have their advantages and disadvantages, but either will adequately protect if applied properly and reapplied every 80 minutes (sooner if swimming or sweating). Of course, abundant use of shade, broad-brimmed hats, and loose, long-sleeved clothing is encouraged. Rashguards are great for swimming.
Choosing a “broad-spectrum” sunscreen is important because it will protect against both UVA and UVB rays. UVB rays are generally the ones most responsible for sunburn, as they penetrate the epidermis. UVA rays, on the other hand, extend much deeper into the dermis and cause wrinkles and other unsightly signs of early aging. Tanning beds use both types of rays in various combinations and several studies show they can increase the lifetime risk of skin cancer by as much as 15-fold.
Some, looking for an excuse to not wear sunscreen, have suggested that Vitamin D is an issue. Science has shown that this is simply not an argument against sunscreen. Besides Vitamin D-enriched food, it would be virtually impossible to wear enough sunscreen to interfere with our body’s ability to absorb adequate sunshine to acquire the required level of Vitamin D in our systems. Practically the only individuals at significant risk for too little Vitamin D are relative shut-ins such as those in nursing homes.
Another concern of some has been how if at all, sunscreen might affect marine life such as coral reefs. While not completely debunked, this issue is still being scientifically debated and there is by no means a consensus as to whether or not sunscreens are a factor at all.
Finally, I have heard it said that the SPF number is not important as there is no added benefit over SPF 15. This is clearly false on several levels. The SPF number is very significant depending on skin tone, amount of sunscreen applied, and intensity of, and amount of time spent in the sun. There is a lot to think about beyond just whether or not you might get a sunburn.
The skin is, by far, the largest organ of the body, and skin cancer is, by far, the most common cancer in the world. If looking younger longer, and the health and lives of you and your loved ones are important to you, then sunscreen is relevant to you.
With regards to cancer spots, dermatologists are frequently asked, “What do I look for?” That is a very good question. As a general guideline, if there is a distinct scaly spot or area on the face or arm that does not respond to moisturizer, it is likely an Actinic Keratosis. For the most part, these are considered pre-cancers and they should be examined and treated.
As for skin cancers, the only true rule is that there are no rules and they can look like almost anything. They don’t need to be pigmented nor raised to be suspicious to a dermatologist. Skin cancers can be raised, flat, or depressed. They can be flesh-colored, pink, red, brown, blue, or black. They can be smooth or rough. They can even act as an open sore that doesn’t heal. So, a good rule of thumb is what some have called the “ugly duckling rule:” If there is a spot anywhere on your body that just doesn’t look like the other various spots you have, you probably should have it checked by a dermatologist.