Dr. Kristin Cam Missmar is a board-certified dermatologist with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente Falls Church Medical Center.
With the warmer days of spring upon us and the sunny summer months approaching, more of us are spending time outdoors. This is the time to remember that sun protection is an important consideration as we head outside. While most people remember to apply sunscreen before heading to the beach, pool, or outdoor activities, many may not realize that applying sunscreen is also important before getting in a car, while working near a window, and even while getting a gel manicure at a salon.
Skin cancer is the most common form of cancer in the United States, and as a board-certified dermatologist, I have diagnosed and treated skin cancer in countless patients. Sunscreen and sun-protective measures are essential to help decrease skin cancer risk and protect our skin from harmful ultraviolet light, so it is particularly important to recognize when UV protection is needed — sometimes even from unexpected or hidden exposures.
Understanding UV Rays
Two types of UV light, Ultraviolet A and Ultraviolet B, are known to contribute to skin cancer risk and affect the skin. UVA rays penetrate the skin more deeply and contribute to the skin’s aging process, causing wrinkles, sunspots, and discoloration. UVB rays are associated with skin-damaging sunburns.
When choosing a sunscreen, choose one that is “broad-spectrum,” which means it protects against UVA and UVB rays. Be sure to use sunscreen with an SPF of 30 or higher and reapply every two hours (more frequently if swimming or sweating). Daily application of sunscreen to the face is helpful to protect from everyday incidental UV exposure year-round. When applying daily sunscreen to your face, don’t forget to apply it to your neck, upper chest, the backs of your hands, and other areas that may be regularly exposed to the sun.
When outdoors, consider wearing sun-protective clothing, such as hats and rash guards with UV protection factor built-in. These provide consistent, excellent protection against the sun’s rays without the worry of needing to reapply sunscreen.
Hidden Sources of UV Rays
While the need for sun protection on a hot, sunny day is clear, there are times when UV exposure may not be so obvious:
Driving. Studies have shown an increase in sun damage and skin cancers on the left side of the body because drivers are more frequently and intensely exposed to UV rays coming through the driver’s side window on their left side. In a car, the window glass blocks most of the UVB rays, but not the UVA rays. Most windshields are treated to block some UVA rays, but the other windows in the car typically do not offer the same protection. Before driving, apply sunscreen, especially to your face, neck, and backs of your hands. Passengers should wear sunscreen, too, since they will be exposed to UVA rays through the windows. These same precautions are advised for travel when you sit by a window on an airplane or train.
Working near a window. UVA rays penetrate the windows of your home and office. In addition to increasing skin cancer risk, exposure speeds up the signs of aging on the skin and can lead to unwanted hyperpigmentation. Try to position yourself several feet from a window and apply sunscreen.
Spending time outside on cloudy days. Although we are not seeing or feeling the rays of the sun on cloudy days, UV rays can travel through clouds. In some ways, cloudy days may leave more people at risk of burning because the need for UV protection is not obvious. Sunburns are still possible on cloudy days, so be sure not to skip applying sunscreen.
Getting a gel manicure. Gel manicures require a UV light to dry the nail polish. A study published in 2023 found that UVA light exposure from nail lamps damages cells and causes DNA mutations similar to those found in skin cancers. Even though UV nail dryers are likely a low risk, that risk may increase with repeated exposures. Take precautions by applying sunscreen to the backs of your hands before putting them under a UV light or by wearing UV-protective gloves that have the fingertips cut off to leave only the nails exposed.
Taking certain medications. Some medications can actually increase your risk of sunburning or developing a rash when in the sun. These medications are “photosensitizing” and include common blood pressure medications, antibiotics, and acne medications such as topical retinoids. Read the labels on your medications and take precautions when in the sun.
Recognizing the Signs of Skin Cancer
The signs of skin cancer can be subtle, but listed below are the “ABCDEs” of skin cancer to help you spot a suspicious lesion:
A: Asymmetry. Is the shape of the lesion asymmetrical? Does it appear different on one half than the other?
B: Borders. Are the borders of the lesion irregular or scalloped?
C: Color. Does the spot contain multiple colors?
D: Diameter. Is the diameter of the growth larger than 6 millimeters, or the size of a pencil eraser?
E. Evolving. Is the spot changing in size, shape, or color? Is it growing or bleeding or causing any other symptoms?
If the answer is YES to any of the above, please see your primary care physician or a board-certified dermatologist to have the lesion examined.
Fortunately, most skin cancers have excellent cure rates when found and treated early. UV protection — from all sources — is the key to decreasing your skin cancer risk.
Feature image, stock.adobe.com
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