Continuing his hugely popular column, Medical Matters, this week Dr Ciaran Roarty writes about the dangers of the sun, sunburn and how best to cope with it.
We know that too much sun is harmful to our skin but we also know we need sunlight for Vitamin D. So how do we safely do both? Firstly, we need to understand what sunlight does.
What exactly does sunlight do to our skin?
There are two main types of damaging ultraviolet sunlight: UVA and UVB
UVA damages deeper tissues within the skin causing wrinkles and makes the skin appear more aged. UVB causes the skin to tan but also burn. Both of them can increase the risk of skin cancer, so getting sunburnt also tells you that you are increasing your risk of skin cancer. The body’s natural defense to sunburning is increasing the amount of melanin in the skin – which makes the skin darker – but unfortunately, while this helps stop us burning, it does not stop the harmful damage that UV rays can do.
Who needs to be careful?
Everybody really can suffer the harmful effects of too much sunlight. But we know that people with lighter skin, freckles and red hair are more at risk. People with white skin have more risk than dark-skinned people but anyone can burn. We all can recognise it. The skin becomes very red, warm and very painful and a few days later the characteristic peeling starts.
What can I do to treat Sunburn?
Cool bathing or showering will help ease the pain. After sun lotions help cool the skin and will moisturise to help with the drying effect. Paracetamol and ibuprofen can help ease the pain and if the sunburn is bad, see the doctor. It is crucial that we do not allow babies and young children to sunburn and if they do they should see the doctor.
Can the sun cause other problems?
Yes, heat exhaustion and heat or sunstroke are discussed in our previous Medical Matters column. Remember heatstroke is a medical emergency.
Too much sun exposure repeatedly also ages the skin prematurely and can cause brown spots, benign warty growths, and skin cancer. Episodes of sunburn greatly increase the risk for skin cancer, which is caused by excessive sun exposure in about 90% of cases. We should all protect our skin but especially the skin of our children, as too much sun exposure in children increases the chances of developing skin cancer in later life.
So how can I protect myself (or children) but still enjoy the good weather?
The sun is strongest between 11am and 3pm, so during this time make good use of the shade and cover up with wide-brimmed hats, and neck protectors, especially for children. Loose baggy t-shirts, and shorts help (they need to be a tightly woven material) as well as wrap-around sunglasses. Make sure your glasses protect against UV light. In addition, liberal use of sunscreen with a high SPF (sun protection factor) is advised. Factor 15 at least should be used for adults and higher if it’s very hot (some experts now advise at least factor 30 for all ) while children should have at least factor 30 and preferably higher creams applied.
UVA protection protects against skin cancer and is indicated by a higher number of stars on your suncream.
Apply the sunscreen at least 20 minutes before required and reapply every couple of hours, especially after swimming, excessive sweating (even the waterproof brands) or toweling. Apply more frequently in children. Sunblock is stronger than sunscreen as it absorbs most UVA and UVB but again it is used in addition to other protective measures discussed. Remember to check the date of sunscreen and that it can deteriorate if kept out in the sun. It does not provide full protection and if you burn or tan, then you have caused some harm. Reflected sunlight can harm and it may surprise you to learn that wet clothes are not as protective as dry clothes. We can still burn if it’s cloudy and or if we are in the water. Tanning means the body is responding to damage done to the skin. Consider a fake tan and AVOID sunbeds, which increase the risks of all types of skin cancer. We can burn in winter time also for example on the ski slopes (snow reflects sunlight) and at high altitudes. Weather forecasts will often give the Solar UV Index which gives us and idea of the likelihood of sunburn. Use sun protection if its 3 or over.
But my doctor tells me I’m low in Vitamin D?
The skin makes Vitamin D with the aid of sunlight and there is generally not enough in the foods that we eat. This means we need some sunlight. We don’t need to avoid sunlight, just enjoy the sun sensibly while avoiding increasing our risk of skin cancer. Two to three sun exposures per week for 20-30 minutes with bare arms and face in the Summer months is usually sufficient to keep our Vitamin D levels up. This is exposure, not lying out sunbathing, and as always, sunburn must be avoided. Fair skinned or freckled people with red hair who burn easily may find it helpful to take supplemental Vitamin D but you should discuss this with your doctor. We should be able to generate enough Vitamin D in the Summer to keep us going through the Winter.
And remember, sunlight improves our general feeling of wellness by making us feel happier. Physical activity and outdoor exercise are good for us so we need to balance this with protecting ourselves by enjoying the sun sensibly using the protective measures advised. Enjoy the sun when it’s not too strong in frequent shorter bursts rather than staying for a long time. If you are out in the middle of the day use the hats, shade creams etc
The above information is intended as advice only and should you have any concerns contact your own Doctor.
Also see this recent column http://www.donegaldaily.com/2018/05/30/medical-matters-taking-care-in-the-sun/
Dr Ciarán Roarty MB, BCh BAO MICGP DRCOG Grad. Cert. Obst. Ultrasound
is a full-time GP at Scally McDaid Medical Practice, Scally Place, Letterkenny, Tel 0749164111