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There’s No Such Thing as a Healthy Tan

Or is it?

Edward H. Nessel, R.Ph, M.S., MPH, PharmD.

There’s no such thing as a healthy tan. Recently, several public health organizations have reported that malignant melanoma, the most deadly type of skin cancer, is spreading in epidemic proportions throughout our population. These reports have come from the American Cancer Society, the American Dermatological Association, the Centers for Disease Control, and the Skin Cancer Foundation. All of these organizations have claimed with alarm that skin cancer is on the rise. One of the most significant statistics is the increase of occurrence in young adults. These concerns are particularly important for many Masters swimmers, who spend a considerable amount of time swimming in the sun. Fortunately, there are several simple methods of protecting ourselves against overexposure to harmful ultraviolet rays.

At one time, malignant melanoma was a type of cancer that affected aging adults who had spent many years in the sun. It was originally thought to be purely the result of years and years of sun exposure. Now it appears in the younger population. Increasing numbers of fair-skinned, young adults are being diagnosed. Melanoma is often one of the most unpredictable types of cancer. It has also been known to spread to deadly proportions in the body in just a matter of weeks. Today, early detection and treatment allow for a good prognosis.

Many of us have heard reports about the declining ozone layer and its decreasing ability to protect us from ultraviolet (UV) exposure. What once caused the average person to get a sunburn with 60-90 minutes of midday exposure has been magnified to where 15-30 minutes will do harm. Additionally, it is the repeated exposure that may cause the most damage.
There is an expression in dermatology: "The skin never forgets." In fact, excess unprotected exposure can cause significant problems years beyond the initial exposure. The Skin Cancer Foundation has recently revised their list of the incidence of melanoma, and there may be approximately three times more than originally reported. Several studies have shown that children exposed to intense sun producing a burn are at greater risk of melanoma years later than those spared the burning rays.

Simple precautions can help. Apply a waterproof sunscreen with an SPF (sun protection factor) of at least 15. The higher the number, the better the protection up to a point. The sunscreen needs to be on the skin for no less than 20 minutes before sun exposure to allow the active ingredients to penetrate into the deep layers. The SPF number theoretically gives a rough approximate number of "safe" minutes allowed in the sun…if you normally burn in 15 minutes, an SPF of 15 should then protect you for 15 times that number, or 225 minutes. But that is not what happens in the real world. Depending on the sun’s position in the sky and time of year, the actual amount of protection could be much less. No matter how good the SPF in the sunscreen, after about 90 minutes, the amount of protection is suspect. It is a good idea to reapply the lotion after swimming and perspiring, and to only allow a maximum exposure of 90 minutes at the sun‘s peak (10AM to 2PM). A new application does not necessarily allow for a complete carefree re-exposure to the sun’s rays.

With today’s atmospheric conditions, damaging rays can reach the skin from sunrise to sunset irregardless of how much burning rays are present. The more the skin has been exposed to the sun over the years the more it must be protected from ALL sun exposure throughout the day.

Skin cancer most frequently occurs on the pointy articular aspects of the body exposed to the sun…the nose, the tips of the ears, the tops of the shoulders, and the backs of the hands. It is also seen frequently on the upper back, especially on those who went shirtless in the sun over the years. The lips have very little natural protection. A lip balm with a good SPF should be used and reapplied regularly. A wide-brimmed hat should also be an important part of your summer wardrobe.

Certain medications can enhance your skin’s sensitivity to the sun. These medications include antibiotics, tetracyclines, sulfas, Cipro, certain antidepressants, tranquilizers, antihistamines, Retin-A, and non-steroidal anti-inflammatories (NSAIDS) such as Motrin, Advil, Naprosyn, and Relafen. Questioning your pharmacist or physician about these particular medications may help protect you.

The sun is psychologically uplifting, and in small doses, even somewhat beneficial. It aids in the production of vitamin D for calcium absorption. However, it must be handled with great caution. Although we cannot survive very long without the sun, too much can be harmful.

Ed Nessel is a pharmacist, biochemist and physiologist; he is on the USMS Sports Medicine Committee and serves as USMS National Librarian. In 1998 he was honored as USMS Coach of the Year.