FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

SUNLIGHT IS THE ENEMY OF FAIR-SKINNED PEOPLE

Question: I have fair skin and burn fairly easily. Does having a sunburn now cause me to have a skin cancer later?

Answer: Studies show that this year, one out of every seven Americans will develop some form of skin cancer. The average age of victims has dropped from those in their 50s and 60s to people in their 20s and 30s. Experts say many cases could be prevented by avoiding unnecessary exposure to the sun.

Individuals with fair, sun-sensitive skin are at the greatest risk for developing skin cancer as a consequence of sun exposure although the risk also increases, but to a lesser extent, for those with darker skin. If you have fair skin and you plan to spend time in bright sunlight, protect your skin with a sunblocker or sunscreen.

Research has shown that infants and adolescent children tend to follow the sun-exposure habits of their mothers. And, too much sun as a child increases the risk of the most life- threatening form of skin cancer later in life as an adult. Further, this potentially fatal type of skin cancer known as melanoma is more common in those that have had episodes of severe sunburn as children. These occasional sunburns are more of a risk factor than would be a greater total sun exposure at a more constant level.

Sunblockers get their name because they actually block ultraviolet rays with ingredients like titanium and zinc oxide. But sunblockers are a paste-white color when applied to the skin, so some people won't wear them.

Sunscreens are usually invisible, and work by absorbing the sun's rays so that they don't reach the skins deeper layers, the layers where the actual damage occurs. There are many brands available with their own unique blend of lotion, sun-blocking chemicals and fragrances. Many contain the effective sunscreen chemical para-aminobenzoic acid, or PABA. Unfortunately, some individuals are sensitive to this ingredient, so other sunscreens are formulated with other chemicals. These products are labeled "PABA Free," and work as effectively as PABA.

The numbers on sunscreens refer to their "Sun Protection Factor" sometimes indicated as simply "SPF." If you normally burn after 20 minutes in the sun, a SPF of 15 means you can stay out 15 times longer, or about 5 hours, before you start to burn. Skin tans at different rates, depending on the amount of darkening protective pigment its cells can produce. Fair-skinned people produce less pigment; therefore, they need more protection against the sun's rays. Dermatologists say for most skin types a sun protection factor of 15 will provide adequate protection. Some very light-skinned people, however, should use a sun screen with an even greater sun protection factor say a "22." Beware of products billed as suntan "lotions" and products with single digit SPF ratings as they're usually designed just to moisturize, not to protect.

So mothers, remember that your sun-exposure habits have effect on you and on your children. Protect your skin now to reduce your risk of skin cancer later. Use a sunblocker, sun screen, or long sleeves and a wide brimmed hat when you go out in the summer sun. And yes, sun exposure now does cause increased risk of skin cancer later. The increased risk, however, isn't a guarantee that you will develop the condition just as driving with your eyes closed doesn't guarantee that you'll have a wreck but it does increase the risk of having one. I use sun screen products regularly. I'd recommend that you consider doing the same.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.