Prevention
The Dangers of UV Radiation
Although the risk of developing melanoma cannot be eliminated, it can be reduced by minimizing exposure to ultraviolet (UV) radiation from the sun and from tanning lamps, especially during childhood and adolescence. Combined with a complete self-skin exam once every month to detect early melanomas, this would drastically reduce the death rate from the disease.
The sun emits several types of radiation, and much of it reaches the earth’s surface. In the animation above, the energy of radiation increases from right to left. Warmth from the sun is due to infrared radiation, while the light and colors we perceive are due to visible radiation. Neither infrared nor visible radiation is harmful under ordinary circumstances. Moving toward the high energy part of the spectrum is ultraviolet radiation, a known carcinogen (cancer-causing agent). Both UVA and UVB radiation reach the earth’s surface. Exposure to either increases your risk of melanoma and other skin cancers. UVC radiation and X-rays have even higher energies, but are absorbed by the atmosphere and never reach the earth’s surface.
Why Limit Sun Exposure?
- UVB radiation causes sunburns. UVA radiation doesn’t burn but penetrates deeper into the skin.
- Skin damage from UV exposure is cumulative throughout your lifetime and cannot be reversed.
- One blistering sunburn before age 20 doubles your lifetime risk of melanoma. Three or more blistering sunburns before age 20 multiplies your lifetime risk by five.
- UVB radiation is partially absorbed by the ozone layer, but UVA radiation is not.
- The UV index is a measure of UVB radiation, but not UVA radiation.
- The intensity of UVB radiation varies depending on season, time of day, latitude, and altitude. The intensity of UVA radiation is not affected much by these variables.
- Temperature does not affect the intensity of UV radiation; exposure in winter can be just as damaging to your skin as exposure in summer.
- Light clouds and haze do not protect against UV exposure. A heavy overcast prevents most UVB exposure but only about 50 % of UVA exposure.
- Reflection of UV radiation from light surfaces such as sand, water, concrete, and snow can damage your skin. A beach umbrella may provide as little as 50 percent protection from UV radiation due to reflection from sand.
- Being in water (or covered in water) does not prevent UV damage to your skin and may even magnify the damage.
- Window glass blocks most UVB radiation, but only 30 percent of UVA radiation. The laminated glass of car windshields blocks most UVB and UVA radiation but side and rear window glass does not block most UVA radiation. Clear films for non-laminated car window glass are available.
What You Should Know About Indoor UV Tanning
The Indoor Tanning Association is lying to you and to tanning salon operators about the risks of indoor tanning. They want you to believe that “responsible” indoor UV tanning is safe, that there is no compelling evidence that UV radiation from tanning beds causes melanoma and other skin cancers, that getting a base tan protects you from subsequent sunburn, and that indoor UV tanning may even protect you from cancer by generating Vitamin D. The absurd claims of the five billion dollar per year UV tanning industry of today and the tobacco industry of 30 to 40 years ago are frighteningly similar.
- UVB radiation from tanning beds and tanning booths has about the same intensity as that from the sun. UVA radiation from tanning beds and tanning booths is 10 to 13 times more intense than from the sun.
- A 2007 Australian study found an overall increased melanoma risk of 22 to 36 percent among individuals who had used a tanning bed.
- A 1994 Swedish study published in American Journal of Epidemiology found that tanning bed users under age 30 who tanned 10 times or more per year multiplied their lifetime risk of melanoma by nearly eight.
- Using a tanning bed to reduce the risk of sunburn before going to a sunny climate is ineffective. A tan provides protection equivalent to a sunscreen with an SPF of 2 to 3, not nearly enough to prevent sunburn.
- UV exposure is not required to provide an adequate amount of Vitamin D. The Vitamin D found in supplements is the same as the Vitamin D generated by exposure to sunlight. Supplements are just as effective as sunlight for those who are deficient in Vitamin D.
Who Says Uv Radiation From Tanning Lamps Causes Skin Cancer?
American Academy of Dermatology (AAD)
American Cancer Society (ACS)
Environmental Protection Agency (EPA)
Federal Trade Commission (FTC)
International Agency for Research on Cancer (IARC)
National Institutes of Health (NIH)
National Toxicology Program (NTP)
US Food and Drug Administration (FDA)
World Health Organization (WHO)
…and many other organizations.
ABC News: “Stop sunbathing and using indoor tanning beds, the acting US surgeon general warned in a report released on July 29, 2014 that cites an alarming jump in deadly melanoma cases since 1973.”
Sunless Tanning
If you want a tan, the only safe option is to use a sunless tanner. Movie stars and models use them; most wouldn’t be caught dead in the sun or in tanning beds. Sunless tanners contain active ingredients that safely tan the dead outer layer of the skin without the damaging effects of ultraviolet radiation. Modern tanning products produce tans that are indistinguishable from those resulting from unsafe UV exposure.
Spray tanning booths are now available in many tanning salons and sometimes make the process of getting a natural-looking tan fast. A more effective, but more time-consuming option, is to apply a sunless tanner yourself. The key to getting a natural-looking tan without an orange color is to choose a product that is only slightly darker than your skin and applying it in a few applications rather than trying to do it all at once with a dark tanner. Pretest a sample on an inconspicuous area of skin 24 hours in advance, then clean your skin and apply following product instructions. For more information about selecting the right product and applying it effectively, visit the nonprofit site Sunless.com. Most sunless bronzers do not contain sunscreen so be sure to use appropriate measures to prevent exposure.
Vitamin D
Vitamin D3, a precursor of Vitamin D, is produced in the skin of all warm-blooded animals upon exposure to UVB radiation. It is subsequently converted to Vitamin D in the liver and kidneys. The US daily recommended dose of Vitamin D3 is 600 International Units (IU) for individuals up to age 70 and 800 IU for those over 70. The maximum safe dose of Vitamin D3 is 4000 IU.
For white Caucasians in the Northern Hemisphere, sufficient Vitamin D3 is generated by incidental exposure to sunlight a few times per week in the summer, but not during winter.
Unless you are at high risk for skin cancer, it isn’t necessary to be fanatic about avoiding sun exposure. Options for reducing overexposure (tanning or burning) are listed below. Using a combination of options is generally more effective than relying on one alone.
Skin Protection Options
OPTION 1: Minimize Direct Exposure
- Stay in the shade whenever possible.
- Minimize sun exposure, especially during the peak intensity hours of 10:00 a.m. to 4:00 p.m.
- Avoid intermittent or sudden exposure of normally covered skin to strong sunlight. (See examples of intermittent exposure.)
- Protect infants from sun exposure to their skin and eyes until they are older than six months.
OPTION 2: Sunscreen
Routinely apply a waterproof mineral or organic sunscreen of SPF 30 or higher when going outdoors.
Sun Protection Factor (SPF) is the time it would take for the first skin redness to occur with sunscreen divided by the time it would take without sunscreen. For example, if your skin normally begins to burn in five minutes without sunscreen, a properly applied* SPF 30 sunscreen will extend the time to 150 minutes (SPF 30 x 5 minutes = 150 minutes).
SPF ratings of sunscreens are based only on UVB protection, and although most modern sunscreens also include UVA-absorbing ingredients, there is no rating system that allows consumers to determine the degree of UVA protection. The best UVA-protecting sunscreens contain micronized zinc oxide and micronized titanium oxide. An added benefit of these ingredients is that they don’t cause allergic reactions like certain organic additives may be prone to cause.
FryFace, a new non-commercial website, lists many popular sunscreens and moisturizers, plus their ingredients. The site was developed by a board-certified dermatologist and has a Product Selector that makes it easy to find the right products based on preferences.
*SPF ratings of most sunscreens are meaningless unless the sunscreens are applied heavily.
Proper Application of Sunscreen
Most people use far less sunscreen than needed for adequate protection. Teens and adults should apply one ounce (a full shotglass) of sunscreen per application for full body protection, and when spending a day at the beach or pool, should go through a full six ounce bottle of sunscreen.
Extra sunscreen should be applied to the nose, under the eyes, and the tops of the ears. These mid-face areas receive the greatest amount of sun exposure. Using a sunblock stick or chap-aid with SPF rating on these areas and lips will avoid the possibility of running into the eyes or mouth that may occur with liquid sunscreens.
Sunscreen should be applied 20 to 30 minutes before exposure, and reapplied at least once every two hours while outside. It should also be reapplied after swimming, towel-drying, or when perspiring heavily. Even “waterproof” sunscreens wear off while swimming or perspiring.
Active ingredients in sunscreens deteriorate with age and temperature so avoid using a sunscreen that is more than a year old or has been stored in a hot location for a long time.
The Difference Between Organic Sunscreen and Mineral Sunscreen
Organic sunscreens contain chemicals that absorb UV radiation, reducing the amount that reaches the skin. Mineral sunscreens contain ingredients that act as physical blockers, reflecting UV radiation away from the skin. The two most common physical blockers are zinc oxide and titanium oxide, which alone, or in combination, block both UVA and UVB radiation.
How do you know which one to buy? Look for a broad-spectrum product with an SPF of 30 or higher that protects against both UVB and UVA radiation based on active ingredients listed on the label.
Ingredients Found in Organic Sunscreens
For UVB protection: Octyl methoxycinnamate, Octyl salicylate, and Phenylbenzimidazole sulfonic acid. There are few single ingredients that provide high SPF UVB protection, so a combination is generally used.
For partial UVA protection: Oxybenzone, Benzophenone, and Octocrylene.
For broad-spectrum UVA and UVB protection: Micronized zinc oxide, micronized titanium oxide, Parsol 1789, and Ecamsule (tradename Mexoryl). A combination of two or more of these ingredients is generally used. Zinc oxide is the single most effective broad-spectrum ingredient.
OPTION 3: Sun Protective Clothing
When going outdoors, wear sun protective clothing, including UV-protective glasses and a hat with a wide brim that goes all around your head to protect your ears and neck. Ultraviolet Protection Factor (UPF) is a rating system similar to SPF, but applies only to fabric. Sun protective clothing usually has a UPF rating of 50+. Some clothing is less protective than you may think. A typical T-shirt has a UPF of 5 or less, not enough to prevent sun damage to your skin.
In hot weather, loose fitting, tightly woven fabrics offer good protection. Sun-protective clothing is available from many retailers. Alternatively, a laundry additive called SunGuard makes ordinary clothing such as T-shirts more UV-protective and is claimed to last through 20 washing cycles.
Wraparound UV-protective sunglasses will protect your eyes. The darkness of the lens, color, or price is not an indicator of the degree of protection. Glasses labeled “100% UV Protection” will completely block both UVA and UVB. Most plastic prescription glasses also block UVA and UVB.
The Melanoma Education Foundation is devoted to educational purposes only and is not engaged in rendering medical advice or professional services. Information provided by the Foundation should not be used for diagnosing or treating a skin problem or disease. It is not a substitute for professional care. If you have or suspect you have a skin problem you should consult a dermatologist, plastic surgeon, or other professional healthcare provider.