By Kari Dickey, DO

Many of us welcome the arrival of summer with open arms, charging into the outdoors to soak up as much sun and fresh air as we possibly can before another New England winter rolls in. While all medical providers encourage our patients to be active outdoors, there are some important safety considerations to keep in mind if you’re going to be exposed to the sun.

Kari Dickey, DO
Kari Dickey, DO

Sunlight consists of two types of ultra violet rays – UVA and UVB rays. Both can damage the skin and cause skin cancer with prolonged or cumulative exposure. UVA rays are the ones responsible for freckles, wrinkles and age spots and UVB rays are the primary cause of sunburns. UVA rays can pass through window glass, so you should wear sunscreen even if you are in the car or a room with natural light.

The American Academy of Dermatology estimates that over 3.5 million cases of skin cancer occur each year in over 2 million individuals, meaning that some people are experiencing multiple incidences of cancerous lesions on their skin. Your risk of developing skin cancer is increased if you have spent many years out in the sun without protection and have experienced multiple sunburns, but it’s never too late to develop safe and healthy sun habits. Here are some handy tips:

  • Look for sunscreen labels that feature the term “Broad Spectrum Protection” – this protects you from both UVA and UVB rays.
  • Sunscreen with a minimum of 30 SPF should be applied EVERY time you go outside and should be re-applied every 2 hours. Even on cloudy days, up to 80% of the sun’s UV rays can penetrate our skin.
  • Everybody, regardless of their complexion should wear sunscreen. You are still susceptible to skin cancer without good sun protection.
  • A good rule of thumb is to use about a shot glass worth (1 oz.) of sunscreen each time you apply it. Apply your first coat 15 minutes before going outside, and re-apply, head to toe, every two hours thereafter – don’t forget the tops of your ears and the back of your neck, and use a lip balm with at least 30 SPF. Remember that water and sand increase the sun’s reflectivity, so even if a sunscreen claims to be waterproof, re-apply every two hours.
  • Sunscreen is safe to apply to babies over the age of 6 months. Up until that age you should be using protective clothing, umbrellas, shade tents, hats and other means to keep your baby out of direct sunlight.
  • Light colored clothing is the most effective in reflecting sunlight away from your skin. I’d recommend covering up whenever you can, particularly between the hours of 10 am and 2 pm, when the sun’s rays are at their strongest.

Some common questions we get about the sun, sun protection and skin cancer are:

What about the safety of tanning beds? UV rays are UV rays, whether they come from the sun or an artificial light source. Both do damage to your skin and both can increase your chances of developing skin cancer. If a tanning bed is being marketed as “safer” it typically means that it produces either UVA or UVB rays, both of which are still harmful.

What if, in spite of my best efforts, I get a blistering sunburn? First, don’t pop the blisters! They are there to protect the burned area from bacteria and infection, so wash the area gently, pat dry carefully and moisturize or apply a hydrocortisone cream, taking great care not to pop the blisters. Sunburns pull moisture from the skin, so drink plenty of fluids to stay hydrated and let the blisters resolve on their own.

When should I be concerned about a mole? If a mole is new, rapidly growing or multi-colored, has irregular borders and/or bleeds when scratched you should have it checked out by your health care provider. Any mole that has grown to over 6 mm in diameter (about the size of a small pencil eraser) should be evaluated as well. The American Academy of Dermatology recommends that each year on your birthday, you should strip down to your birthday suit and examine yourself for any skin changes.

Are there different types of skin cancer? Yes. Some are more easily treated than others, and all are treated more easily if detected early. Squamous cell or basal cell cancers can often be frozen or scraped off in a fairly minor procedure. Melanomas are the most serious type of skin cancer, as they put out roots and can spread to other organs of the body.

How do I know if I have heat stroke or sun poisoning and what should I do? If, after spending time in the heat and in the sun you are feeling light-headed or dizzy, have a low-grade fever or are experiencing chills you may have heat stroke. Some people with heat stroke may also feel nauseated. Get out of the sun, into a cool, shaded environment and drink lots of fluids. Sports drinks can replace electrolytes lost through excessive sweating. If the nausea is making it difficult to keep fluids down, you may need a visit to your physician or the local Emergency Department for some intravenous fluids.

Does sunscreen ever expire? The FDA requires that sunscreens maintain their strength for at least three years from time of manufacture. But if you’re correctly following the recommended guidelines of applying an ounce of sunscreen every time you go outside, and re-applying every 2 hours, even the largest bottle of sunscreen won’t last that long! All sunscreens carry expiration dates, so make sure to check those and discard any that have expired.

So now that you know how to protect yourself, stock up on sunscreen, slather it on generously and get out and enjoy your summer in the garden, at the lake, hiking, biking, or spending time in our beautiful wilderness areas. We wish you a safe and healthy summer season!

Kari Dickey, DO is a board certified family practice physician at Putney Family Healthcare, a department of Brattleboro Memorial Hospital. She can be reached at 802-387-5581.