Don’t you believe it! A “healthy tan” is anything but that. It is actually an oxymoron, or a situation where the two words contradict each other. Tanning is actually a sign of injury to the skin – the pigment cells have to be damaged enough to produce increased pigment leading to a tan. Even more dangerous is having the skin type that does not tan at all but only burns. The Academy of Dermatology condemns tanning and the use of tanning booths. Excess exposure to the sun or to tanning lamps leads to premature aging of the skin, wrinkling, and brown spots. And there is a direct relation between sun exposure and skin cancers.
At the Carl T. Hayden VAMC Dermatology Clinic, not a day goes by without our diagnosing multiple skin cancers. The most common skin cancers are basal cell and squamous cell carcinomas. As you would predict, they are most common on the sun exposed areas of the arms, face and head. They grow slowly, over years. They are not ordinarily life threatening although they do require removal.
The skin cancer that can spread and lead to death is the melanoma. There seems to be an epidemic of melanomas in Arizona (especially the Sonoran Desert region). At the VA dermatology clinic, we have actually diagnosed three patients with melanomas in one day. Fortunately, many of those we diagnose are early and have a favorable outlook. Your doctor should examine any mole that grows, has irregular borders or colors, or bleeds.
So how do we prevent (or at least minimize) this sun damage? Clothing can be helpful. Unfortunately, unless the clothing is dark in color and/or thick and closely woven, the Sun Protective Factor (SPF) of ordinary clothing is about eight. In spite of the controversy surrounding SPF numbers, there appears to be little doubt that in Phoenix a SPF of 30 is necessary. There are clothes manufactured with a SPF of 30 which have been tested by the Skin Cancer Foundation. These are worthwhile but expensive. If you wear lightweight or light colored clothing, you should put sunscreen on before your clothes.
Topical sunscreen comes in all shapes and sizes. The most effective appear to be those that leave a whitish film on the skin. Perspiring does not readily lose them. For the acne age group, gels are less likely to cause acne flares. Your sunscreen must be at least SPF 30. There is no “waterproof” sunscreen. When the FDA ground rules are published, “waterproof” will be struck from sunscreen labels. Look for ingredients such as Parsol 1789, titanium dioxide, zinc oxide and cinnamates in your sunscreen. Because all sunscreens are lost to contact and perspiration, they must be renewed every two hours if you are outdoors and every hour if you are doing water activities.
Hats are wonderful. They protect the top of the head and provide some shade for the face and neck. Notice, I did not say “cap.” Your hat must be broad brimmed, at least four inches.
In the mountains, there is five percent more ultraviolet for each 1,000 feet of elevation. Even if it’s cooler, the ultraviolet is increased. On cloudy days, 85% of the ultraviolet comes through the clouds. So protection is necessary. So heed my advice and also look younger as you minimize your sun damage.
Selma E. Targovnik, M.D. is a dermatologist at the Carl T. Hayden Veterans Affairs Medical Center which is part of the Phoenix VA Health Care System. PVAHCS has been providing quality health care to area Veterans since 1951. Although we can’t provide personal health care advice, if you have a topic of general health interest that you would like to see addressed in this column, e-mail your suggestion to Paula.Pedene@va.gov