Two years ago, Melanie Heider noticed that a mole on her left leg was starting to grow, and that it had changed color. On her mother’s advice she went to a dermatologist, and one week after having a biopsy, Heider learned she had malignant melanoma, the most dangerous type of skin cancer. The American Cancer Society estimates that in 2014, more than 76,000 new cases of melanoma will be diagnosed in the U.S. and 9,700 Americans will die from the condition.
Heider, now age 25, didn’t have a family history of melanoma, but she acknowledged that her's was "a beach family” and that they went to the beach on most weekends.
“I have a decent amount of freckles on my body. I was lucky enough that the cancer was in a place, inside of my left leg, right by my knee, where you put suntan lotion or shave, so I saw it. I really started to take notice when it got lighter, almost like it was fading, but then it just grew and started to bubble up and get bigger. I said, 'this is strange; this is not normal. Freckles don’t bubble up.’ It was a little scary and it was the unknown,” Heider said.
Despite being aware that Heider had skin cancer, and has also had some other skin spots removed that were not serious, many of her friends don’t seem concerned about using sunscreen. “They want to get tan,” she said.
July is UV Safety Awareness Month, and Healthline sat down with Dr. Hooman Khorasani, an assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City, to find out how dangerous tanning is, and how people can protect themselves and their families from skin cancer.
Young Women Ignore Sun Warnings
Khorasani agreed that young women are still not paying attention to the message that tanning in the sun and in tanning salons is dangerous. “Young women are a bigger problem group because since the 1970s and 80s, all of our magazines and TV have portrayed tan as being a beautiful skin. The likelihood of women going to a tanning salon or tanning is much more common than for men. There’s a clear correlation between melanoma and tanning beds. It’s one of the main reasons melanoma is the number one skin cancer in women in their 20s,” said Khorasani.
Young people in their twenties and thirties feel invincible, Khorasani added. “They don’t feel like they are going to get cancer. They think that’s something that happens to older patients. They shake their heads. You think they are listening, but they are not,” he said.
So, how does Khorasani encourage his young women patients to slather on sunscreen? He shows them photographs of people who have sun damage, such as a female typist who worked in Australia and sat by a window for 15 years. The right side of her face faced the window, while her left side faced a wall. “You can clearly see the right side of the face that was exposed to sun is much more photo damaged and aged. On the right she looks 60 years old, and on the left she looks 45 years old,” said Khorasani.
Both UVA and UVB Rays Are Harmful
There is a difference between UVA and UVB rays, but both are harmful. UVA is the wavelength of radiation from the sun that makes up the majority of the ultraviolet rays we receive. It penetrates deeper than UVB rays and has been linked to photo aging and wrinkling, and is also believed to contribute to skin cancer. UVB rays do not penetrate the layers of the skin as deeply as UVA rays, but they are responsible for reddening of the skin, sunburn, and the formation of skin cancers.
Khorasani recommends using sunscreens that provide a broad spectrum of UVA and UVB protection. He also instructs that since a baby’s skin is more permeable than an adult's and absorbs chemicals more easily, for the first six months of a baby’s life, parents should use cream-only sunscreens. After six months babies can use most of the products that adults use.
“When I bring my kids to the beach, they are basically fully covered; they have a hat on and they wear a body suit. That’s the best thing you can do for your children. Protective clothing like a rash guard is much more efficacious than any sunscreen you can use,” said Khorasani.
When it comes to spray sunscreens, Consumer Reports recently announced that with the Food and Drug Administration (FDA) investigating the potential risks of spray sunscreens, the products should generally not be used by or on children, unless there is no other sunscreen product available. The sunscreen should be sprayed onto your hands and then be rubbed on the skin.
"As with all sunscreens, be especially careful on the face, taking care to avoid the eyes and mouth. Adults should not use sprays on their face. Instead, spray it on your hands and rub it on, making sure to avoid your eyes and mouth, and try to avoid inhaling it," Consumer Reports said.
While most people think the higher the SPF (sun protection factor) number, the better the protection, Khorasani said, "It doesn't really matter how high the SPF is. It’s more the frequency and how often you reapply. If you are outdoors, you need to apply it at least every 40 minutes ... If you are on the beach and in the water, you need to reapply it every 20 minutes. Some people say, 'I have 120 SPF and I only put it on once and that’s it.' It’s not enough. If you are out hiking the whole day, you can’t just put it on once and that’s it. In the summer, even if it’s cloudy, you are still getting UV rays through the clouds, so you still need to have sunscreens.”
Cover Up and Plan Ahead
No matter how old you are, always wear a large hat, said Khorasani. "The areas that you get the most amount of skin cancer, especially basal carcinoma, are on the face — the areas that have large surface areas. The two places you should always cover by clothing or a hat are both your ears and the nose. Anywhere else you get a skin cancer, such as the cheek, we can cut it out and stitch it back together. The nose doesn't have a whole lot of skin, so it usually needs some sort of reconstruction.”
In the summer, since the sun is much closer to the surface of the earth, if you are going to go running, Khorasani advises you avoid the sun from 10 am to 2 pm, when the UV Index is the highest. "Either go in the morning or in the afternoon," he said.
Darker skinned individuals can also get skin cancer. "African Americans and Hispanics usually get it on the sole of the foot or the vaginal area. But even though you are dark-skinned, even black or Hispanic, it doesn't mean you cannot get melanoma. I have a lot of Hispanic patients that are medium dark who get melanoma," said Khorasani.
Is any sun exposure healthy? Khorasani said getting a little bit of sun on a daily basis is actually protective against melanoma. “Farmers in California get a little bit of sun every day, and that actually gives a little hardening of their skin and protects against melanoma. They can get non melanoma skin cancers like basal cell and squamous cell, but these are not as deadly as melanoma,” he explained.
Widow Takes on a Worthy Cause
Rhonda Sparks knows the angst of losing a loved one to melanoma, but she has taken a personal tragedy and turned it into a way to raise awareness about skin cancer. Her husband died from melanoma when he was just 32 years old.
"We tried to fight the battle and it just spread though his body and took his life in September 2001, a few days after the 9/11 tragedy. Talk about a whirlwind. The whole world is in shock, and I’m trying to help my husband pass as well," she said. "We had three babies, age one, three, and six. Needless to say, my life went into a tailspin. It took a couple of years to get back on my feet."
When she did get back on her feet, Sparks started a nonprofit foundation to raise funds for cancer with an annual ski event. Today, she runs a business called UV Skinz, which provides a line of sun protection clothing for children and adults, complete with Ultraviolet Protection Factor (UPF 50+) protection against harmful UV rays. The clothing is sold in stores and online at www.uvskinz.com.
"I feel I have a purpose and this is the story I was given, and I am going to do the best I can," said Sparks. "You have to pick yourself up and keep going. There’s no crawling in a cave, especially when there are kids involved."