Despite increased awareness about the dangers of ultraviolet (UV) radiation, melanoma rates continue to rise in the United States. For “Don’t Fry Day” on May 26, the American Cancer Society is cautioning that many people may be using sunscreen improperly, not only limiting its effectiveness but potentially increasing their risk of skin cancer.
Data from the CDC’s Surveillance, Epidemiology, and End Results (SEER) program show rates of new melanoma cases have been rising for three decades, and on average 1.4% each year over the last 10 years. The rise comes despite heightened awareness about the dangers of UV radiation as well as widespread promotion of the use of sunscreen.
“Our fear is people are not using sunscreen correctly, and even when they do, many are using it inappropriately,” said Richard C. Wender, M.D., chief cancer control officer of the American Cancer Society. “People may be using sunscreen to go out in the sun in the middle of the day, when the risk is highest, and to stay out longer. Adding to the problem is the fact that many people do not use enough sunscreen and do not re-apply frequently enough.”
“People primarily worry about sunburn, which is understandable. Severe sunburns are an important risk factor for melanoma. But sunburn only tells you how much UVB radiation exposure you’ve had; it tells you very little about how much exposure you’ve had to UVA radiation,” said Dr. Wender.
While UVB is the chief culprit behind sunburn, UVA rays penetrate the skin more deeply, are associated with wrinkling, leathering, sagging, and other light-induced effects of aging. UVA rays also exacerbate the carcinogenic effects of UVB rays, and increasingly are being seen as a cause of skin cancer on their own.
Sunscreens vary in their ability to protect against UVA and UVB. Sun Protection Factor or SPF measures how effectively the sunscreen formula limits skin exposure to UVB rays that burn the skin. SPF does not measure UVA. Only “broad spectrum” sunscreens protect against both UVA and UVB.
“Sunscreens are important, no doubt,” says Dr. Wender. “But they should not be a first line of defense against the sun. The first line should be avoiding midday sun.”
The American Cancer Society recommends:
- Seek shade Avoid being outdoors in direct sunlight too long between the hours of 10 am and 4 pm, when UV light is strongest.
- Protect your skin with clothing: When you are out in the sun, wear clothing to cover your skin. Long-sleeved shirts, long pants, or long skirts cover the most skin and are the most protective. A tightly woven fabric protects better than loosely woven clothing. If you can see light through a fabric, UV rays can get through, too.
- Wear a hat: A hat with at least a 2- to 3-inch brim all around is ideal because it protects areas that are often exposed to intense sun, such as the ears, eyes, forehead, nose, and scalp.
- Wear sunglasses that block UV rays
- Use sunscreen: Use an SPF 30 or higher broad spectrum sunscreen. Ideally, about 1 ounce, about a shot glass or palmful, should be used to cover the arms, legs, neck, and face of the average adult. Sunscreen needs to be reapplied at least every 2 hours to maintain protection.
While sunscreens with SPF above 50 are available, Dr. Wender says they offer little additional protection, and could backfire if people overestimate the additional protection they provide.
“SPF 30 sunscreens filter out about 97% of the sun’s UVB rays. SPF 50 brings that to about 98%, and SPF 100 to about 99%. So the higher you go, the smaller the difference becomes. And that number says nothing about UVA rays,” said Dr. Wender. “People may see the higher number, overestimate its ability to block additional rays, and increase their exposure and their risk. That’s why your first line of defense must be avoiding the bright sun in the middle of the day.”
The National Council on Skin Cancer Prevention (NCSCP www.skincancerprevention.org) designated the Friday before Memorial Day as “Don’t Fry Day,” a public awareness campaign that promotes sun safety and encourages people to protect their skin while enjoying the outdoors. Core members of NCSCP include the American Cancer Society, the American Academy of Dermatology, the Melanoma Research Foundation, and the Skin Cancer Foundation.
For more information, see: Skin Cancer Prevention and Early Detection on cancer.org.