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A melanoma fighter's summer guide to sunscreen

Everything we love about summer revolves around the longer, warmer days and nights. Here's how you can best put yourself in position to avoid long-term skin damage that can ultimately lead to melanoma.

Hey guess what – summer is already here! This weekend, grills will be fired up, picnics will be unpacked, boats will be dropped in, and hordes of people will descend on beaches up and down the Shore.  We're also a month away from the longest day of the year and the hottest three-month stretch. Everything we love about summer revolves around the longer, warmer days and nights.  Unfortunately, an overwhelming majority of those activities happen outside, under the hot sun. Which means the chances of having your own melanoma blog one day just went up - if you're not careful.

I will spare everyone the preachy "don't end up like me" shtick and get right into how you can best put yourself in position to avoid long-term skin damage that can ultimately lead to melanoma.

First, what are the important things to know?

  1. The sun is at its hottest between 10a and 3p.  This DOES NOT mean you are OK the rest of the day, especially beach days that begin before 10 and end after 3.  It means that during the extended lunchtime hour, extra vigilance is needed. Reapply sunscreen.  Sit under the umbrella or a shady tree for a while. Give yourself and your skin a break.

  2. Most sun damage occurs before the age of 18.  For goodness sakes, make sure your kids are covered up and/or use sunscreen effectively.  I have mentioned it before; this isn't an excuse for responsible adults to irresponsibly ignore sun protection.  You are not just setting the right example for your children, you are keeping yourself healthy.

  3. Getting a "base tan" is NOT sun protection.  You just happen to be a darker shade of exposed.  While it is true certain skin types are more susceptible to damage from the sun (sorry, me fellow Irishmen), it DOES NOT mean once you get that initial tan, your skin is protected and sunscreen isn't necessary.  The sun can do just as much damage after you neglected to protect your skin the first time as it can before you neglected to protect it the first time.  This includes anyone with naturally tan or dark skin, too.

  4. Stay the HELL away from tanning beds.   This goes for those who believe in the base tan, and the ones who are trying to extend that summer look well into football season.  33 states have some form of tanning bed restriction for minors, and even the FDA is putting warning labels on them.  Not putting on sunscreen when you know better may be dumb, but getting into a tanning bed is stupid.  Don't do it.

OK smart guy, so HOW do I stay safe?

  1. This is restating the obvious, but wear sunscreen.  Not SPF4 Bronzer, either.  A 30 SPF will keep you safe for a few hours.  Anything under 15 is no longer considered sun protection by the FDA.  Also, higher numbers don't give you exponentially better protection; if anything, there are diminishing returns above 30.  They won't hurt, but don't expect SPF 90 to work three times better than 30. It's negligible.  Stick with SPF 30.

  2. Remember "Broad Spectrum" and "UVA".  SPF measures only UVB ray protection; UVA protection must be obtained from different minerals (or chemicals) added to the sunscreen.  The FDA has FINALLY updated the labeling on sunscreens (see above link), so you should find the shelves stocked with better labeled products this summer.  If it says "Broad Spectrum", then it includes UVA protection, too.  Note – there isn't a SPF-like standard measure for UVA measurement, it either has it or it doesn't.  Make sure you see one of those phrases on your sunscreen bottle.

  3. Most people know you are supposed to reapply sunscreen every couple of hours.  Very few do it consistently; heck, I don't reapply an embarrassingly high number of times.  There are plenty of excuses, so try and stick with a manageable plan.  For example: apply before leaving the house (while getting dressed is the perfect time), reapply before eating lunch, and if the day is long enough, reapply when you have that mid-afternoon snack or drink refill.  Reapply before eating, as afterwards the kids (and adults) will be eager to start having fun or falling asleep in a beach chair.  Either way, the chances of getting sunscreen out and on everybody post-food has greatly diminished.  Find your own method based on your typical summer days, as long as you have some cadence or routine.  Share suggestions in the comments below.

  4. The spray and squirt on sunscreens, while better than nothing, are much less effective than lotions.  Especially if you don't actually rub them in after spraying; they wear or wash off even quicker than typical sunscreen.  In a pinch, or with a fussy kid, they will do, but get you and your children in the habit of rubbing sunscreen in, not spraying it on.  Oh yea, they're expensive, too, for the coverage provided.  If you are going to spend extra on sunscreen, make it the good kind, not the convenient stuff.

  5. Don't make the false assumption sun protection is just for pale white people who sit out sunning themselves.  Sunscreen isn't just for the shore trips and pool days; you can easily get burnt quickly at home working outside.  The sun is just as hot in your backyard or on the basketball court as it is at the 30th Street beach.  Sun exposure and skin damage can happen anytime, anywhere, to any race or ethnicity.  Make it a habit to apply before any outdoor activity.

Is there anything else I should know?  Glad you asked; as a matter of fact, there is.  There is a lot of debate in the oncology world about toxins and cancer; some of the more integrative practitioners fully believe that a toxic body is the root cause of cancers.  While I am not 100% sold on that, when we have Johnson & Johnson hiding formaldehyde in their baby shampoo, I'm not really trusting chemicals put in our personal care products, either.  So, what is good and bad in sun protection?

First, any sun protection is better than no sun protection – you are more likely to get cancer from unprotected sun exposure than chemicals in sunscreen.  That being said, there are shades of grey.  Current research suggests that two minerals are the safest – zinc oxide and titanium dioxide.  They are notable because their molecular structure makes them too big to be absorbed into your skin, so they sit on top of your skin and reflect the sun's rays away.  That white stuff on a lifeguard's nose?  Zinc oxide, or some form of zinc protective cream.  Most sunscreens with either/both of these ingredients are referred to as Physical Barrier sunscreens, since they reflect UV light, rather than absorbing it.

Common sunscreen chemicals like oxybenzone and retinyl palmitate (Vitamin A) have been linked to toxicity and are designed to be absorbed into your body through the skin.  Guess what?  Those chemicals are cheaper than the Physical Barrier minerals, so your beach bag is likely filled with sunscreens containing one of these chemicals.  For sunscreens – and anything related to toxins and your personal care – the Environmental Working Group website is the gold standard for information on products and ingredients.   Their 2013 Sunscreen Guide can offer far more in-depth information than this blog, or anything else I have seen.  You will find recommended brands there, and can look up every sunscreen you have (and other personal care products) for levels of toxicity in each ingredient.

Finally, and directly from the ewg.org website: "The best sunscreen is a hat and a shirt."  There is a reason that fishermen, lawn maintenance workers, and others who are out in the summer sun are wearing loose, baggy shirts and pants that cover their arms and legs, and a bucket hat to match the ensemble.  You don't need to bundle up or wear heavy clothes – just something that has sleeves.  There are plenty of SPF shirts that are cool even in the summer; heck, even Target has some inexpensive ones, if the pricier models by Columbia, Under Armor, etc… are out of your budget.  Look, tans look nice, even I admit that.  Long sleeves and hats at the pool, beach, or park?   They may be less stylish to the MTV clowns, but are you really out there to impress strangers with your bravado challenging ultraviolet rays?

So this summer, pack that broad spectrum SPF 30 sunscreen.  Bring along the floppy hat.  Toss on the long sleeve shirt during the midday pelting of UV rays.  Ignore the example set by countless sun worshippers, as if their tan is enviable.  Chances are, their future dermatological problems won't be.

T.J. Sharpe shares his fight against Stage 4 Melanoma in the Patient #1 blog. Read more »