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  • Writer's pictureRyan Allen

Skin protection and cancer

Summer is officially upon us, and that means many of us are spending more time outside, probably getting more sun exposure than usual. With this, of course it’s all the more important to protect our skin with sunscreen, hats, clothing, etc. However, the American Academy of Dermatology actually recommends using sunscreen every day if you go outside, not just when there is hot, sunny weather. While you may think they say this out of an abundance of caution, and perhaps rightfully so, I certainly believe that usage of preventive measures for skin protection should be much higher than it is right now for most people.


Now, before you stop reading because you already know that you probably ought to wear sunscreen more often, just take a minute to let me perhaps convince you that this actually matters. It is very well-established that overexposure to ultraviolet (UV) radiation (present in sunlight) can cause cancer. The mechanism is quite clear: ultraviolet light is short in wavelength and therefore high-energy, powerful enough to penetrate our numerous cellular barriers and directly damage our DNA. When DNA damage occurs, we have many pieces of molecular machinery in place to fix it. In fact, this is why your skin gets red and painful with sunburn; inflammation takes place to aid in this process, but this is not an actual “burn” in the way we’d typically imagine. Despite our body’s best efforts, countless mutations–or changes in our genetic code–still arise from DNA damage and subsequent repair. Cancer is caused by certain mutations (of which there are many) that allow cells to grow and divide uncontrollably. For this reason, we virtually always would like to avoid anything that causes DNA damage.


Granted, we expose ourselves to carcinogens, or things that can cause cancer, in different circumstances all the time: processed foods we might eat, various chemicals, radiation such as sunlight, certain drugs and therapies, etc. If this general cancer risk is not convincing enough to avoid unprotected sunlight exposure, though, maybe some data will shed light on why this specific carcinogen must be addressed. First and foremost, skin cancer is the most common form of cancer, with one in five Americans affected in their lifetime and more than two dying every hour. This is likely because the skin is the largest organ in the body, has a high surface area, and is largely exposed to our external environment where more carcinogens may be present. It is frightening to then consider that we have 19 million cells in every inch of our skin, and only one needs to be mutated in a certain way to generate a tumor.


Another key contribution to skin cancer is the amount of times it goes unrecognized, unreported, or undiagnosed. Many people tend to see a spot, patch, or other feature on their skin that they perceive to be harmless, when it may actually be cancerous. In general, it is safest to inquire with a physician regarding any such concern, no matter how mild. However, another major issue that may lead to late detection stems from a common misconception. Many may feel they “do not need” to use sunscreen if their skin is of a darker complexion, and this is not true. In fact, while the incidence of skin cancer is lower in those with darker skin tones, these patients are less likely to survive when diagnosed. A critical factor in this is that these patients are often diagnosed too late, when the cancer is already advanced beyond the point of treatment. In other words, if anyone thinks they are getting by without sunscreen, not actually suffering any DNA damage or other consequences at the cellular level, that is likely not the case.


The take-away: when in any doubt, protect yourself from sunlight exposure. Like most people I’d assume, this is something I definitely struggle with. In fact, the inspiration for writing this comes from spending an hour at the beach just last week. Thinking that with a decent amount of cloud cover I could get away with no sunscreen for just this short time, I suffered the consequences with sunburn on my face, hands, and legs. From now on, I plan to frequently check the UV index available on most weather reports, on which I will base the necessity of my sunscreen use. While it seems a drastic measure to start using sunscreen every moment outside of every day, I feel titrating my sun protection based on the UV index confers the vast majority of the risk reduction I’m after. Lastly, I certainly plan on wearing hats more outside. I’ve never really considered how serious sunburn can be on one’s scalp, always thinking that somehow my hair offered a decent amount of protection, when actually it’s rather minimal.


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