THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Tuesday, October 29, 1996 TAG: 9610290034
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: BY PAT DOOLEY, STAFF WRITER
LENGTH: 235 lines
TRY TO BUY sunscreen in Hampton Roads in fall or winter and you'll likely find supplies sorely depleted or relegated to a corner, somewhere behind cleaning solvents and toilet paper.
While we might slather on sun protection in the height of beach and bikini season, most of us pack away the bottles and tubes along with the folding chairs once Labor Day rolls around.
Never mind the outdoor tailgate parties, bazaars, weekend sports, mountain hikes and skiing.
Those hours spent under the sun in fall and winter are partly to blame for a growing incidence in cancers of the skin, along with early wrinkles, brown spots, sagging, leathery texture and other not-so-flattering facial characteristics.
The crinkles and lines we've become used to seeing in our late 20s, 30s and 40s most often are signs of too much sun - beginning in childhood. Without sun damage, many of those outward signs of aging wouldn't appear naturally until our 50s and 60s, doctors say.
And skin cancer probably wouldn't be the most common cancer in the United States.
To help prevent premature aging and skin cancer, many dermatologists recommend year-round use of full-spectrum sunscreens, which shield us from the sun's invisible ultraviolet-B rays and their equally damaging companions, ultraviolet-A.
Ultraviolet-A, the type also used in most tanning beds, once was considered ``safe.'' Health experts now know better.
Those long, penetrating ultraviolet-A's wreak cellular damage by going deep into the skin. The shorter, ultraviolet-B's cause the pink or red we see.
Ultraviolet-B is strongest between 10 a.m. and 4 p.m. in summer - hence, the annual warnings to shield our bare bodies. But ultraviolet-A may be an even greater threat: It bombards the earth fairly consistently all day, all year.
``On a nice day even in February or November, there is a risk,'' said Dr. Kevin D. Cooper, chairman of the Department of Dermatology at Case Western Reserve University and University Hospitals of Cleveland.
Damage from ultraviolet rays is cumulative, so even small amounts of sun are harmful. In a tenth of the time it takes to burn or pinken under the sun, minor changes in skin structure and immune response begin.
``You get exposure going to the car even once or twice a day,'' said Cooper, a spokesman for the American Academy of Dermatology.
A tan, often mistaken as a sign of good health, is the darkening of pigment in response to injury. Unfortunately, a little damage goes a long way.
Skin cancer afflicts 800,000 people in the U.S. annually - and is increasing, the American Cancer Society reports. Sun exposure is the major cause.
Malignant melanoma, the deadliest form of skin cancer, is increasing faster than any cancer in the U.S., claiming about 7,000 lives each year.
Today, one in 87 Americans is at risk for developing melanoma in his lifetime - an 1,800 percent increase since 1930, the cancer society reports.
Contributing to the rise: a depletion of our upper atmosphere's ozone, which blocks ultraviolet rays; fashion trends toward skimpier, less protective clothing; and an increase in leisure time and outdoor activities, such as boating, golf and gardening.
Certain people are more at risk - fair-skinned blonds or redheads, with a family history of skin cancer and one or two blistering sunburns in childhood. But anyone who spends time in the sun exposes himself to early aging or skin cancer, said Case Western's Cooper.
In Hampton Roads, dermatologists are seeing more young people with sun-induced skin changes, said Dr. David A. McDaniel, a Virginia Beach dermatologist.
``We didn't used to see them before their 40s,'' he said. ``Now we see them in their late 20s and 30s.''
Although people are more aware of the dangers - not tanning as deeply, or using tanning booths less often - ``they are not being careful enough,'' McDaniel said.
The best defenses: Avoid the sun, and use sunscreen every day.
``Build it into your routine,'' McDaniel said.
And start early. Studies show that most sun damage occurs before age 20, and children who've suffered two blistering sunburns have double the risk of melanoma.
``Using sun block faithfully your whole life cuts your risk dramatically,'' McDaniel said. Using sun block on children 10 and under slashes their lifetime skin-cancer risk by 85 percent.
Yet, in a recent survey by the academy of dermatology, 58 percent of parents with children under 13 said they allowed their children to play outdoors without sunscreen or sun-protective clothing. Thirty percent said they and their children had been sunburned in the last summer.
In the same survey, 58 percent of young adults said ``working on a tan'' was part of their outdoor activities. Twenty-six percent said they lie out in the sun.
It's unlikely they're thinking about ultraviolet rays.
``Most people don't use sunscreen,'' said Dr. Frederick Quarles, a Norfolk dermatologist.
In a 1994 American Health magazine survey, only 16 percent of respondents said they use sunscreen every day. Eighty-eight percent said they use it sometimes.
In fall and winter, stores stock fewer sunscreens because consumer demand is down.
And many people don't buy sunscreen in the off-season because they don't know about the dangers of ultraviolet-A, how to protect from it and how to choose a sun block, said dermatologist McDaniel.
Selecting the right product can be tricky.
Sunscreens and sun blocks generally guard against ultraviolet-B rays by absorbing, reflecting or scattering them.
The amount of UVB protection is determined by a product's Sun Protection Factor, or SPF. An SPF of 15 to 30 shields most adults for work or play, McDaniel said. An SPF of higher than 30 probably gives little, if any, added safeguard.
But SPF is not a measure of coverage for ultraviolet-A. The only way to tell if a product protects against UVA is to look for those letters on the label. Even then, McDaniel said, there is no way to tell how much UVA protection a product gives.
The Food and Drug Administration is considering uniform guidelines for UVA/UVB protection, and more full-spectrum products have come onto the market in the last year, McDaniel said. But for now, if a product doesn't say it protects against ultraviolet-A, it probably doesn't.
Don't think you're safe in a car, sunroom or tanning booth, either.
Ultraviolet-A rays can penetrate glass and some plastics. Studies have shown a higher incidence of cancers and early aging on the left sides of airline pilots and others who work in vehicles, McDaniel said.
Tanning beds and sunlamps - often touted as safe - generally produce heavy doses of ultraviolet-A, as well as some ultraviolet-B, he said.
A half-hour in the typical tanning booth is equal to six to eight hours of uninterrupted exposure to the sun, according to the Skin Cancer Foundation.
About 2 million Americans a day use tanning beds in peak season - from winter to spring - the foundation reports. Between 1 and 2 million ``tanning junkies'' use the beds about 100 times a year.
People who use them more than 10 times a year have seven times more melanoma risk than do nonusers, one study showed.
``No tanning booth is safe,'' said Case Western's Cooper.
Certain medications - including some antidepressants, diuretics and antibiotics - can increase a person's sensitivity to ultraviolet rays - and exacerbate the damage.
And people who work indoors, then spend vacation or weekends in the sun, may be at higher risk too.
Any time you're in the sun, wear thick-woven clothing, which blocks more ultraviolet rays, said dermatologist Quarles.
People in warm climates often wear white, lightweight fabrics, he said. But sheer fabrics, as well as wet clothing, may allow rays to penetrate skin.
Wear long sleeves, long pants and broad-brimmed hats, even on cloudy days, Quarles said.
There is some evidence that using a full-spectrum sunscreen and avoiding ultraviolet light daily encourages the skin to start repairing some of the sun's damage, McDaniel said.
But if you think no one will know you haven't worn your sunscreen, think again. A sun-damaged face stands out - the wrinkles around the eyes and mouth, the lack of elasticity, the leathery texture.
``I see it all the time,'' said Quarles. ``I can tell by the look of the skin. It's really bronze, but it has a lot of aging on it.'' ILLUSTRATION: Graphic
ABOUT SKIN CANCER
Skin cancer is the most common type of cancer. More than 800,000
people in the United States get skin cancer each year. About 9,500
of them die from it. Sun exposure causes most skin cancers.
Most at risk are people who: sunburn easily; have fair skin or
red or blond hair; have blue or green eyes; are of Celtic ancestry;
have a family history of skin cancer; have many moles; work
outdoors; sunbathe; work indoors then spend weekends or vacations in
the sun; move to more southern climates. Anyone who spends time in
the sun can get skin cancer.
Ninety percent of skin cancers occur on parts of the body usually
not covered by clothing - the face, hands, forearms and ears. People
trying to get tans also get skin cancer on the shoulders, back,
chest and legs.
The three most common types of skin cancer are basal cell
carcinoma, squamous cell carcinoma and melanoma.
About 75 percent of skin cancers are basal cell. Once considered
a disease of older people, it is being seen more in young people.
Basal cell cancer usually develops on the face, ears, lips and
around the mouth of fair-skinned people. It can start as a red patch
or shiny bump that is pink, red or white. It may be crusty or have
an open sore that does not heal. Treated early,it can be cured.
Squamous cell carcinoma usually appears as a scaly patch or
raised, warty growth. It can be cured if treated early; untreated,
it can be deadly.
Melanoma is the most dangerous form of skin cancer. It often
looks like a dark brown or black mole with irregular edges.
Sometimes, it is multicolored with shades of red, blue or white.
Melanoma is increasing by 4 percent annually - faster than any
type of cancer in the United States. About 7,000 people in the U.S.
die from melanoma every year. Among men, melanoma is most often
found on the trunk; among women, it is common on the lower legs.
Caught early, melanoma often can be cured; ignored, it spreads
throughout the body and can kill.
To spot trouble early: Practice frequent self-examinations,
including the back of the knees and neck; and the legs, feet and the
spaces between toes.
Watch for changes in size, shape, color or pattern or,
occasionally, disappearing or bleeding moles or pigmented lesions.
Some danger signs include: asymmetry (one half is unlike the other),
irregular border (edges are ragged, notched or blurred), varied
color, and any mole larger than a pencil eraser, or growing.
Any unusual sore, lump, blemish or other skin marking may be a
warning sign, although most skin problems are not cancer. If you
have questions or concerns, see a dermatologist.
Sources: the American Academy of Dermatology, the National Cancer
Institute and the American Cancer Society
Graphic
SUN-SAFETY TIPS
Here are sun-safety tips for all seasons, from the American
Academy of Dermatology:
Avoid the sun between 10 a.m. and 4 p.m., when rays are
strongest, especially in summer.
For maximum protection, apply sunscreens about 20 minutes before
going outdoors. Use a broad-spectrum sunscreen with an SPF of at
least 15 every day, unless you are indoors or it is raining.
When working or playing outdoors, reapply sunscreen every two
hours, even on cloudy days.
Wear protective clothing, such as tight weaves, long pants, long
sleeves and a wide-brimmed hat, even for short periods.
Wear sunglasses with both UVA and UVB protection. If you are
unsure what type to purchase, check with your eye doctor or
dermatologist.
Stay in shade as often as possible.
Avoid sun-reflective surfaces - such as sand, water, snow and
decks.
Keep children out of the sun. Most lifetime damage occurs before
age 20.
When outdoors, minimize a child's exposure to the sun by
liberally applying sunscreens of SPF 30 or higher, beginning at 6
months of age.
Graphic
MORE INFORMATION
The American Cancer Society. For information on skin cancer,
call: (800) ACS-2345.
The American Academy of Dermatology publishes free pamphlets -
``The Darker Side of Tanning,'' ``The Sun and Your Skin'' and ``Skin
Cancer: An Undeclared Epidemic.'' Send a self-addressed, stamped
envelope to the AAD, P.O. Box 4014, Schaumburg, Ill. 60168-4014.
The Skin Cancer Foundation, 245 Fifth Ave., Suite 2402, New York,
N.Y. 10016. Or call (212) 725-5176 or (800) SKIN490.
Sun Precautions Inc., makes SPF 30-plus sunscreen, hats, scarves,
gloves, shirts, parasols, jackets, pants and skirts. For a
mail-order catalog, call: (800) 882-7860.
KEYWORDS: SUNSCREEN SKIN CANCER by CNB