Misconceptions about lifetime sun exposure still abound

Dermatology Nursing, August, 2008 by Daniel B. Burfeind

Many people take a laissez-fair attitude about protecting themselves from the sun because they think the damage is already done. Experts have known for quite some time that this is not the case.

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"For years, dermatologists believed that the majority of sun exposure was received before the age of 18," said Dr. Perry Robins, president of The Skin Cancer Foundation. "We now know that the damage is typically spread out over the course of a lifetime and that all of the damage matters, yet many people still don't know that. That's why it's so important to be diligent about sun protection at every age."

As reported in the Sun & Skin News, a publication of The Skin Cancer Foundation, a multi-center study led by Dianne Godar, PhD, showed that we get less than 25% of our total sun exposure by age 18. Dr. Godar's team carefully analyzed national UVR exposure data over a 2-year period as well as the outdoor activity profiles of almost 10,000 Americans (see Table 1).

Sun safety tips for active lifestyles. The Skin Cancer Foundation encourages people to be active and enjoy the outdoors while still protecting themselves from the sun. A little extra effort goes a long way when it comes to sun protection.

Watch the time. The sun is strongest between 10 AM and 4 PM, so try and do outdoor activities in the early morning or late afternoon. It's cooler during those times anyway which makes overheating less likely.

Use a sunscreen of SPF 15 or higher whenever outdoors. Choose a sunscreen with ingredients that block both UVB and UVA rays. Apply liberally and evenly to all exposed skin before going outside. The average adult in a bathing suit should use approximately one ounce of sunscreen per application. Not using enough will effectively reduce the product's SPF and the protection received.

Be sure to cover often-missed spots: lips, ears, around eyes, neck, scalp if hair is thinning, hands, and feet. Reapply at least every 2 hours, more often if some of the product may have worn off while swimming, sweating, or towel-drying. Choose a product that suits your skin and the activity. Sunscreens are available in lotion, gel, spray, cream, and stick forms. Some are labeled as water resistant, sweatproof, or especially for sports; as fragrance-free, hypoallergenic, or especially for sensitive skin or children.

Cover-up with clothing. Wear long-sleeved shirts and long pants. Or, opt for specially made sun-protective clothing that offers a specific UPF (ultraviolet protection factor) number and may be more lightweight and comfortable to wear. The Skin Cancer Foundation considers a UPF of 30 or higher to be very good protection.

A broad-brimmed hat goes a long way toward preventing skin cancer in often-exposed areas like the neck, ears, scalp, and face. Opt for a 3 to 4 inch brim that extends all around the hat. Baseball caps and visors shade the face but leave neck, lower face, and ears exposed. UV-blocking sunglasses with wraparound or large frames protect the eyelids and the sensitive skin around the eyes, common sites for skin cancer and sun-induced aging. Sunglasses also help reduce the risk of cataracts later in life.

Daniel B. Burfeind, RN, DNC, is a Staff Nurse, Mohs Department, Panzer Dermatology, Neward, DE; and a Dermatology Nursing Editorial Board Member.

Table 1.
Lifetime Sun Exposure

* Based on a 78-year lifespan

        Cumulative Average Percentage of
Ages         Lifetime Sun Exposure *

 1-18                22.73%
19-40                46.53%
41-59                 73.7%
60-78                  100%