A primer on summer safety

FDA Consumer, May-June, 2004 by Michelle Meadows

When it comes to summer, Olivia Kane, 36, mostly remembers the happy times: eating crabs on the beach, chasing flickering fireflies at night, and playing softball with friends. But there are other memories the Arlington, Va., resident wishes she could forget. Like the rash from poison ivy that broke out on her face, neck, and arms two days before she had to walk down the aisle in her sister's wedding. Or the time she went to the beach to get a tan before high school graduation. "What I got was a bright red sunburn," she says. "I had blistered cheeks, a blistered chest, and I was the graduation speaker."

But her worst summer memory was when she took a sip from a can of soda and gulped down a bee that had crawled into the can when she wasn't looking. "I knew I swallowed something," Kane says. "I got so hysterical that I threw up." Out came the bee, and she went straight to the emergency room where she was treated for difficulty breathing.

Experts say there's a lot people can do to minimize the risks of health problems related to summertime activities. "While treatment with FDA-approved products is good, prevention is even better," says Jonathan Wilkin, M.D., director of the FDA's Division of Dermatologic and Dental Drug Products. So before you pack your swimsuit or hit the hiking trail this year, brush up on these summer hazards.

Sunburn

As a child in Pratt, Kan., Linda Talbott got frequent, blistering sunburns while playing outside all day. Then in her college years, it was cool to be tanned. "Everyone wanted a tan, and I thought tanned skin looked beautiful," Talbott says. "But it's not beautiful when you're 65 and you've had melanoma."

In 1997, Talbott noticed a dark spot under her left eye. "I thought it was mascara, but it grew to the size of a raisin and started to bleed" after about six weeks. Her doctor said it was melanoma, a serious form of skin cancer. Another lesion on her cheek, previously misdiagnosed as an age spot, also turned out to be malignant. She needed immediate surgery on her face to remove the cancerous tissue and save her life.

Everyone is at risk for skin cancer, but especially people with light skin color, light hair or eye color, a family history of skin cancer, chronic sun exposure, a history of sunburns early in life, or freckles, according to the American Cancer Society. Rays from artificial sources of light such as tanning booths also increase the risk of skin cancer.

What you can do: Remember to limit sun exposure, wear protective clothing, and use sunscreen. Sunscreen should be applied 30 minutes before going outdoors and reapplied at least every two hours. Use water-resistant sunscreen with a sun protection factor (SPF) of 15 or higher. The FDA regulates sunscreen as an over-the-counter (OTC) drug and is working on a proposed rule that will specify testing procedures for determining levels of UVA protection in sunscreen products. It will also include labeling for UVA protection to complement existing SPF labeling for UVB. So in the future, consumers will be able to choose a sunscreen based on both UVB and UVA protection levels. Sunscreen is formulated to protect the skin against the sun's ultraviolet light (UV), not to help the skin tan.

Some medications can increase sensitivity to the sun. Examples are tetracycline antibiotics, sulfonamides such as Bactrim, non-steroidal anti-inflammatory drugs such as ibuprofen, and some fluoroquinolones. Cosmetics that contain alpha hydroxy acids (AHAs) may also increase sun sensitivity and the possibility of sunburn. Examples are glycolic acid and lactic acid. It is important to protect your skin from the sun while using AHA-containing products and for a week after discontinuing their use.

According to the American Academy of Dermatology (AAD), along with regularly using sunscreen, it's smart to wear wide-brimmed hats and seek shade under a beach umbrella or a tree. Sunscreens alone may not always protect you. And don't forget sunglasses, which protect the sensitive skin around the eyes and may reduce the long-term risk of developing cataracts. People who wear UV-absorbing contact lenses still should wear UV-absorbing sunglasses since contact lenses don't completely cover the eye.

If you do gel a sunburn, don't put ice or butter on it, says Bruce Bonanno, M.D., an emergency physician at Bayshore Community Hospital in Holmdel, N.J. "Use a cold compress, and if you don't have that, a pack of frozen vegetables will work." OTC pain relievers may also be helpful. Mild and moderate cases may be helped by topical corticosteroids such as hydrocortisone. Severe cases may require oral steroids such as prednisone.

Be on the lookout for moles that change color or size, moles that bleed, or moles that have an irregular, spreading edge--all potential signs of skin cancer.

Bites From Mosquitoes and Ticks

Rob Baxley, 32, of Savage, Md., never saw the tick, but thinks he came into contact with one when he helped his brother build a deck in June 2003. "Soon after that, I noticed a little red spot on my thigh," Baxley says. "But then it grew." He estimates the rash was about the size of a grapefruit when he went to the emergency room in mid-July.