Dr Samantha Hunt- consultant dermatologist
Perhaps we are tempting fate, but dare we say, there have been a few glimpses of Spring lately? Daffodils out in force, and some beautiful sunny spells, even if the temperatures are still struggling to get in to double figures. It’s all pointing towards the presence of increasing levels of UV radiation, which in the UK peak in late June, but can reach skin burning levels any time between March and October. Bang on cue, the National Institute for Clinical Excellence (NICE), has just published updated guidance on sun exposure. Read on for Winchester GP’s potted version, enhanced with the invaluable advice of local consultant dermatologist and great friend of Winchester GP, Dr Samantha Hunt, for all you need to know to stay safe and healthy in the sun.
Sun sense is for March-October, not just for summer
Crazy though it may seem to worry about sun exposure as you shiver on an Easter holiday outing, Dr Hunt advises ‘Sun screens are needed from March through to October when the sun is strong enough to damage the skin.’ The highest risk time on any day is between 11 am and 3pm.
We are all at risk to a greater or lesser extent
NICE has outlined some specific ‘at risk’ groups, which we have reproduced at the end of this article. However, while some of us might think we are on safe grounds genetically (i.e. darker colouring, lack of freckles and moles) the lifestyle groups are pretty difficult to avoid. For example, if we don’t work outside most of the time, it is pretty likely that we work inside at a desk a lot of the time, and then experience intermittent bursts of sunshine! There are very few people who could declare themselves off the hook entirely.
You know this already, but we’re going to bang on about it anyway!
It won’t be the first time you’ve heard this, but here we go again: Overexposure to sunlight is generally bad news. It is an important and avoidable cause of skin cancer, certain eye diseases, such as cataracts, and premature ageing/wrinkles. Nevertheless, studies have shown that, while the risks of excessive UV exposure are well known, we are, as a population, pretty bad at protecting ourselves from them. Why would this be the case?
Sun safety pitfalls and misconceptions
We get caught out. Overexposure doesn’t just happen to those who are out in the sun for long periods on a habitual basis. It can equally occur in people who spend little time outdoors and then experience short, intense bursts of sun- whether on their holidays, weekends away or even during a sunny lunchbreak. In other words, you can’t save up time in the shade to offset it against time in the sun – it just doesn’t work that way. Thinking ahead is the order of the day; Dr Hunt says “I strongly recommend applying your sunscreen first thing in the morning before getting dressed. Many people only get around to applying it once the sun is starting to ‘hot up’ in the late morning or around midday by which time if you are out and about in the garden or at the beach the skin may already have been damaged. Sunscreen should then be reapplied later in the day particularly if you have a fair skin.” And for when the sun really catches you out on a lunchbreak, we recommend furnishing your handbag/man bag with a mini tube of sun cream, a cute sunhat/suave panama, and of course some super cool wraparound sunglasses!
We get complacent. ‘I only burn abroad…’, ‘the UK isn’t sunny enough…’, ‘It’s not even summer yet…’ All misguided… sorry!
We don’t notice the damage… until long after it’s happened. Touch a hot iron and you will be recoiling in a split second. Over-expose your skin to UV, and you might not notice the burn until several hours later, and the longer term effects (wrinkles, possibly cancer) might not surface for years…follow the advice in this article, and you will be feeling and seeing the benefits for years to come, we promise!
Sun makes you feel good. Particularly at this time of year, the odd burst of sunshine feels like such a treat that few of us would think to go hiding in the shade. We hear you, but those short term benefits have to be weighed against the longer term consequences- we really hope this article will encourage you to reach for the lotion or a sunhat as you bask…
We are vain… many people like to have a sun tan … but Dr Hunt is quite clear on this point; there is no way to get a safe or healthy tan from sunlight. “A tan is the sign of sun damage.” This is one occasion on which doctor’s orders are to hit the (fake tan) bottle…
I’m already tanned so I won’t burn now… yes, tanning is the skin’s attempt to protect itself against further sun exposure, but it’s not that effective- certainly nothing compared to sun creams or clothing. You’re damaging your skin a lot, to get a very marginal protective effect.
I need to deliberately sunbathe to get enough vitamin D This is not the case. Between March and October, most people can make sufficient vitamin D by going out for short periods and leaving only areas of skin that are often exposed uncovered (e.g. forearms, hands or lower legs). That being said, it is true that a significant proportion of the UK population are believed to be deficient in Vitamin D, but this is linked to very specific cultural, lifestyle and genetic (notably skin pigmentation) factors. NICE’s guidance emphasises dietary supplementation, and Dr Sam Hunt agrees “Although some sun exposure is helpful for the production of vitamin D… there are other ways to get your vitamin D through diet and supplements that do not put you at risk of sun burn that could potentially lead to the development of skin cancers.’
Suncream Commandments
1. Aim HIGH for your SPF.
NICE guidance is to never venture below an SPF 15 with 4-star UVA protection. But Dr Samantha Hunt would go further: ‘As a dermatologist I would recommend the use of a sunscreen with at least SPF 30 and 5 star UVA rating.’
2. Use way more than you think you need!
Dr Hunt notes ‘most people do not apply sunscreen thickly enough or frequently enough’. The amount of sunscreen needed for the body of an average adult to achieve the stated SPF is around 35 ml. To put this in context, someone on a beach holiday with, say 6-8 hours in the sun per day, reapplying every 2 hours would use more than half a standard 200ml bottle of lotion in a single day!! Suddenly those 3 for 2 offers are looking even more appealing.
3. Re-apply, re-apply, re-apply.
Yes, please do what it says on the bottle!! Most recommend every 2 hours, and straight after being in the water (even if water-resistant), after towel drying, sweating or when it may have rubbed off.
4. Double up for prolonged exposure.
If you are going to be out long enough to risk burning, apply your sunscreen twice – once half an hour before you go out, and then again around the time you go out. This includes face, neck and ears. And don’t forget that if you will be sweating or in and out of water, use a water-resistant cream.
Better safe and informed than sorry
As we have already said, sun damage can take years to be detected and even if you are super careful now, you might have inadvertently suffered some damage years ago. If you have changing moles or areas of sun damaged skin that you are worried about please see your GP or a dermatologist for assessment and advice.
For further online information we recommend consulting the British Association of Dermatologists.
Having said all that, we are firmly crossing our fingers for warm and sunny days ahead!!
Footnote: NICE ‘at risk’ groups for over exposure to UV
- Children and young people,
- People who tend to burn rather than tan,
- people with lighter skin, fair or red hair, blue or green eyes, or who have lots of freckles.
- People with lots of moles.
- People whose immune system is suppressed (perhaps as a result of disease or the use of particular drugs).
- People with a personal or family history of skin cancer (regardless of skin colour).
- Outdoor workers and lovers of the great out doors
- People who enjoy high but intermittent exposure to sunlight – e.g. holidays in sunny countries.