May is Skin Cancer Awareness Month: These are the Sneaky Ways You Could be Getting UV Exposure

As Spring comes to an end and we move into some of the hottest months of the year we also see the end of May, which is Skin Cancer Awareness Month. By now, you may have read up on the best type of sunscreen, the most common types of skin cancer and how to identify them, and some of the easiest ways to avoid sun exposure. You know to always wear sunscreen when planning a big day in the sun, but it is important to remember that skin protection shouldn’t be reserved for special occasions. Each time you run out to get the mail, walk the dog or commute to work without sun protection, it can also add to the damage that leads to skin cancer.

As a medical dermatologist based in southern Florida, I have made it my mission to not only treat skin cancer, but also educate as many people as possible to ensure prevention. Skin cancer is the most common type of cancer Americans are diagnosed with, but it is also one of the most preventable, and I would happily be out of a job if it meant more people in the United States were educated on the proper protection from skin cancer and we saw less cases as a result.

As a refresher, here are the basic facts about UV exposure and skin cancer: There are two types of UV rays that have the ability to reach the earth’s surface: UVB rays, which are the primary cause of skin reddening and sunburn, and UVA rays, which have longer wavelengths and therefore penetrate deeper into the skin, contributing to premature wrinkles and age spots. Both rays increase the risk of developing cancer when they come in contact with your skin.

Sunburn is caused by your body sensing UV rays damaging the DNA in its cells. It reacts by flooding the exposed area with blood to help with the healing process, causing the characteristic red skin and sometimes painful inflammation. This damage can also cause the DNA to mutate, allowing cells to acquire the ability to avoid dying, the result of which is skin cancer.

You know that UV exposure happens when you are out enjoying the sunshine, but what you may not be aware of are the other ways in which you can still be at risk for exposure that often don’t immediately cross our minds. Below are some of the most common ways in which you are still very much at risk for sun exposure if you do not properly protect yourself.

DURING THE WINTER

Contrary to popular belief, you can still get sunburned in the winter. UVB rays are strongest in the summer, but they still have the potential to damage your skin throughout the year, and especially when you live at higher altitudes or in locations that get a lot of ice or snow. In fact, snow can actually reflect up to 80 percent of the sun’s UV light. This means that the rays are not only hitting you directly from the sun, but are also being indirectly bounced back up at you, increasing your skin cancer risk even when you can only feel the bite of winter air.

Obviously, you tend to wear more clothing in the winter which is a very effective protection from UV rays, but your head and neck tend to remain uncovered even in the winter, which is where skin cancer most commonly occurs. To combat this make sure to wear UV-blocking sunglasses to protect your eyes and aid against glare from the snow, and a wide-brimmed hat will do double duty of keeping your head warm and preventing UV rays from harming your scalp. You should also continue to wear sunscreen (with an SPF of at least 15) daily on all exposed skin. It may be beneficial to purchase a sunscreen that is specially formulated to be moisturizing for the winter to combat dry skin.

IN THE WATER

It can be hard to imagine your sun burning when you are taking an icy dip in the ocean, but even there UV rays are able to penetrate and damage your skin. Submerging yourself can lower your body temperature and make you forget all about the sun’s UV rays, which might mean sunscreen is the last thing on your mind. However, UV rays can bounce off surfaces like water, sand, pavement, or even grass, leading to an increase in UV exposure that is potentially worse than when you are out of the water, as like with the snow you are receiving UV exposure from two different sources.

Obviously nobody wants to go swimming fully clothed, but there is something to be said for rash guards, which are increasing in popularity in countries such as Australia and New Zealand. In addition to coverage from clothing such as a wide-brimmed hat, it is important to be aware that sunscreen is “water resistant” and not “waterproof.” They can claim to be water resistant for either 40 or 80 minutes, so reapplication at least that often is imperative to maintain adequate protection.

THROUGH A WINDOW

Yes, you are still susceptible to sun damage through windows. Glass is efficient at blocking UVB rays, but it allows UVA rays to pass through leaving your skin vulnerable without proper preventative care. Your windows at home are included in this, but having shade blocking the light as well as larger spaces prevent direct exposure more often than not. The place to truly keep an eye out for is the windows of cars, trains, buses, and airplanes, where you are sitting quite close to a window for extended periods of time. The front of your car windshield is usually treated to protect drivers from UVA rays, but all of the other windows such as the sides and back typically aren’t. You are just as susceptible on buses, trains and airplanes, where they typically don’t treat windows at all. In fact, airplanes may pose an even higher risk because you are at such a high altitude — if you’ve ever sat on the sunny side of an airplane then you may know the feeling of burning thighs as the sun beams down through the window. In fact, airline pilots and crew members tend to get more skin cancer than people in other professions.

When you’re traveling and going to be positioned near a window for a long period of time, don’t forget to protect yourself with clothing, sunglasses, and sunscreen whenever possible. Make sure the sunscreen you use is broad spectrum, meaning it protects against both UVA and UVB rays. In addition, you can also have UV-protective window film applied to both your car windows and those in your home as well.

IN THE SHADE/ON A CLOUDY DAY

It’s a common suggestion to seek the shade during the peak sun hours between 10 AM and 4 PM, but it is important to remember that just because you have an umbrella over your head at the beach doesn’t mean you’re completely protected from UV rays. Indirect exposure to UV radiation is still possible in the shade, and there are various other factors to look at when determining the protection your shade of choice may provide. Larger shaded areas in general will provide better protection than smaller ones, as the more coverage the shade has, the less chance there is for you to get both direct and indirect exposure Additionally, you should also be wary of cloudy days — up to 80 percent of the sun’s UV rays can still pass through clouds.

Wearing sunscreen even in the shade and on cloudy days is necessary, but most people don’t realize they aren’t using enough sunscreen. An average adult should use around one ounce of sunscreen to cover their entire body. To aid in visualization, one ounce is equivalent to a shot glass. You should apply it to all exposed areas of your body and make sure to cover often-missed spots like the tops of your ears, around the eyes and near the hairline.

TANNING BEDS

Despite the known adverse effects, tanning beds continue to be a popular method of getting that sun-kissed glow, and people continuously misunderstand how they work, believing the myth that they do not cause skin cancer. Don’t use them. Just don’t. Tanning beds are NOT safer than the sun. In fact, indoor tanning even once raises the risk of developing skin cancer — using a tanning bed before the age of 35 increases your risk of melanoma by 75 percent. Another myth is that your body produces vitamin D when you use a tanning bed, but the bulb used emits mostly UVA light, when it is UVB light your body needs to produce vitamin D.

If you desire the look of a sun tan, self-tanner is an effective way to achieve the look without damaging your skin. However, having tanned skin does not protect you from additional harmful sun exposure in any way, so always practice other preventative care as previously discussed such as protective clothing, sun avoidance, and sunscreen.

Staying vigilant to the many ways you can be exposed to UV rays is the first step in avoiding a skin cancer diagnosis. However, it is impossible to completely avoid sun exposure, and genetics play a factor in the potential you face for developing skin cancer. When caught early skin cancer is highly treatable, so examine yourself monthly for any new or changed anomalies on your skin to identify any potentially cancerous cells early, and schedule an examination at least yearly with a dermatologist.

Follow Tim Ioannides on Twitter and Medium.

Dr. Tim Ioannides is the founder of Treasure Coast Dermatology located in Port Saint Lucie, Florida