Sun’s Out, Suncreen Out

There is an expression, “Sun’s out, gun’s out;” here “guns” refers to biceps, not the epidemic of violence in our country. In other words, when the weather is warm, it is time to expose all those muscles that we have been working on during the colder months of the year.

Perhaps the expression should be changed to “Sun’s out, suncreen out.” This is true at every age. When I was younger, there was not much awareness around the dangers of sunburns and the importance of wearing protective lotions/clothing to prevent them. As person with light skin, I was especially prone to damaging burns and I am paying for it now. Over the last 20+ years I have had more than five skin cancers; thankfully, all of them have been basal cell carcinomas which are removed (sometimes easily, and sometimes with more difficulty) and do not require further treatment.

Older adults, however, should be extra cautious for a number of reasons. First, many older adults are retired and that means (depending on the climate) they spend less time inside and more time playing golf, gardening, sitting by the pool, or engaging in other outdoor activities. Second, many retire to places where not only is more time spent outside, but due to the latitude the rays of the sun are more direct and intense. Third, as we age our skin becomes thinner and more vulnerable, meaning that burns can have more serious consequences. Finally, older adults are usually not in the habit of applying sunscreen–even if they are going to be at the beach–so this requires an extra step in our regular routines. We must remember that the more exposure to sun, the more likely that burns will occur, and the greater the chances of developing skin cancers–some of which can have very serious consequences.

When should sunscreen be used, and what kind is best for older adults? Some say that it is okay to skip the lotion if you are going to be out less than an hour; this is not good advice since it is often difficult to control how long one will actually be outside. Any time you will be exposed to direct sunlight for more than 5-10 minutes it is a good idea to apply to exposed areas; certainly more than 20 minutes makes it a obligatory. Also, remember that it is necessary to re-apply sunscreen; check the usage directions on the product for more details. Experts recommend at least a 30 SPF for older adults, but depending on the kind of skin you have it may make sense to go with a higher number. I never use anything less than 50 because of the sensitivity of my skin and my past history of basal cell carcinomas. When in doubt, this is a great conversation to have with a dermatologist; if you do not have an appointment coming up soon, you can usually send an email message to your doctor through the practice’s website or through apps like MyChart.

I wish that I knew when I was a kid what I know now. It would have avoided a lot of scares and procedures. I have two children with fair skin and I am grateful that there is much more awareness and better products to prevent sunburn.

It is officially summer! So, sure, go ahead and flash those biceps, quads, pecs, or abs…but make sure they have a layer of sun protection on top first!

Use That Sunscreen

Today was my 5th Mohs procedure..and it was a doozy.

For those unfamiliar with Mohs, it is a surgery that removes layer by layer of skin in order to excise cancerous cells. First, you or your doctor may see something that looks unusual on the skin; s/he may decide it’s nothing or that it looks suspicious in which case it is removed and sent to a lab. The pathology can come back as benign (nothing dangerous) or cancerous. In my case, it was a basal cell carcinoma–the fifth one I’ve had. In order to make sure all the cancer has been completely removed, the dermatologist or a specialist will perform the Mohs procedure. One layer of skin is removed and if the edges are cancer-free, you’re done; you get a band-aid and you go home (well, it’s a little more complicated). Every other time I’ve had a Mohs, that is the way it went down. If, however, there are still cancerous cells on the periphery, the doctor will do another layer. This keeps going until the peripheries are clear. The average number of times a patient will have a layer removed is 1.8. Today, I set a personal record with 4! I was at the surgeon’s office for nearly 4 hours…and if you think the bandage looks bad, you should have seen what the wound looked like before it was closed!

The doctor and I had a conversation about why I was on my 5th procedure (my first being about 20 years ago and the last 2 years ago). I am fair- skinned and as a kid no one really paid attention to UV rays or sunscreen. It was a regular occurrence for me to get a sunburn; sometimes quite painful. Who knew that 40 years later this would be the result? Now I have to be especially careful.

What I did not know is that all that sun damage has actually altered the DNA of my affected skin cells. Some of them are OK and will never morph into anything else. Others, however, may be at the edge (99% and ready to go) of going cancerous. What will determine the next steps? It is entirely in my hands–literally. Sunscreen.

From here on out, I will be wearing it on my face (a special one designed for that purpose) every day. I will also wear an over-the-counter on my other exposed body parts. Windshields and car windows, as well as clouds, do not filter out the damaging radiation that can trigger these cells. Only a good sunscreen with a high enough SPF will work.

I am getting to be pretty high maintenance! Actually, this is a relatively easy step to add to my routine each morning…and later in the day if I am outside quite a bit.

I have been fortunate. So far, all have been basal cell carcinomas–easily treated. Next time, who knows?

My warning to you, my readers: the future of your skin is in your hands too. Sunscreen every day!