There’s no such thing as a healthy tan. Recently, several public health organizations have reported that malignant melanoma, the most deadly type of skin cancer, is spreading in epidemic proportions throughout our population. These reports have come from the American Cancer Society, the American Dermatological Association, the Centers for Disease Control, and the Skin Cancer Foundation. All of these organizations have claimed with alarm that skin cancer is on the rise. One of the most significant statistics is the increase of occurrence in young adults. These concerns are particularly important for many Masters swimmers, who spend a considerable amount of time swimming in the sun.

At one time, malignant melanoma was a type of cancer that affected aging adults who had spent many years in the sun. It was originally thought to be purely the result of years and years of sun exposure. It now appears in increasing numbers of young adults, particularly those who are fair-skinned. Melanoma is one of the most unpredictable skin cancers and can spread quickly, often in a matter of weeks. Today, early detection and treatment allow for a good prognosis.

Many of us have heard reports about the declining ozone layer and its decreasing ability to protect us from ultraviolet (UV) exposure. What once caused the average person to get a sunburn with 60-90 minutes of midday exposure has been magnified to the point where 15-30 minutes will do harm. In addition, it is the repeated exposure that may cause the most damage.

There is an expression in dermatology: “The skin never forgets.” In fact, excess unprotected exposure can cause significant problems years beyond the initial exposure. The Skin Cancer Foundation has recently revised its list of the incidence of melanoma, and there may be approximately three times more than originally reported.

Simple precautions can help. Apply a waterproof sunscreen with an SPF (sun protection factor) of at least 15. Sunscreens with higher SPF numbers are said to provide better skin protection. The SPF number gives a rough approximate number of “safe” minutes allowed in the sun. If you normally burn in 15 minutes, an SPF of 15 should theoretically protect you for 15 times that number, or 225 minutes. Depending on the sun’s position in the sky and time of year, the actual amount of protection could be less. The sunscreen needs to be applied to the skin 20 minutes prior to sun exposure to allow the active ingredients to penetrate into the deep layers of the skin. No matter how good the SPF in the sunscreen, after 90 minutes, the amount of protection is suspect. It is a good idea to reapply the lotion after swimming and perspiring, and to only allow a maximum exposure of 90 minutes. A new application does not necessarily allow for a completely carefree reexposure to the sun’s rays.

Skin cancer most frequently occurs on the nose, the tips of the ears, the backs of the hands, as well as the shoulders and upper back. It can also occur on the lips, which have very little natural protection. A lip balm with a good SPF should be used and reapplied regularly. A wide-brimmed hat should also be an important part of your summer wardrobe.

Certain medications can enhance your skin’s sensitivity to the sun. These medications include antibiotics such as tetracyclines, sulfas, Cipro, certain antidepressants, tranquilizers, antihistamines, Retin-A, and non-steroidal antiinflammatories (NSAIDS) such as Motrin, Advil, Naprosyn, and Relafen. Questioning your pharmacist or physician about these particular medications may help
protect you.

The sun is emotionally uplifting and can be beneficial in small doses. It must be handled with great caution, however. Although we cannot survive very long without the sun, too much can be harmful.

Ed Nessel is a registered pharmacist with a Doctor of Pharmacy, MS in biochemistry and MPH in public health. He is on the USMS Sports Medicine Committee and serves as USMS National Librarian. In 1998 he was honored as USMS Coach of the Year.