Today is the last in our 4 part series on skin cancer. It’s all about prevention! If this is the first post you’re seeing, this series on skin cancer is a way to honor my Dad, Ronald Mitchell, who passed away on August 22, 2022 after a long battle of metastatic melanoma. (And when I say long, I mean long…he was first diagnosed with melanoma at the age of 39 and he died at the age of 83). In case you missed it, please first read here for more about my dad’s fight with melanoma.
Here is the video on this topic!
First up with prevention, it is imperative to be doing your regular skin checks…if you missed the post that covers this, you can catch it here. This would be particularly important for those individuals with unmodifiable risk factors such as a family history (like me); to understand or review risk factors look here. This part of prevention means staying ahead of things before they become a significant and harder to fix problem.
Does sun exposure matter in regards to skin cancer prevention?
A big area for prevention deals with your sun exposure, which I feel most people know to some degree (though maybe not). The worst time of the day to be out in the sun is midday, basically that's when UVA and UVB rays are the worst. Midday typically means between the hours of 10:00 am to 2:00 pm. Minimizing your sun exposure, so either staying out of the sun completely or being in the shade, particularly during these times is recommended. Along these lines of minimizing sun exposure, if you must be out in the sun and particularly during midday, then wearing a hat to cover your face, head, and neck would be strongly recommended. (I remember growing up that my Dad would wear this awful (and embarrassing to a kid) hard plastic wide-brimmed white elephant safari type of hat…he didn’t care what it looked like, but he was taking those steps to prevent further problems after his melanoma diagnosis). Also wearing sunglasses helps to block UVA and UVB rays to your eyes; this is important but something you may not connect to skin cancer prevention. Interestingly, people can get melanoma in areas that are not sun exposed. You can get melanoma in your eye. People of color need to check under their fingernails. Now why people get skin cancer in areas that aren’t really exposed to the sun; this is not really understood and obviously needs further research.
Does my sunscreen matter in regards to skin cancer prevention?
Another way for prevention is to wear sunscreen. The current recommendation is to wear sunscreen with an SPF of up to 30 (that last part may surprise you). Specifically about sunscreen, first you must actually wear it! And then maybe you’re already wearing it, but you have to be certain that you are reapplying often!
More about sunscreen specifically and this is a little bit more about me but I tend to take a holistic approach: i do really believe that food is medicine, I think how you treat your body if you're looking for optimal health is SO important. So you're looking at what you're eating, you're looking at what you're doing whether you're being sedentary, whether you're exercising. This also includes your environment and what you're putting on your skin. If you think about your skin, it is it does absorb the things you put on it. Think about transdermal patches and that medications are absorbed from your skin, so understanding the things that you put on your skin is also part of taking care of your overall health. If you're not aware of EWG (that’s Environmental Working Group), this is a great resource for a variety of topics. They have a database called Skin Deep; it is a list of different products, rating them and listing the good, bad, and the ugly of these different products. This is not specific to sunscreen. They also have a great resource page specific to sunscreen, you can check that out here!
So specifically in regards to your sunscreen, EWG doesn’t recommend SPF over 50. This may be a little bit surprising for some people but, basically anything over 50, you're probably either wasting your money and/or it's not really any more effective than anything really 15 to 50. I also think that people may have this misconception in their head that “Hey I’m using 100-that's even better than 50…So I don't have to be as diligent or I'm getting more protection.” And that's just really not found to be the case. The other one that I myself thought was interesting was they don't recommend spray sunscreens. I do actually use or have used spray sunscreens as I'm often putting sunscreen on completely by myself, so a spray sunscreen you can reach places your arms cannot…or so you think! If I’m alone and can’t fully reach my back in certain areas, I’ll spray it, and think I’m getting all the areas. The other piece with sprays is that people often don’t rub them in, so it’s just little aerosol particles and so there may be tiny areas not covered. And conversely if it’s tiny particles flying around, it may hit areas you don’t want to hit such as into your nose. (and then also if your spray sunscreen has harmful chemicals, then this is even worse).
Speaking of harmful chemicals, EWG also recommends avoiding a certain chemical called oxybenzone. There are certain sunscreens that are considered to be reef safe. Oxybenzone is one of those chemicals that can affect reefs so if you're in certain areas like Hawaii or Australia-they really and truly want you to use those reef safe type of sunscreens because that is affecting the integrity of the coral reef and that's just sad. By the choices that we make with the products that we're using, we're destroying natural things like coral reefs and the living organisms that depend on them. But that's another topic for another time. So find sunscreens that do NOT have oxybenzone and are reef safe. Two other recommendations from them were to avoid retinal palmitate and also to avoid sunscreen with added insect repellant in it.
Some active ingredients you do want to look for are zinc oxide or titanium dioxide (these also which coincide with being reef safe). I will say that those are a mineral based type sunscreen versus more chemical based, and mineral based sunscreen are a little harder to rub in. You do get better coverage though. You might have seen people walking around on the beach with a bluish tint to them; that’s likely a mineral based sunscreen, so they may look a bit odd but they’re better covered! If you’re at least my age, you might remember Zinka (basically zinc oxide that people mainly put on their nose and it came in different colors back in the 80’s). So if someone can find better options, well then that would probably be a big money maker!
So other recommendations are to use a lot (make sure you are covered) and to reapply often! For me personally I will say, I've definitely had sunburns growing up. I spent a lot of time in the sun as a kid. I do spend time out in the sun, though maybe not as much as I used to when I was younger. I have had sunburns and they typically fall into two different categories. I actually am really diligent about putting on sunscreen. I am also good about trying to reapply it more than just once a day, but like some people, I don’t actually apply it often enough. (once in the AM and once in the PM…people that is NOT enough especially if you’re in the water…and I’m saying that as much to myself as to you!). This last category is one that I don’t think is talked about very much and I know it’s important for me. I most often get burned in areas that you think you've got it covered but you don't. What I mean by this is areas NEAR your swimsuit, where you think your swimsuit is covering you, but your swimsuit moves around. Particularly as a female wearing a swimsuit is you just want to make sure you lift up on the straps, make sure you are actually putting the sunscreen even a little bit under your swimsuit to allow for the movement that is going to happen with the swimsuit as you are moving around during the day. And then also making sure to cover areas you think might not hit the sun…like think armpits!
Should I do indoor tanning if I’m at risk for skin cancer?
The last recommendation is to AVOID indoor tanning beds. So I've personally never gone to a tanning bed (specifically because of my family history), but I have friends who will only go to a tanning bed in preparation for a vacation; they do this to establish a base tan; their intention with this is to avoid getting burned. I feel like this is a hard call if you want to use a tanning bed in this way, as preventing a major burn is advisable, but you are also exposing yourself to harmful rays (though you are minimizing your time in the tanning bed). I do not know the answer to this one. I don’t know that there’s a hard and fast rule for this one. But overall, you are NOT going to a tanning bed to just to go to a tanning bed to increase your tan.
In summary for for those who want to Cliff Notes version (or to reiterate the highlights)
Skin cancer prevention:
Regular Skin checks
Minimize Sun exposure
Avoid midday 10 am-2pm
Wear a wide-brimmed hat
Wear sunglasses
Wear Sunscreen
SPF 15-50 (you do not need above 50…save your pennies)
Avoid spray tans or at least rub in
Avoid oxybenzone and look for reef safe
Utilize Skin Deep database to identify a good sunscreen for your overall health
Mineral based is better
Avoid retinal palmitate
Avoid sunscreens that also have insect repellent in them
Apply sunscreen thoroughly to your entire body, make sure to hit the areas where your swimsuit moves (bc it’s moving around all day)
Reapply often! (more than once in AM and once in PM)
Avoid regular use of tanning beds
For more information on skin cancer, please check out the following resources.
If you don’t have a dermatologist but have a family history, please find one for regular skin checks!
I hope you learned something new in regards to skin cancer prevention! Share this with someone you think needs to read it! Comment below with something you learned or also if you think there is something else that should have been included, comment below with that. I’d love to hear from you!
