As you pursue the bronzed body beautiful, can you be sure the sunscreen you choose really has you covered? And what are the consequences if it hasn’t? Samantha Wong reports.
SPF, UVA, UVB, water- and sweat-resistant – the labelling used on store- bought sunblock leaves a lot to be desired. The marketing terms are at best vague (ultra-sport!), at worst misleading (total block!). It’s no wonder then that so many of us diligently apply a ‘high protection’ sunscreen only to find ourselves burnt to a cinder within an hour or so. What we wanted was a golden, sun- kissed tan; one that hides a multitude of flaws, and makes us look slimmer and healthier… and what we got was lobster.
Only ourselves to blame? Possibly. We all know deep down that sunbathing is a mug’s game – too much exposure can cause not just temporary discomfort but premature wrinkling and sagging of the skin, eye damage (due to macular degeneration), and skin cancer. Still, sunscreen manufacturers claim to (literally) have our backs covered, so maybe those of us who factor- up religiously – who have made sunscreen an integral part of our daily beauty regimes – have a right to complain when the products don’t do what they say they will do.
It’s been over 30 years since the US Food and Drug Administration (FDA) introduced its first regulations for sunscreen. Historically, it was thought that the UVB rays that caused sunburn were damaging, while the UVA rays that caused tanning were relatively harmless. In recent years, however, research has shown that the effects of UVB and UVA overlap.
“Under 2011 FDA regulations, all sunscreens must be broad spectrum; in other words, they protect against UVA and UVB,” Dr Yau Wing Him of Quality Healthcare Medical Centre (DB) explains. “To be classified as broad spectrum, the sun- protection factor (SPF) must be at least 15 (the maximum is SPF50+). To qualify as water resistant, a sunscreen must demonstrate that it retains its SPF value after a person has been immersed in water for 40 or 80 minutes.”
An SPF15 product is said to screen about 94% of UVB rays, an SPF30 97%. But you’ll still burn if you don’t apply enough, often enough. Remember you are not using sunscreen in the way that it’s measured in the lab – use a SPF30 too sparingly and its effectiveness is reduced to one third.
Dr Yau suggests you follow the modified teaspoon rule – one teaspoon of sunscreen for face/ head/ neck; two teaspoons for front and back torso; one teaspoon for each arm; two teaspoons to each leg – 15 to 30 minutes before exposure. And that you reapply it every two to three hours. If you sweat a lot or swim a lot, reapply a water-resistant sunscreen after 40 minutes.
If it is used properly, sunscreen use has been shown to reduce the risk of skin cancer but Dr Yau also recommends we implement common sense strategies. “Other than using broad-spectrum sunscreens, wear protective clothing – long sleeve shirts and pants, and broad brimmed hats. Wear sunglasses (children’s eyes are particularly vulnerable) and bear in mind many types of glass do not filter UVA. Stay in the shade at midday.
“Oral retinoids and dietary soy isoflavones may help to prevent skin cancer,” Dr Yau adds. “Nicotinamide, polyphenols (found in green tea), and fern-leaf extract have been shown to reduce the effects of UV radiation.”
The bottom line is that there is no such thing as a healthy ‘natural’ tan. “It is important to dispel the notion that having a tan is protective,” says Dr Yau. “Tanning of the skin is a result of UV-ray damage to the DNA of your skin cells, and skin damage is cumulative.”
The rate of skin cancer (both melanoma and non-melanoma) is on the rise. The term non-melanoma skin cancer includes two major types – basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
“Risk factors for skin cancer are UV radiation exposure (sunlight and artificial tanning), sunburn, having pale skin and ageing,” says Dr Yau. “Men are twice as likely to develop skin cancer as women. Tobacco smoking has also been linked to SCC. With malignant melanoma (MM), you also need to consider your family history and whether the number of moles you have on your skin is increasing.
“Public education is essential,” Dr Yau adds. “For instance, childhood sun exposure is strongly associated with skin cancer. For babies of six months and younger, it is best to avoid sun and sunscreen. Their skin is thinner with lower melanin protection, so UV radiation penetrates deeper.”
Detecting skin cancer
BCC accounts for 75-80% of non- melanoma skin cancers. It usually manifests as slow-growing, pearly nodules on the face of an elderly person. These rarely spread elsewhere but they erode into the surrounding tissue and bone.
Accounting for about 20% of non- melanoma skin cancers, SCC tends to be more aggressive than BCC. It invades tissues beneath the skin and may spread to lymph nodes and distant parts of the body. These cancers (ulcerated or crusted lesions) typically develop on sun-exposed parts of the body, such as the face, ears, neck, lips and back of hands but they can also develop within scars.
Dr Yau stresses that we should also be mindful of actinic keratoses (AK) – a precursor to SCC – that manifests as small, scaly red patches or yellow- white scaly crusts on sun-exposed skin. “In some countries, over half the population over 40 has one or more,” he says. “These growths usually start to appear in middle-age but are now being seen in people in their 20s.”
MM is the most dangerous form of skin cancer. “The five-year survival rate is improving (now upwards of 80%) but since a cure for this form of cancer is still being sought, we need to concentrate on prevention and early detection,” says Dr Yau. “Watch for the development of a new pigmented or unusual looking growth on your skin, or changes to the shape or colour of existing moles.
“As with SCC and BCC, MM usually develops as a lump on normal skin but 30-50% of growths develop in a pre-existing mole,” Dr Yau adds. “So a mole which is changing could indicate a melanoma. Look for ABCDE changes in a mole: Asymmetry/ Border irregularity; Colour irregularity; Diameter over 6 millimetres; Evolving over time. Changes in size, shape and colour are more significant signs than itching, pain, or bleeding in any mole.”
People with fair complexions (especially those whose skin burns easily and never tans), anyone living under high sun exposure, outdoor workers and those with a family history are most at risk. Dr Yau recommends six- to 12-monthly skin examinations by a dermatologist.
Seeing all this in black and white will be an unwelcome eye-opener for diehard DB sun worshippers. But maybe it really is time to forgo the shore and start faking it.
While tanning beds are not the way forward, as they are known to emit both UVA and UVB radiation, you can get a great fake tan in tablet form or in a bottle. Apply it yourself or visit a tanning booth and have a beautician spray it on you. Thus prepped, if you must head to the beach, slap on the SPF30+ and seek shade.