The sun and skin damage

Adopting a healthy lifestyle has become a priority for people of all ages. A well balanced diet, stress reduction, and regular exercise are used to achieve this goal. Exercising outdoors, in the fresh air and sunshine, is a joy that triathletes share with many other athletes, but it is also a risk. Sun exposure has long reaching consequences that affect both appearance and health. Excessive sun exposure can be fatal.

Ultraviolet (UV) radiation from the sun is damaging to the skin. It causes destruction of the outermost lining of the skin (epithelium) as well as damage to the deeper structures. Collagen is a substance that provides a supporting framework for the skin. As we age, collagen decays, and wrinkles occur. UV radiation greatly accelerates this process and causes small breaks in the DNA of skin cells. This damaged DNA may cause a cell to ultimately form a cancer.

Skin cancers

The most common cancer is the U.S. is skin cancer, affecting approximately 600,000 people per year. There are three types of skin cancer: squamous, basal cell, and malignant melanoma. The rates of each of these types of skin cancer are increasing, and the vast majority of cases occur in fair-skinned individuals.

Basal cell is the most common skin cancer, and 85% occur in the head and neck region. Thus, these are the areas to target preventive measures. Poor tanning ability and long term sun exposure during day-to-day workouts increases your risk for basal cell carcinomas.

Malignant melanoma is the least common of these types of skin cancer but can be very aggressive, accounting for 75% of the total number of skin cancer deaths. Particularly disturbing is the fact that the incidence of malignant melanoma has increased 80% between 1973 and 1987, with an associated increase in deaths, especially among white males. Malignant melanoma appears to be caused by periodic, severe sunburn (eg. a long training ride, or a half- or full Ironman with no sunblock). Most melanomas occur on the torso in men and on the legs in women. Because these areas may not get a great deal of continual sun exposure, the less pigmented skin is subject to more damage during a short-term, intense sun burn. The greatest risk for melanoma occurs in those who have a propensity to burn, who have a family history of melanoma, or who have certain types of moles. It is very important to see your doctor for a thorough examination and assessment of your risk for developing skin cancer.

Myths and misconceptions

The first myth that I want to clear up is that cancer parlors, sometimes called tanning spas, are safe. They are not. It doesn't matter whether you get radiation from the sun or a man-made source, it still does damage.

Another favorite misconception is, "I'm young and my skin looks good, so why worry"? The fact is that it usually takes years for the damage due to solar irradiation to become evident.

There are many examples of professional athletes who have damaged their skin. Add to this the constant media pressure showing "healthy tans" and the result is a poor message, especially to children and adolescents. The more frequent the sun exposure at an early age, the higher the risk of skin damage such as premature aging, wrinkling, and even cancer. There is no such thing as a healthy tan.

Protect yourself from the sun and from myths.

PREVENTION

The best way to prevent sun damaged skin and skin cancer is to limit or modify your exposure. Sun light, like other forms of radiation, is a cumulative toxin -- the more you are exposed, the more damage is done.

  1. Limit unnecessary exposure, and avoid training during peak UV loads (approximately noon- 4 pm)
  2. Clothing provides an effective barrier to sunlight; hats, sun-visors and sunglasses can help protect some areas of your face.
  3. Use sun screen. Apply to the areas of your body that are most likely to get burned or are at risk for skin cancer. Apply liberally and frequently. (Note: Don't forget the top of the ears and the temples)
  4. Transition tip. For those who don't want to spend an extra 15 seconds applying sunscreen in transition, put sunscreen into two small plastic bottles (eg. hotel shampoo sample bottles) and take it with you. Most of you have the necessary co-ordination to apply sunscreen while in motion, but be careful. Remember to dispose of the empty bottles properly (ie. not on the side of the road!)

More about sun screens

As awareness of the damaging effects of the sun has increased, so has the availability of sunscreens. A good product will provide protection against both UV-A and UV-B light. Many are now available that are "waterproof" or "sweatproof" and these are the ones that athletes should use. The sun protection factor (SPF) reflects how many times better the sun protection is over unprotected skin. The higher the SPF number the better. For example, a SPF factor of 15 means that in 15 hours of sun exposure the skin "sees" the same amount of sun as in one hour without protection. But don't let this fool you; all sunscreens must be re-applied during continued exposure -- even the "waterproof" ones.

Early Detection: The ABCs

Physician examinations and frequent screening self-examinations are the best insurance for early detection of skin cancer. The greater the risk factors for an individual, the more frequently these exams should be done.

The self-exam should be done with the aid of bright lights and two mirrors (a hand held and a full length). Undress completely. Look systematically from head to toe and make sure that you do not miss any areas. Do it the same way every time.

To help you look at difficult areas this examination can be done with the aid of a spouse or friend. Basal cell carcinomas may appear as a rough patch of skin with a central ulcer and may intermittantly bleed.

Take a close look at all moles because this is where melanoma begins. The following, known as the ABC's, are warning signs of potentially cancerous moles.

Take notes on your findings and see your doctor. Dermatologists are generally the most skilled physicians in evaluating for skin cancer.

More resources

  1. The National Cancer Institute - Cancer Information Service 1-800-422-6237
  2. The National UV forecast can be found on the Internet at http://www.intelicast.com/weather/usa/suncst.gif