Illustration by Gloria Diianni
Sporting a sun tan is an aspiration for many of us, whether we sunbathe at the beach or in a booth. Americans learned more about the dangers of excessive sun exposure and indoor tanning beds by the ’80s and ’90s, but many of us had already over-exposed ourselves by then, desiring that perfect shade of bronze. However, our quest to appear sun-kissed can set the stage for unsightly wrinkles or more serious health problems. The good news is that you can enjoy the sun — if you take some precautions.
Avoid Premature Aging
According to a recent study published in the National Library of Medicine, up to 80% of visible skin aging can be attributed to sun exposure. This includes wrinkles, age spots, dry patches and the loss of skin elasticity. The study also found that even short periods in the sun can contribute to skin damage over time. While we can’t prevent ourselves from aging naturally, we can take measures to keep our skin smoother, longer.
“The main thing we can do is protect ourselves from the sun,” says Dr. Arul Mahadevan, medical director of radiation oncology at the Seacoast Cancer Center at Wentworth-Douglass Hospital (soon to be renamed Mass General Cancer Center). “It’s a cumulative thing,” Mahadevan says. “We need to start early. As parents, we need to emphasize why we need to do it, and make sure our kids do it.”
Still, many Americans continue to forgo protection. According to a 2022 survey conducted by the American Academy of Dermatology, 63% of respondents reported getting a tan in 2021, up from 54% in 2020; and 33% reported getting sunburned in 2021, up from 25% in 2020.
While the warmth of the sun feels great, exposing yourself for too long or too often can result in more than wrinkled skin. Depending upon your age, race and where you live, the sun can have an even greater impact on your skin health. New Hampshire has one of the highest rates of melanoma, a type of skin cancer.
“It’s pretty common,” says Dr. David Posnick, a dermatologist at Nashua Dermatology Associates. “The problem is that unlike places in the South where people get sun all year-round, in New Hampshire, we’re not exposed to the sun as often. That can lead to being more prone to burning,”
Recognize the Signs of Skin Cancer
Beyond making our skin appear leathery, the sun can also make us more prone to developing skin cancer. While you might think of large, dark moles when you think of skin cancer, it doesn’t always present that way. There are three different types of skin cancer: basal cell, squamous and melanoma. Thankfully, many of these cancers are up to 100% treatable if caught early.
At his practice, Posnick says he sees 10 cases of basal cell carcinomas — the most common type of skin cancer — each day. Basal cell carcinomas look like pink, flat lesions that don’t heal; if you don’t treat them, they can get bigger and more painful, he says. However, your chances of dying from it are very low.
The second type of skin cancer, squamous cell carcinoma, gets its name from the type of skin cell it invades. These are more commonly firm, scaly or crusty bumps that can grow quickly, according to Dr. Daniel Stewart, a dermatologist at Dartmouth Hitchcock Clinics in Manchester. This type of cancer has a slightly higher chance of being metastatic, and can be higher risk if it’s found in places like the lip or ear.
The third type of skin cancer, melanoma, is the one that presents as dark spots or patches. However, that doesn’t mean any mole you find on your body qualifies as melanoma.
“The ABCDE mnemonic is an easy way to help remember some of the features that could be a sign of melanoma,” Stewart says. “Particularly for melanoma, the deeper they grow, the lower the cure rate, so early detection is critical.”
- A is for asymmetry, where one half of the mole does not look like the other.
- B is for border, where the edge of the mole is distinct.
- C is for color, such as having a lesion with multiple colors like black, brown, tan and red.
- D is for diameter, where the bigger the mole, the bigger the possible concern, especially if it is wider than a pencil eraser.
- E is for evolving, or changes in size, color and shape over time.
While it’s important to check yourself for any suspicious bumps, visiting your primary care physician and getting regular skin checks can help you determine what lesions you really need to watch. If your PCP expresses concern, he or she may refer you to a dermatologist, who’ll examine you and do a biopsy, according to Posnick. You could know within a week if your lesion is cancerous.
“If it’s positive, you can be treated with a simple surgical procedure,” Posnick says. “You’re usually not seeing oncologists or getting chemotherapy.”
Melanoma tends to be a more aggressive cancer and has more potential to spread compared to the other types, Mahadevan says. Depending on whether or not it’s spread to the lymph nodes and what stage it is, doctors might use a combination of immunotherapy, radiation and/or chemotherapy to treat it.
Even though you think you may be safe, it’s hard to know if prior sun damage could affect you later. The rate of new skin cancers increases steadily with age, peaking somewhere in the 85-90-year-old age bracket, Stewart says. Consider playing it safe. Whether it’s overcast or you plan on being outdoors for just a little while, it pays to slather on the sunscreen.
“There is no truly safe level of UV exposure,” says Stewart. “Your risk goes up with increased duration of exposure as well as when the sun’s rays are the strongest, typically from about 10 a.m. to 4 p.m.”
Tips for Staying Safe in the Sun
When enjoying the great outdoors, there are steps you can take to protect against skin cancer:
- Wear protective clothing that covers your arms and legs. Consider wearing a hat with a brim to protect your face, ears and neck.
- Apply sunscreen before you go outside, and often! Use a broad-spectrum sunscreen with an SPF of at least 30 and re-apply every two hours or after swimming or exercise.
- Take a break in the shade. During the hottest parts of the day, usually between 10 a.m. and 2 p.m., consider staying out of direct sunlight.
- Just say no to tanning beds. While you may like the idea of starting the season out with a “base tan,” tanning beds still cause skin damage and can increase your risk of skin cancer.
- Conduct your own skin checks regularly. Look for any changes in moles or any new growths. If you notice any changes, consult your health care provider.
- Get regular skin cancer screenings. Talk to your provider about how often you should have a skin cancer screening.