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The tanning delusion – why do we ignore the risks of skin cancer?

August 03, 2018

Skin cancer is on the rise yet many of us are unaware that we’re at risk.

We all know how good the sun feels, so much so that we often devote our precious holidays to basking in it on the beach. Not only does the sun seem to make us happier – research found that exposure to sunlight produces endorphins, known as ‘feel good’ hormones – that are vital for our physical and mental health.

UV light on our skin helps in the synthesis of vitamin D in our body, which is important for healthy bones, teeth and muscles. Vitamin D deficiency has also been associated with increased risks of serious illnesses such as cancer and cardiovascular disease.

But while the sun can do us lots of good, if we’re not careful it can have a catastrophic effect on our health. For some of us, it will even be deadly. Yet all too many people are still not careful enough.

Skin cancer – a deadly disease on the rise

Rates of both non-melanoma and melanoma skin cancers have been increasing over the past decades, according to the World Health Organization. There are currently between two and three million new diagnoses of non-melanoma skin cancer and 132,000 incidents of melanoma skin cancer around the world each year.

"One in five Americans will get skin cancer. But, to a large extent, we are in denial. We think that it will be someone else who is the one in five."

– Dr. Darrell Rigel, Clinical Professor of Dermatology, New York University Medical School

The good news is that at least nine out of 10 cases of non-melanoma skin cancer are successfully cured. It’s a different story, however, for melanoma skin cancer. While much less common, it is also the most dangerous type of skin cancer. It affects melanocytes, cells that produce the brown pigment called melanin, which acts as the body’s natural sunscreen. Not only is it one of the most common cancers among 20- to 35-year-olds, especially in Australia and New Zealand, it has the highest rate of increase worldwide of all skin cancers.

The vast majority of the non-melanoma and melanoma skin cancers we suffer from are caused by overexposure to ultraviolet (UV) light, most of it from the sun.

Why it’s all about our behavior

Skin cancer is the most preventable form of cancer. In fact, experts believe that four out of five cases of skin cancer could be prevented, as UV damage is mostly avoidable.

While most people today understand the potential risks of too much sun exposure, their behavior does not necessarily reflect this.

“One in five Americans will get skin cancer. But, to a large extent, we are in denial. We think that it will be someone else who is the one in five,” says Dr. Darrell Rigel, Clinical Professor of Dermatology, New York University Medical School. “It’s like smoking – I mean everyone knows it’s bad for you, but some people still smoke.”

“One of the problems with skin damage and skin cancer is that it's insidious. It can take five, ten, twenty plus years by the time you do the damage.”

But skin cancer doesn’t just affect sunbathers. People forget the risks of chronic exposure, and the need to protect yourself on a daily basis. Working outside everyday puts you particularly at risk. Research by Imperial College London found that skin cancer cases, as a result of working outdoors, equates to one death and around five new cases of melanoma skin cancer every week.

But even if you’re the sort of person who spends most of your time indoors and then has short, intense periods in the sun, such as sunbathing on holiday, skin cancer research suggests you are still putting yourself at real risk of melanoma.

Most sun damage is incidental, but there remains a widely-held belief that because you’re not burning, you don't perceive there to be a problem.

Infographic that details the benefits and risks of sun exposure
Infographic that details the benefits and risks of sun exposure

The psychology of sunscreen

One of the main ways to enjoy being in the sun – while reducing your risk of skin cancer – is to use sunscreen. But while it’s been around since the 1930s, we still fail to use it properly.

According to the Journal of the American Academy of Dermatology, the majority of Americans still don’t use sunscreen regularly. The study found that men were more likely than women to never use sunscreen, with 43.8% of men (compared to 27% of women) saying they never use sunscreen on their face and 42.1% of men (compared to 26.8% of women) saying they never use it on other exposed skin.

Even if we do use sunscreen, many of us are not using it properly. According to the American Academy of Dermatology, people who got sunburned didn't use enough sunscreen, didn't reapply it after being in the sun, or used an expired product.

“There are several factors why people do not apply sunscreen correctly,” says Eduardo Ruvolo, director of US and International Medical Affairs Skin and Sun Care at Bayer. “For some, it is too messy or greasy and they don’t like the feeling of having a thick layer on their skin. For others, it is an extra step in their routine that they don’t want to waste their time on. And thirdly, some people think that there are too many harsh chemicals in sunscreens so they don’t want to apply it to their skin.”

Another problem is the misconception that you don’t need sunscreen if it’s cloudy, when in fact up to 40 percent of the sun's UV radiation reaches the earth on a completely cloudy day, according to the Skin Cancer Foundation.

In the shadow of the sun

For decades we’ve been warned about the dangers of the sun, yet rates of skin cancer continue to rise. Some of us don’t protect ourselves because we don’t think we need to, while others simply don’t use sunscreen properly. Ultimately it is down to us to understand that short-term decisions not to apply sunscreen could lead to long-term problems.

“The most important thing is to protect yourself. The acronym I use is WAR - Wear protective clothing; Avoid the mid-day sun when the rays are strongest, and Regularly use sunscreen. Those three in combination have been shown to definitely lower the skin cancer risk,” says Dr. Rigel.

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