Bridging the Gap - Health Equity for all

What Can We Learn from the Aussies About Protecting our Skin from the Sun?

Across the world, summers are increasingly smashing records as the most brutal ones ever. For countries and regions not used to extraordinary temperatures, it feels like someone dropped a bomb in the ozone layer. The intense sunshine naturally brings with it a greater risk for sun-damaged skin, and whether you’re enjoying or suffering under the heat, it’s important to prepare for it safely. Sunburns are an obvious outcome of failing to do so and skin cancer can be the knock-on effect of regular complacency. The rates of this disease differ greatly between countries for reasons climatic and genetic, but Australia stands out as the most troubled of the lot. The Aussies call skin cancer the “national cancer” because of their disproportionate rates of the disease. It continues to be a major problem, but the country has responded to solar threats through highly effective public campaigns that have peeled back disease rates. And what’s one of the most important messages behind these campaigns? Sunblock is essential, but it’s not enough. <h2>The Slip, Slap, Slop campaign</h2> The Australians have a lot up against them. Men in this part of the world have a melanoma rate 20 times higher than that of Europe (for women, it’s 10 times higher). It’s no secret how scorching hot and sunny the country is, and the Aussies have an additional disadvantage in that the southern hemisphere is actually closer to the sun during their equivalent of summer (northern folks’ winter). This is because of the imperfect nature of the Earth’s orbit. What you get from this is higher UV rates, something to be found elsewhere in the southern hemisphere too. The highest UV index ever recorded was up in the Bolivian Andes, where researchers recorded an index of 43. The risk imposed by UV rays became more apparent in the early eighties, and this development was the basis of an Australian sun safety campaign that carries on to this day: Slip, Slop, Slap. The idea is to “slip on a shirt, slop on sunscreen, and slap on a hat”; in other words, cover up and use extra means to deflect rays to give yourself the best chance at protection. “Seek and Slide” were added later to encourage seeking shade and sliding on a pair of sunglasses. Also known as the SunSmart campaign, it’s been going strong for four decades and is considered one of the country’s most effective public health efforts. It’s been linked to significant declines in melanoma rates in people under 50 nationwide, which required a massive cultural shift for a cohort that grew up embracing the sun and tanning. “There's absolutely no doubt that the Slip, Slop, Slap campaign increased public awareness of sun exposure, and it has been hugely effective in influencing our behavior,” said Phil Barker from the University of Wollongong. “But the message needs to be constantly reinforced to educate the new generations of parents and their children.” <h2>Become a pro blocker of sunshine</h2> Sunblock is a core component in defending against sunburn. It works best when combined with wide-brimmed hats, sunglasses, and shirts to cover elsewhere, and it can be considered the final protection against harmful rays. <figure> <img src="https://cdn.storymd.com/optimized/MAN8EniNdl/thumbnail.jpg" alt /> <figcaption>Wear sunglasses and a hat with a brim to block the sun. Source: chezbeate/Pixabay</figcaption> </figure> The problem is that there’s confusion out there as to how to properly use it, and there are also dangerous myths that add petrol to fire. When used correctly, it dramatically lowers your risk of skin cancer. Daily use of SPF 15 has been linked to a 40% reduction in the risk of squamous cell carcinoma and 50% for melanoma. You’ll also be totes gorge for much longer, as sunscreen impedes skin aging caused by the sun (e.g., sagging and wrinkles). Sounds good, so how do I know if I’m doing it right? Let’s dig in. <h3>What type of sunscreen is best?</h3> The most important elements of an effective sunscreen are as follows: <ul> <li>Broad spectrum. You need your cream to be able to protect you from the different kinds of UV rays. Broad spectrum sunscreen covers UVA and UVB; UVC is blocked by the atmosphere, so don’t worry about that.</li> </ul> <ul> <li>SPF 15. This is the standard recommended for everyday use.</li> </ul> <ul> <li>SPF 30 or higher. This is recommended for days when you expect to be out for large portions of the day.</li> </ul> <ul> <li>Waterproof. Relevant if you expect to go swimming or engage in intensive exercise. No sunscreen is 100% waterproof as they all wash off eventually. Depending on the brand, this likely ranges from 40 to 80 minutes of coverage.</li> </ul> As an aside, SPF stands for sun protection factor, and the associated number indicates how long it’ll take for UVB rays to turn your skin into a tomato, as compared to going without. So, for example, SPF30 takes 30 times longer to redden your skin than it would using no protection. <figure><img src="https://cdn.storymd.com/optimized/2dZ89NfjAG/thumbnail.jpg" alt /> <figcaption>SPF 50 Sunscreen. Source: Katamaheen/Pixabay</figcaption> </figure> <h3>Chemical versus mineral</h3> There are two major types of sunscreen: chemical and mineral. Confusingly, the secret sauce in both is chemically derived, contrary to some of the thinking out there that mineral-based sunscreen is more “natural”. Mineral sunscreen works by blocking and scattering rays, whereas chemical sunscreen absorbs sunlight and transforms it into heat through a chemical reaction. Although there is limited evidence concerning the potential side effects of exposure to the chemicals found in chemical sunscreen, more research is needed, and the FDA still considers this type to be safe. Chemical types absorb into the skin, while mineral types are the streakier kind. However, the latter starts working faster — chemical sunscreens need longer to start taking effect. Both are valid options. <h3>How much sunscreen do I need to apply?</h3> This is a recurring question and one of the most frequently cited issues with incorrect usage among the public. Craig Sinclair from the Cancer Council Australia had this to say: “…when applying sunscreen, you need at least one teaspoon per limb, one for the front of the body, one for the back, one for the head. A full body application should be around 35ml (around 1.2oz), or seven teaspoons. It’s more than Australians think.” And it’s more than Americans think as well. Research has found that most people apply less than half of the amount that Sinclair recommends, leading to insufficient protection. To contextualize this, a family of four should go through a 4oz bottle of sunscreen per person on a long day outdoors. (PS: applying on dry skin is best.) <h3>When should I apply?</h3> Timing and reapplication are important factors. Ideally, you should apply half an hour before leaving to go outside, and you should reapply every two hours (even if the product says “all day”). Remember that even on a cloudy day or a mild but clear one, you can still get burned. Upward of 80% of the sun’s rays make their way through to the Earth on a gray day, so make sure to protect yourself regardless. <h3>How much coverage does my body need?</h3> An expert would tell you that it’s best if you cover your whole body before you get dressed. That way, even if your clothes shift around over the course of the day, you’ll still have protection. Now, that’s all good and well, but it’s not always realistic. What is essential is to ensure there is coverage for any parts of your skin that are exposed, and no, we’re not just talking about obvious spots like your arms. Ensure that you take care of: <ul> <li>The ears (including the tips!). Research has found that up to one-third of skin cancers are found in the ears.</li> <li>The tops of your feet. Your sandals won’t save you.</li> <li>Lips. “But that’s disgusting!”, you say. Don’t worry, there are lip balms with SPF for this very reason.</li> <li>Eyelids. Same as the lips — we’ve got special SPF-rich products for this sensitive area.</li> <li>Scalp. Your hair can only do so much, and parts of your scalp are directly facing the sun (especially if you’re bald). Give ‘em a dab as well.</li> </ul> <h2>Myths about sunscreen</h2> There are many myths about sunscreen circulating down under as well as in North America. Below is a quick counter to the usual suspects: <ul> <li>Sunscreen is safe to use daily. The ingredients are strictly regulated, and it can be worn daily without harming your health.</li> <li>Vitamin D levels are not significantly impacted by daily use of sunscreen. Studies have failed to find anything to worry about in this area.</li> <li>Fake tan is not a substitute for sunscreen.</li> <li>Dark skin still requires protection from the sun. Lighter-skinned folk certainly are at more risk as they are more likely to develop skin cancer (owing to lower melanin levels), but all people are at risk. It can also be harder to spot lesions on darker skin than on lighter skin, so it’s important to stay extra vigilant.</li> <li>Having SPF in your makeup is not likely to offer enough protection. The chances are that you’re not applying enough SPF-infused makeup, and you’re also unlikely to apply it to all exposed areas.</li> </ul><h2>More on Sunscreen</h2><ul><li><a href="https://soulivity.storymd.com/journal/wep6b8v15j-sunscreen" target="_blank">Sunscreen: How to Help Protect Your Skin From the Sun</a></li><li><a href="https://soulivity.storymd.com/journal/dmqndq6tem-sunburn" target="_blank">Sunburn</a></li><li><a href="https://soulivity.storymd.com/journal/lw2335718m-sun-safety" target="_blank">Sun Safety: How to Protect Yourself from Harmful UV Rays</a></li></ul>

storymd