SUN SAFETY

Florida Department of Environmental ProtectionCentral District Office

What is skin cancer?

Skin cancer is a disease in which cancer (malignant) cells are found in the outer layers of your skin.

Skin Cancer This year more than one million Americans will

develop one of the three most common forms of skin cancer.

Over 90 percent of these cancers will appear on sun-exposed skin, usually on the face, neck, ears, forearms, and hands.

Every hour an American dies from skin cancer.

What causes skin cancer? Sunburn and Sunlight Heredity Environment

How it happens Overexposure to ultraviolet UVA and UVB rays

ravages skin cells. The top layer, or epidermis, is the most vulnerable. Too much sun prompts visible damage (like sunburn or tanning) as well as invisible, cellular-level damage that adds up over the years.

Layers of Skin Epidermis Dermis Subcutis

Epidermis Top layer of skin. Contains three kinds of cells:

flat, scaly cells on the surface called squamous cells; round cells called basal cells; and cells called melanocytes, which give your skin its

color.

Dermis The middle layer of skin. Contains blood vessels, nerves, and sweat glands. The hair on your skin grows from tiny pockets in the

dermis, called follicles. The dermis makes sweat, which helps to cool your

body, and oils that keep your skin from drying out.

Subcutis The deepest layer of skin. The subcutis keeps in heat and has a shock-

absorbing effect that helps protect the body's organs from injury.

Three Most Common Forms of Skin Cancer Basal Cell Carcinoma Squamous Cell Carcinoma Malignant Melanoma

Basal Cell Cancer - What is it? Most common type of nonmelanoma skin cancer. Affects the skin’s basal layer, or 5th layer of skin. Onset most commonly occurs after the age of 40;

however, an increasing number of younger adults are developing this from of cancer.

Basal Cell Cancer - What causes it? Skin damage from the sun that has occurred

over many years.

Basal Cell Cancer - What does it look like?

Often appears as a small raised bump that has a smooth, pearly appearance.

Another type looks like a scar and is firm to the touch.

It could also be a small lesion or sore that does not heal and has other specific characteristics.

Basal Cell Cancer - Where does it usually occur?

On areas of your skin that have been in the sun, including the face, scalp, ears, lips or around your mouth.

May spread to tissues around the cancer, but usually does not spread to other parts of the body.

Basal Cell - Is it curable? Early treatment results in a cure rate of more

than 95%. However, new growths can occur. Stay vigilant!

Squamous Cell Cancer - What is it? A malignant growth of the epithelial layer of the

skin, or the external surface.

Squamous Cell Cancer - What causes it? Overexposure to x-rays Excessive exposure to the sun

Squamous Cell Cancer - What does it look like?

Often appears as a firm red bump.

Sometimes the tumor may feel scaly or bleed or develop a crust.

Squamous Cell Cancer - Where does it usually occur?

Occur on areas of your skin that have been in the sun, often on the tip of the nose, forehead, lower lip, and hands.

May also appear on areas of your skin that have been burned, exposed to chemicals, or had x-ray therapy.

Squamous cell tumors may spread to other parts of the body if not treated.

Squamous Cell Cancer - Is it curable? Yes, early treatment results in a cure rate of

more than 95%. As with basal cell, new growths can occur. Stay

vigilant!

Melanoma - What is it? Type of skin cancer that starts in the

melanocytes, the cells that give your skin color. Not as common as basal cell or squamous cell

skin cancer, but much more serious. Nearly 48,000 Americans will develop it this year. Accounts for about 4% of skin cancer cases, but

causes about 79% of skin cancer deaths.

Melanoma - What are the risk factors? Moles Fair Complexion Family History Immune Suppression Too much UV radiation exposure Age

Melanoma - What does it look like? Melanoma usually begins as a

dark brown or black patch with irregular borders and is characterized by the uncontrolled growth of pigment-producing tanning cells.

Melanoma - Where does it usually occur? It may appear anywhere on the body without warning or start near a

mole. Men most often get melanoma on the trunk (the area between the

shoulders and hips). Women most often get melanoma on the arms and legs. It has a tendency to spread, making it essential to treat it right away. Since melanoma is often linked to a change in one of your moles

(most of us have 100 or so), you should inspect them regularly and look for any changes in their size and color, such as the appearance of a bump or the spreading of pigment around the border.

Identifying Melanoma The Skin Cancer Foundation

and the American Academy of Dermatology recommend using the ABCD method (see photos) to help detect melanoma.

Asymmetrical

Most early melanomas are asymmetrical.

Borders

Borders of melanomas are uneven.

Colorcolor; varied shades of brown, tan, or

black are often the first sign of melanoma.

DiameterDiameter; early melanomas tend to grow

larger than common moles.

Skin Signs and Changes to Watch For

SizeSudden or continuous growth especially if it is bigger than a pencil eraser.

ShapeIrregular borders (not symmetrical).

Skin Signs and Changes to Watch For Color

A mole that darkens or develops a dark spot in its center. Pearly, translucent, tan, brown, black, pink or multi-colored.

Skin Signs and Changes to Watch For Elevation

Sudden elevation of a flat freckle Surface Characteristics

Bleeding, itching, oozing, hurting, crusting, and/or scabbing.

Skin Signs and Changes to Watch For Surrounding Skin

Redness, swelling, or spots of color, especially near a mole.

ConsistencyAny softening, hardening, or crumbling of skin.

Skin Signs and Changes to Watch For Sensation

Itching, tenderness, or pain. Open sore that lasts for more then 4 weeks,

heals and then reopens. Scaly or crusty bump that is dry and rough, and

that may produce a prickling or tender sensation.

One serious sunburn can increase the risk by as much as 50%.

The effect of UV light has on your skin is dependent on: the intensity and the duration of your exposure your genetic background

http://www.aad.org/skinrisk.html

How can I determine my personal risk?

Are there precautions that will reduce my risk?

Yes! Six steps recommended by the American Academy of Dermatology and the Skin Cancer Foundation to help reduce the risk of sunburn and skin cancer.

Minimize your exposure to the sun at midday and between the hours of 10:00AM and 3:00PM.

Apply sunscreen with at least a SPF-15 or higher, to all areas of the body which are exposed to the sun.

Reapply sunscreen every two hours, even on cloudy days. Reapply after swimming or perspiring.

Six Steps to Reduce Your Risk

Wear clothing that covers your body and shades your face. (Hats should provide shade for both the face and back of the neck.)

Avoid exposure to UV radiation from sunlamps or tanning parlors.

Six Steps to Reduce Your Risk

Protect your children. Keep them from excessive sun exposure when the sun is strongest (10:00AM and 3:00PM), and apply sunscreen liberally and frequently to children 6 months of age and older. Do not use sunscreen on children under 6 months of age. Parents with children under 6 months of age should severely limit their children's sun exposure. Most people receive 80% of their exposure to the sun by age 18.

Six Steps to Reduce Your Risk

Should everyone use sunscreen? Yes! Even if you rarely sunburn, sensitive areas

such as your lips, nose, and palms of the hands should be protected.

The FDA (Food and Drug Administration) and the American Academy of Dermatology (AAD) recognize six skin categories: Skin Type (I-VI)

Skin Type I Sun History: Always burns easily, never tans,

extremely sun sensitive skin Example: Red-headed, freckles,

Irish/Scots/Welsh

Skin Type II Sun History: Always burns easily, tans

minimally, very sun sensitive skin Example: Fair-skinned, fair-haired, blue-eyed,

Caucasians

Skin Type III Sun History: Sometimes burns, tans gradually to

light brown, sun sensitive skin Example: Average skin

Skin Type IV Sun History: Burns minimally, always tans to

moderate brown, minimally sun sensitive Example: Mediterranean-type Caucasians

Skin Type V

Sun History: Rarely burns, tans well, sun insensitive skin

Example: Middle Eastern, some Hispanics, some African-Americans

Skin Type VI

Sun History: Never burns, deeply pigmented, sun insensitive skin

Example: African-Americans

Note:

The AAD suggests that regardless of skin type a sunscreen with an SPF of at least 15 should be used year-round.

When should a sunscreen be used? Every day if you are going to be in the sun for

more than 20 minutes. When on or around reflective surfaces such as

water and snow. Snow can reflect up to 80% of the suns rays!

On cloudy days too!

How do I choose a sunscreen? Choose a sunscreen that has an appropriate sun

protection factor (SPF). Consider allergic reactions. Some people are

sensitive to PABA (para-aminobenoic acid) and its esters.

Sunscreens come in ointments, creams, gels, lotions, oils and wax sticks.

What is an SPF? Sun Protection Factor Typically range from 2 to 60 Rating is calculated by comparing the amount of

time needed to produce a sunburn on protected skin to the amount of time needed to cause a sunburn on the unprotected skin.

Example: If a sunscreen is rated for SPF 2 and a fair-

skinned person who would normally turn red after 10 minutes of exposure uses it, it would take twenty minutes of exposure for their skin to turn red. Subsequently, if that person used a sunscreen with SPF 15, it would take 15 times longer to burn, or 150 minutes.

Does SPF 30 have twice as much protection as SPF 15?

No! The SPF protection does not increase proportionately with the designated SPF number.

In higher SPFs such as SPF 30, 97% of rays are absorbed; however, an SPF of 15 indicates 93% absorption, and an SPF of 2 indicates 50 % absorption.

Does the SPF give the protection rating for UVA or UVB rays?

SPF rates protection for UVB - there is no rating system for UVA protection.

What is the difference between UVA and UVB light wavelengths?

UV-B ranges in wavelengths between 280 and 320 nm. The wavelengths of UV-A radiation range between 320 and 400 nm.

While UVB rays are the primary cause of sunburn and skin cancer, UVA rays, which penetrate deeper into the dermis, also contribute to sunburn and skin cancer.

Sunscreen Selection Note:

Some sunscreens only protect against UVB rays. Examples: Products using PABA, PABA esters, and cinnamates.

If you want protection from UVA rays, you must select a “broad-spectrum” sunscreen that uses products like benzophenones, oxybenzone, suilisobenzone, titanium dioxide, zinc oxide and Parsol 1789.

How much sunscreen should you use? Enough to liberally cover the exposed skin,

approximately one ounce.

How often should you apply? Apply to dry skin 15 to 30 minutes before going

outdoors. Reapply after swimming or perspiring heavily.

Remember that water-resistant sunscreens may lose their effectiveness.

Reapply according to the SPF factor selected.

What is the difference between a sunscreen and a sunblock?

Sunscreens absorb UV rays; Sunblocks deflect UV rays.

What should I do to protect myself from the sun?

Use sunscreen or sunblock. Use wide brimmed hats, protective clothing

such as long-sleeved shirts, long pants, etc. Avoid sun exposure as much as possible.

How do I know at what level to protect myself?

Use the UV Index as a guide. The UV Index is a publication provided by the

Climate Prediction Center (CPC), National Centers for Environmental Prediction (NCEP), National Weather Service (NWS), National Oceanic and Atmospheric Administration (NOAA), and U.S. Department of Commerce (DOC).

How do I access the UV Index web site and obtain the current UV Index for my area?

http://www.cpc.ncep.noaa.gov/products/stratosphere/uv_index/index.html

Protective Measures based on UV Index

Exposure Category UV Index Protective ActionsMinimal 0, 1, 2 Apply skin protection factor (SPF) 15 sun screen.Low 3, 4 SPF 15 & protective clothing (hat)Moderate 5, 6 SPF 15, protective clothing, and UV-A&B sun

glasses.High 7, 8, 9 SPF 15, protective clothing, sun glasses and make

attempts to avoid the sun between 10am to 4pm.Very High 10+ SPF 15, protective clothing, sun glasses and avoid

being in the sun between 10am to 4pm.

Note: If you are aware that you are extremely sensitive to UV exposure or have a skin condition that is worsened by UV exposure, more stringent measures are probably required.

Estimate Minutes to Skin Damage using UV Index Data

How do I treat a sunburn?The two most common sunburns are first andsecond degree burns. First degree sunburns: use cool baths and moisturizers or

over-the-counter hydrocortisone creams. Caution your use of “-caine” products.

Second degree sunburns: May need medical attention. If the burn is severe, accompanied by a headache, shills or a fever, seek help right away.

Are tanning booths a safer way to tan? Although no direct linkage has been proven,

tanning booths emit UVA radiation. UVA is known to cause cataracts, sunburns, skin cancer and premature aging of the skin.

Credits American Academy of Dermatology American Cancer Society Climate Prediction Center (CPC), National Cancer Institute National Centers for Environmental Prediction (NCEP) National Oceanic and Atmospheric Administration (NOAA) National Skin Centre The Skin Cancer Foundation South Seas Trading Company