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Australians have learned a lot of lessons about the sun and health the hard way. Writer Erin Walton shares this knowledge about how to love the outdoors and reduce the riskof skin cancer.
Text: Erin Walton
Country: Australia

lease add this disclaimer at the top of the article:

This article is purely informative, and is not meant as a definitive, expert guide to sun protection. It should be read in conjunction with your own research and visits to health care professionals.

Australia is all but synonymous with hot, clear days spent beachside. And while beach lovers may wish it weren’t true, failing to care for your skin in a country like Australia is no laughing matter. Skin cancer caused by sun damage is real. But what is it? And how can we protect ourselves from the sun?

Why is Australia a high-risk country?

The depleted ozone layer over Antarctica has particularly affected Australia. The country’s clear atmospheric conditions, the fact that it’s closer to the sun than Europe during the summer months, and the Aussies’ taste for being outdoors in general combine for increased skin damage and risk of skin cancer. In fact, Australia has one of the highest rates of skin cancer in the world. Benign cancers are estimated to cost the health system more than AUD$700 million annually, and according to the Australian Bureau of Statistics, 2000 Australians die from skin cancer each year.

A quick guide to UV rays

Sunlight contains ultra violet (UV) radiation. There are three types of UV rays —UVA, UVB, and UVC. Of these, UVC rays are the most dangerous; however, very few reach the Earth’s surface because water vapour, ozone, oxygen, and carbon dioxide absorb them as they pass through the atmosphere. This is also true for a large percentage of incoming UVB rays. Therefore, here on Earth, we are largely affected by UVA and some UVB rays.

UVB rays penetrate the top layer of skin and are responsible for causing sunburn and many non- melanoma cancers. They are partially blocked by glass, meaning that being indoors or in the car somewhat diminishes their effect. On the other hand, UVA rays are not filtered by glass (so indoor “sunbaking” is not safe). These rays cause the visible signs of ageing associated with sun exposure.

The UV Index levels go from 2 (low) to 11 (extreme) and tell us how we should protect ourselves depending on the radiation that day. There are different—and increasing— precautions to take at each level.

What does sun exposure cause?

There’s a reason that the generation that spent its youth working on its tan now looks worse for wear. These days, we know that prolonged, unprotected exposure to the sun has a number of not-so-nice results, including premature ageing, eye damage, sunburn, and skin cancer, the most severe of all.

There are three main types of skin cancers: Basal cell carcinoma (BCCs, which make up around 70% of non-melanoma cancers), squamous cell carcinoma (SCCs, accounting for the remaining 30%), and melanoma. Of these three, the deadly melanoma is by far the most dangerous.

BCCs and SCCs are associated with accumulated sun damage over years, and as such they’re often seen on the face, hands, neck, ears, or other areas frequently exposed to the sun. BCCs usually present as fleshy or pearly lumps; or a scaly, dry area with a pale, shiny colour or bright pink colour. SCCs present as scaly red patches or have the appearance of sores that have not healed. They may also be tender when touched.

Melanoma—often presenting as a dark spot on the skin—is associated with briefer, more intense periods of sun exposure and is the 4th most diagnosed cancer in Australia. Amy Amonette, a board-certified dermatologist and Mohs surgeon (a method for removing skin cancers), highlights that while periods of intense sun exposure are associated with melanoma, other risk factors— such as a family history, being very fair-skinned, or having a large number of sizeable moles on the body—can play a part.

What to look for when performing a skin check

If you have moles, dermatologists recommend you go for regular mole scans with a heath care professional, and keep an eye on your moles and freckles in between checkups. While most moles will be benign, your medical professional will want to hear about any changes in a mole’s appearance, as well as the arrival of additional moles in adulthood. (The expression “change is as good as a holiday” is not the case when it comes to moles.)

Use “ABCDE” to remember how to check and assess your moles for change:
A – asymmetry (Is one side of a mole different to the other?)
B – border (Are the mole’s edges blurred, irregular, or raised?)
C – colour (Does your mole have different colours? Is it changing colour or becoming blotchy?)
D – diameter (Is its diameter greater than that of a pencil’s eraser?)
E – evolving (Is your mole changing shape, size, colour, or starting to itch or bleed?)

“SCAN” is another helpful abbreviation to remember when performing a skin check:
S for Sore (Is the spot bleeding, itchy, tender, or not healed after six weeks?)
C for Changing (Is it altering in colour, texture, shape, or size?)
A for Abnormal (Does this mole look different to your others?)
N for New (If you see additional moles or spots, report them quickly.)

Everyday sun, safe habits

Since the early 1980s, Australians have become more sun-smart. In 1981, the “Slip! Slop! Slap!” campaign, and its icon Sid the Seagull, took over television. The idea? To “slip on a shirt, slop on sunscreen, and slap on a hat”—the minimum required to be sun-smart. In recent years, this has been updated to “Slip, slop, slap, seek, and slide”. Want to resist looking like a withered peach pit in middle age? Here’s how to be sun-smart in Australia:

Slip on a shirt
Hopefully a long-sleeved top with a collar. When choosing yours, look for material with tightly-woven, ideally darker-coloured fibres (cotton and linen work well). Extra points if the fabric has a good Ultraviolet Protection Factor, or UPF. The higher the UPF’s number, the better: for example, a UPF of 25 means that 1/25 of UV radiation will reach your skin.

Slop on sunscreen
Which sunscreen? Why, broad spectrum SPF 30+ of course! “Broad spectrum” means you’ll be protected against both UVA and UVB rays, while its SPF, standing for Sun Protection Factor, describes the level of protection a particular sunscreen gives. As with the UPF, the higher the number, the better. SPF 30 sunscreen means that if your skin would burn in 10 minutes when unprotected, applying sunscreen increases the time to 300 minutes, 30 times longer.

nother important tip when using sunscreen is not to skimp. Dr Elizabeth K. Hale (a clinical associate professor of dermatology at the New York University School of Medicine) on SkinCancer.org says that most people don’t apply enough. A good guideline, she says, is to apply a shot glass amount of cream (around two tablespoons) to your face and body, reapply every two hours or more frequently if swimming.

Slap on a hat
These days, Australian primary school uniforms include wide-brimmed hats, and schools have “no hat, no play” policies at recess. Always choose a wide-brimmed hat— baseball caps and bucket hats don’t provide adequate protection—and remember that if you can peek through the weave, the sun can too.

Seek shade
See a tree? Get under it. At the beach? Hop under a beach umbrella or beach shelter. Shade is your friend.

Slide on sunglasses
Don’t choose any old sunglasses. The type that best protects us from the sun’s rays will be tight-fitting or wrap-around (and won’t cost $3 from the dollar store).

With a few simple steps, it’s easy to protect your skin from the sun’s harmful rays. When in Australia—or travelling in the Southern Hemisphere in general—take care of your skin, and it will continue to take care of you!

How can the sun damage our skin?

Premature ageing
This can be seen in the sun spots (discoloured patches of skin) on the hands, arms, and face; leathery or tough skin; some premature wrinkles; and a loss of elasticity in the skin.

Eye damage
The cornea can become burned, and excessive sun exposure is also associated with an increased chance of developing cataracts.

Sunburn
This is something we’ve all experienced in one form or another. Symptoms include redness, swelling, blistering, fever, tenderness, nausea. Fair-skinned people burn far quicker and more severely than darker-skinned people, though they can still experience symptoms.

Skin cancer
Basal cell carcinoma, squamous cell carcinoma, and melanomas are the three main types.




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How to safely enjoy the sun


Australia is known for its beautiful, sunny beaches. However, the Australian sun is quite strong and can pose a risk to your skin.

The depleted ozone layer over Antarctica particularly affects Australia. Australia has clear atmospheric conditions, is closer to the sun in the summer months than Europe, and Australians love the outdoors. In fact, Australia has one of the highest rates of skin cancer in the world.

Prolonged, unprotected exposure to the sun can cause premature ageing, eye damage, sunburn, and skin cancer. There are three main types of skin cancers: Basal cell carcinoma, squamous cell carcinoma, and melanoma. Of these three, the deadly melanoma is by far the most dangerous. If you have moles you should have regular check-ups with a dermatologist and also keep an eye on your moles and freckles between visits.

Use "ABCDE" to remember how to check and assess your moles for change:

A – asymmetry (Is one side of a mole different to the other?)

B – border (Are the mole's edges blurred, irregular, or raised?)

C – colour (Does your mole have different colours? Is it changing colour or becoming blotchy?)

D – diameter (Is its diameter greater than that of a pencil's eraser?)

E – evolving (Is your mole changing shape, size, colour, or starting to itch or bleed?)

In 1981 Australia introduced a campaign called "Slip! Slop! Slap!" where Sid the Seagull taught television viewers how to be sun smart. Recently the campaign has been updated to "Slip, slop, slap, seek, and slide". It encourages people to slip on a shirt, slop on sunscreen, slap on a hat, seek shade, and slide on sunglasses.

With a few simple steps, it's easy to protect your skin from the sun's harmful rays. And remember to be sun smart when you travel to Australia or elsewhere in the Southern Hemisphere.

 

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How to safely enjoy the sun

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