Severe sunburn is on the rise: health authorities are worried

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Sunburn for some is as Aussie as budgie smugglers and Vegemite sangers. If you spent the summer holidays largely outdoors enjoying barbecues, lazy days at the beach or pool, watching sport, or gardening, you probably experienced some degree of sunburn. January is a peak time for extreme sunburn. Last month SunSmart reported a record number of Victorians had attended public hospital emergency departments with severe sunburn in 2017. Most of the 355 people treated were children and people in their 20s. With school starting for the year, it’s no time for complacency.
 
Health authorities are worried because melanoma is the leading cause of cancer in older teenagers and young adults. Cancer Council Victoria data shows a third of Victorians aged 18 to 39 don’t know how to calculate sunburn risk. A fifth of them thought temperature was the most useful way to assess a day’s sunburn risk. Just 60 per cent correctly identified UV levels and sun protection times as the best way to calculate sunburn risk. And it’s not just severe sunburn that poses a risk. Each time you expose your skin to UV radiation, you increase your risk of developing skin cancer.
 
It’s thought the increase in severe burns may be due to an overreliance on sunscreen, with people ignoring other forms of sun protection such as a hat, sunglasses, clothing and shade. Sunscreen also needs to be reapplied every two hours in sufficient quantity to be fully effective.

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The Burning Truth: fact vs fiction


By Dr David Lester
Campaspe Family Practice
MB;BS, FRACGP, DPD, Dip. Skin Cancer Med/Surgery

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A bit of a tan is healthy, right?

Many of us over a certain age will remember being told as a child that a tan was ‘healthy’. Like so many things, it’s a tiny bit true… but mostly wrong…
 
You only have to compare the skin of Queenslanders and Victorians… and their cancer stats. The tanned bunch up north have double the incidence of skin cancer compared to the overall Australian incidence.
 
It’s known that more pigment in skin provides slight protection from UV rays. It has been shown to have an SPF of about 3, that is, it triples your time until burning compared to no extra pigment being present. Given that the best sunscreen protection available in Australia is SPF 50+, SPF 3 is not much protection.
 
In fact, we now know that extra pigment is stored on the sun side of the skin cell nucleus to shade the nucleus from the incoming irradiation. This is the skin’s way of limiting DNA mutations and lessening cancer. Ideally, the skin is protected better and the mutation doesn’t start in the first place.
 
So, the short answer is that for most fair-skinned people, every bit of tan represents stress or damage to the skin that may lead to premature ageing and skin cancer.
 

Occasional sunburn doesn’t mean much, does it?
 

For you as an individual, I honestly don’t know. What is known, is that 5 or more blistering sunburns between 15 and 20 years of age, increases your melanoma risk by 80 per cent, that is, it almost doubles your risk. Other studies have suggested blistering sunburn every 2 years may quadruple your risk of melanoma.
 
It’s also known that the skin cancer risk for those people who come to Australia after age 10, is substantially less than that of those who grow up here from birth. The good news here is that you can actively help your children’s long-term health by protecting them from the sun’s harmful UV rays.
 

But brown is beautiful!
 

So many of us fair Caucasians still pursue what we don’t naturally have! Alas, the pursuit of a tanned skin in Australia has been demonstrated to prematurely age skin. A study published in 2017 showed on average Australian females demonstrated signs of severe photoageing 20 years earlier than women in the USA, Canada and the UK. 
 

What can I do?
 

The UK campaign  ‘Own your tone’ is a great message. Minimising exposure to the sun will slow your skin ageing and lessen your skin cancer risk. If you must get a tan – fake it! Otherwise, take SunSmart’s advice and protect your skin whenever the UV index is 3 or above – slip on a shirt, slop on sunscreen, slap on a hat, slide on shades, seek shade.
 
If you have a fair complexion, more than 20 moles, or a spot on your skin that concerns you, then consider having a skin check. Also, if you have experienced blistering sunburn in the past then make this a priority. Early diagnosis may save your life.


© Dr David Lester  2018

Did you know?

Australian skin cancer facts from Cancer Council Victoria

  • Sunburn can occur in as little as 15 minutes on a fine January day; 95 per cent of melanomas are due to overexposure to UV radiation 
  • High exposure to the sun before the age of 10 more than doubles your melanoma risk
  • Skin cancer causes more deaths annually than transport accidents
  • Women have a 1 in 24 chance of being diagnosed with melanoma by the time they turn 85, compared with 1 in 14 men
  • Melanoma rates are higher in regional areas than in cities
  • The number of moles you have increases your likelihood of melanoma
  • Intense, intermittent sun exposure increases your risk of melanoma

Tips to protect you and your family

SunSmart summarises the issue of sun exposure in a pithy slogan: ‘UV. It all adds up.’ Adequate sun protection is gained by using a combination of methods:
 
Slip on clothing: for example, long sleeve shirts (with collars) and trousers made from lightweight, tightly woven natural fibres (linen, cotton or hemp) in darker colors.
 
Slop on sunscreen: SPF 30 + broad spectrum, water-resistant sunscreen applied every 2 hours. As a guide, apply one teaspoon of sunscreen to cover your face/head/neck area. Use two teaspoons on your torso. Apply one teaspoon to each arm and two teaspoons to each leg.

Slap on a hat: choose one with a wide brim.

Seek shade: under a shady tree, shade sails, or shadows cast by buildings, for example.

Slide on sunglasses: close-fitting wrapround-style sunglasses are best. Sunglasses with an Eye Protection Factor (EPF) rating of 9 or 10 give excellent protection.