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Skin Cancer 101

Have specific questions about sun protection? Find the answers here. Click on a topic to learn more.

Sun Safe Clothing and Hats
Sunglasses
Sunscreen
Shade
Sunburns and Tans
Risk Factors
The UV Index
Skin Cancer
Ultraviolet Radiation (UV)
Skin Self-Exams
Vitamin D


SUN SAFE CLOTHING AND HATS

What is sun protective clothing? Sun protective clothing are hats, shirts, pants, shoes, gloves, etc. that cover sufficient skin and are made from fabrics with a tight weave that doesn’t allow UV rays to pass through it. The most sun protective hats have a wide brim all the way around or a Legionnaire’s style flap in the back. In addition to a tight fabric weave, sun protective clothing can be treated with chemical UV absorbers (like sunscreen for clothes). Some sun protective clothing is labeled by the manufacturer with a UPF of 15 to 50+.

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What is UPF? UPF stands for Ultraviolet Protection Factor. UPF is a measure of the UV protection provided by a fabric. UPF measures the ability of a fabric to block UVA and UVB from passing through it and reaching the skin. For example, a fabric with a UPF 50 allows only 1/50th, or 2%, of the UV radiation striking it to pass through to the skin. By U.S. standards, in order for a garment to be labeled as “sun protective” it has to have a UPF of between 15 to 50+.

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Are all hats sun safe? Any hat provides some shade and is better than no hat at all. However, some hats are more sun safe than others. Tightly-woven hats with at least a 3-inch brim all the way around can help reduce sun exposure to the head, face, and neck by as much as two-thirds. Remember that more skin cancers occur on the head and face than any other place on the body.

Sun Safe Hats Chart

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What factors make the fabric used in clothing and hats sun protective? The three primary factors that affect the sun protective quality of clothing are style, weave and chemical enhancement. First, clothes designed to cover the most skin provide the most sun protection. Long-sleeved shirts with collars, long pants, and shoes and socks provide more coverage than tank tops, shorts and sandals. Sun protective clothing styles cover to the neck, to the elbows, and to the knees. Sun protective hats have wide brims all the way around or a brim in the front and a Legionnaire's-style flap in the back. Second, fabrics with a tight weave block more sunlight than loosely woven fabrics. Fewer, smaller holes between the threads allow less UV to pass through to the skin. Third, fabrics and clothing may be laundered with optical brighteners or treated with chemical absorbers to increase their UV protectiveness.

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What other factors can make fabric sun protective? Other factors that affect the sun safety of clothing include its color, the thickness of the fabric, the fiber content, how much it stretches and how it reacts when wet. Lighter colors of fabrics feel cooler because they reflect infrared light, but darker colors absorb UV better and provide more protection for the skin. Fabrics that stretch can allow more UV to pass through. When wet, some fabrics stretch and allow more UV through while other fabrics shrink and block more UV .

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How can I tell if my clothes are sun safe? You don’t have to have your clothes tested for UPF in order to tell if they are sun protective. Wear hats with a tight weave and wide brim. Wear clothes that cover a lot of skin. Choose clothes with dark colors and a tight weave. To assess UV protection of a garment easily, hold the material up to a bright light and see how much visible light you can see through the holes in the weave. If the visible light can get through so can the invisible ultraviolet light. Look for fabrics with the tightest weave. Some textile fibers, such as polyester crepe, bleached cotton and viscose, are quite transparent to UV and should be avoided in the sun.

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How do pre-market chemical enhancements work? Some manufacturers treat fabrics with UV-absorbing chemicals before they are sold. This can improve the sun protection of lighter, cooler, more open weave fabrics and last a long time.

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How do after-market chemical enhancements work? Once purchased, garments can be treated in a few ways. Some common laundry detergents contain optical brighteners that can improve UV absorption and make garments more sun safe. Other special laundry products work in much the same way. Clothes also can be treated with spray-on treatments that can increase UPF and last through repeated washings.

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Does all clothing need to be labeled with a UPF? No. According to U.S. standards, only clothing whose manufacturer claims that it protects against UV , claims the reduction of risk of skin injury associated with UV exposure, or uses a rating system that quantifies the amount of UV protection afforded needs to be labeled with a UPF value and classification category.

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What are the Classification Categories? According to U.S. guidelines, the three classification categories for sun protective fabrics and clothing: Good UV Protection (for UPF 15 to 24), Very Good UV Protection (for UPF 25 to 39) and Excellent UV Protection (for UPF 40 to 50+).

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How is fabric tested for UPF? Fabric is tested with special reflectance equipment called a spectrophotometer, not on human subjects like sunscreen is tested. If labeled as sun protective, the clothing must have a UPF between 15 and 50+.

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What UPF should I choose? For sun protection, choose clothing with a UPF 15 or more. A UPF 15 blocks 93% of UVA and UVB. A UPF 50+ blocks 98% of UVA and UVB.

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How long does the UPF last? In the U.S., a UPF rating should indicate the minimum UPF for the typical life of the garment (about two years of normal wash and wear). However, very old, threadbare or faded garments may have a lower UPF rating.

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What are the U.S. standards for the preparation, UV testing and labeling sun protective clothing? American Society for Testing Materials standards D6544 and D6603 combine with American Association of Textile Chemists and Colorists 183 to form the most stringent UV -protective clothing standard in the world. ASTM D6544, a voluntary standard, is unique among the world’s UV textile documents. It ensures that the UV protection claimed on labels reflects the least or lowest degree of protection during the use-life of the garment rather than the degree of protection when the garment is new. D6544 asks fabrics manufactures making a claim of sun protectiveness to undergo 40 simulated launderings, to be exposed to 100 fading units of simulated sunlight, and if intended for swimsuits, to be exposed to chlorinated water prior to UV -transmission testing with AATCC 183. AATCC 183 is the U.S. gold standard for determining the UPF and percent UVA/UVB blocked by a fabric or garment. D6603 requires fabrics to be labeled with a UPF value between 15 and 50+ and a classification category similar to those used in Australia and New Zealand.

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Are sun protective fabrics and clothing regulated by the government? No. Fabrics, clothing and hats are not regulated by the U.S. Food and Drug Administration or any other government agency. However, the Federal Trade Commission monitors sun protective claims and the industry encourages textile and clothing manufacturers and marketers to self-regulate and adopt the U.S. standards.

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SUNGLASSES

Do all sunglasses provide the same amount of UV protection? No. All sunglasses block some UV, but not all sunglasses block 100% of UV. There are no government regulations on the amount of UV that sunglasses must block. Also, UV protection is not necessarily better with darker or more costly lenses. Sunglasses should be large enough to shield your eyes from many angles to help block scattered, reflected, or refracted UV. Polycarbonate, polarized and blue-blocking lenses do not necessarily offer greater UV protection.

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What makes sunglasses sun protective? A chemical coating applied to the surface of the lens makes sunglasses and other eyewear sun protective.

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Are sunglasses labeled with an SPF? No. There is no SPF or UPF rating for the UV protection of eyewear in the U.S. You can look for sunglasses labeled as providing at 99% or 100% UV protection. The tag also may say something like “UV absorption up to 400 nm” or “absorbs UV up to 400 nm” which is equivalent to blocking at least 99% of UVA and UVB.

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How are sunglasses tested for UV protection? Sunglasses are tested with special transmittance equipment, not on human subjects like sunscreen.

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Are sunglasses regulated by the government? Yes. Sunglasses are regulated by the FDA. They must comply with impact-resistant requirements and labeling regulations.

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SUNSCREEN

What is sunscreen? Sunscreen is a preparation with a Sun Protection Factor (SPF) of 15 or more that is used to protect the skin from the damaging rays of the sun. Sunscreen may be a lotion, spray, lip balm, soap, towelette, make-up, etc. The active ingredients in sunscreen absorb, reflect, or scatter the harmful UVA and/or UVB rays of the sun. Sunscreen, when used correctly, is an effective means of sun protection. It is estimated that consistent use of sunscreen in childhood and adolescence could reduce skin cancer incidence by about 80%. However, sunscreen should not be your first or only defense against UV .

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What are the active ingredients in sunscreen? Sunscreen ingredients are classified as either chemical or physical based on how they perform on the skin. Chemical sunscreen ingredients are absorbed into the skin and work by absorbing UV radiation. Most chemical sunscreen ingredients absorb a wide range of UVB radiation only. Only some chemical sunscreen ingredients absorb a wide range of UVA radiation. Physical sunscreen ingredients lie on top of the skin and work by reflecting or scattering UV radiation. Two physical sunscreen ingredients block UVB and most UVA. Many sunscreen products contain a combination of chemical and physical sunscreen ingredients to make them more effective and less allergenic. See some active ingredients below:

  Ingredient UVB
Protection
UVA
Protection
Chemical
Absorbers
Avobenzone (Parsol 1789) No Yes
Cinnamates Yes No
Octocrylene Yes No
Oxybenzone (Benzophenones) No Yes
PABA (para-aminobenzoic acid) Yes No
Padimate-O (Octyl dimethyl paba) Yes No
Salicylates Yes No
Physical
Blockers
Titanium Dioxide Yes Yes
Zinc oxide (including transparent) Yes Yes

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How should sunscreen be applied? Sunscreen should be applied in a THICK even layer over all sun-exposed skin. Lip balm with SPF 15 or more can be used on the lips. Apply sunscreen 15 to 30 minutes before going outside to give the chemicals time to work. Reapply sunscreen every 2 hours or after swimming, toweling off, or sweating. Even water-resistant sunscreens should be reapplied often.

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Want a simple way to remember how much sunscreen your body needs? The Rule of Nine makes it easy. When applying sunscreen, imagine the body segmented into 11 areas that take up 9 percent of the body's surface-also known as the Rule of Nines. To achieve maximum sunscreen protection indicated by the container, apply two finger lengths of sunscreen along the index and middle fingers to each of the 11 areas that are exposed. The "two finger" amount should provide SPF protection when applied to each of these skin areas exposed to UV rays. If two-finger lengths feels like too much sunscreen for the skin to absorb, simply apply one finger length of sunscreen to each area of the skin and then reapply the same amount within 30 minutes. And remember, the sun is most intense between 10 a.m. and 4 p.m. That means reapply sunscreen throughout the day.

Body Areas by "Rule of Nines" for extent of burns

  1. Head, neck, and face
  2. Left arm
  3. Right arm
  4. Upper back
  5. Lower back
  6. Upper front torso
  7. Lower front torso
  8. Left upper leg & thigh
  9. Right upper leg & thigh
  10. Left lower leg & foot
  11. Right lower leg & foot

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Should sunscreen be reapplied? Yes. Sunscreen should be reapplied about every 2 hours or after swimming or sweating. However, according to the Australian Radiation Protection and Nuclear Safety Agency (the body of the Australian government that regulates sunscreen), " …remember that reapplication only keeps up the protection of the first application, it doesn’t give you extra protection. If applying sunscreen of SPF 15+ gives you 2 hours in the sun without burning, then reapplying the sunscreen after 2 hours does not protect you for another 2 hours!" If you know you'll be outdoors for a long time, use a higher SPF.

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What is SPF? SPF is a measure of a sunscreen’s ability to prevent sunburn on the skin for a period of time. SPF is a measure of UVB protection only. Currently, no standard exists to label UVA protection from a sunscreen. SPF numbers tell a person how much longer they can stay in the sun without burning if they wear the product as opposed to not wearing any sun protection product. For example, if your skin usually begins to redden in 10 minutes (without any type of sun protection) then a SPF of 15 means that you can stay in the sun 15 times longer (150 minutes) until you begin to burn.

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What SPF should I choose? Choose sunscreen with an SPF 15 or more. Higher SPFs will provide more protection for a longer amount of time.

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Does sunscreen expire? Yes. Look for an expiration date. Sunscreens have a shelf life of about two years, after which time the chemicals separate from the solution. If your sunscreen feels gritty, the chemicals have likely separated and it should be thrown away.

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Is sunscreen a good sun protection measure? Yes. Consistent use of sunscreen in childhood could help prevent about 80% of all skin cancers. However, sunscreen must be used correctly. Ideally, sunscreen should be used in addition to shade and protective clothing. It should be used to protect against normal sun exposure, not to prolong it.

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How much protection does sunscreen provide? No sunscreen lasts all day or blocks 100% of the sun’s harmful UV rays. Sunscreen provides protection for a limited amount of time; usually the number of minutes it takes skin to redden multiplied by the SPF of the product. All sunscreens block UVB—the burning rays. Broad-spectrum sunscreens block UVB and some UVA—the aging rays that penetrate more deeply into the skin.

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How are sunscreens tested? Sunscreens are tested according to FDA regulations on human subjects in controlled clinical trials.

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How are sunscreens regulated? Sunscreens are regulated as over-the-counter drugs by the FDA who has established conditions under which sunscreen products are recognized as safe, effective, and properly labeled.

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Does sunscreen cause skin cancer? There is no clear evidence to show that sunscreen puts you at greater risk of developing skin cancer. However, sunscreen must be used properly. No sunscreen blocks 100% of UVA and UVB. Sunscreen does not always prevent sunburn, but rather delays it. Some UVA and UVB rays still get through and can damage skin, though at a delayed rate. Sunscreen should be used in addition to shade, cover-up clothes, and wide-brimmed hats.

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SHADE:

What are fabric-based shade structures and shade devices? Fabric-based shade structures are large, often stationary pavilions with shadecloth roofs and sturdy pole supports. Shade structures can shade large areas and many people at one time. Some are small enough to be portable. Shade devices are smaller, portable and more personal in nature. They tend to cover one person or fewer people at a time. Parasols, patio umbrellas, beach tents, baby carrier covers, car window screens and the like are shade devices.

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Do all shade products provide the same amount of protection? No. Many fabrics block the sun’s ultraviolet radiation (UV), but not all of them block enough UV to be classified as sun protective. Also, the style or construction of the shade product affects how much shade it provides.

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What factors make the fabric in shade products sun protective? The two primary factors that affect the sun protective quality of fabrics used in shade products are weave and color. Fabrics with a tight weave block more sunlight than loosely woven fabrics. Fewer, smaller holes between the threads allow less UV to pass through to the skin. Lighter colors of fabrics feel cooler because they reflect infrared light, but darker colors absorb UV better and provide more sun protection.

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Do all shade products need to be labeled with an SPF or UPF? No. According to U.S. standards, only manufacturers who claim that the fabric in their shade product protects against UV, claim the reduction of risk of skin injury associated with UV exposure, or use a rating system that quantifies the amount of UV protection afforded by the fabric need to label their products with a UPF value and classification category.

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What is UPF? UPF stands for Ultraviolet Protection Factor. UPF is a measure of the UV protection provided by a textile or fabric. UPF measures ability of a fabric to block UV from passing through it and reaching the skin. For example, a fabric with a UPF 50 allows only 1/50th, or 2%, of the UV radiation striking it to pass through to your skin. Sun protective shade device fabrics have a UPF of 15 to 50+. Shadecloth used in large shade structures may have a UPF of 10 to 50+ (according to Australian/New Zealand standards).

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What are the Classification Categories? According to U.S. guidelines, there are three classification categories for sun protective fabrics. These are: Good UV Protection (for UPF 15 to 24), Very Good UV Protection (for UPF 25 to 39) and Excellent UV Protection (for UPF 40 to 50+).

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How is fabric tested for UPF? Fabric is tested with special reflectance equipment (e.g., a spectrophotometer).

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What UPF should I choose? For sun protection, choose shade devices made from fabrics with a UPF 15 or more. A UPF 15 blocks 93% of UVA/ UVB. A UPF 50+ blocks at least 98% of UVA/UVB. Choose shade structures made from fabrics with a UPF of 10 to 50+ (according to Australian/New Zealand standards). A UPF 10 blocks 90% of UVA/UVB.

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How long does the UPF last? When a fabric is tested according to U.S. standards, a UPF rating should indicate the minimum UPF for the typical life of the product. However, very old, threadbare or faded fabrics may have a lower UPF rating.

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What are the U.S. standards for the preparation, UV testing and labeling of sun protective fabrics? American Society for Testing and Materials standards D6544 and D6603 combine with American Association of Textile Chemists and Colorists 183 to form the most stringent UV -protective fabric standard in the world. ASTM D6544, which is voluntary, is unique among the world’s UV textile documents. It ensures that the UV protection claimed on labels reflects the least or lowest degree of protection during the use-life of the garment or product rather than the degree of protection when it is new. D6544 asks fabrics manufactures making a claim of sun protectiveness to undergo 40 simulated launderings, and to be exposed to 100 fading units of simulated sunlight prior to UV -transmission testing with AATCC 183. AATCC 183 is the U.S. gold standard for determining the UPF and percent UVA/UVB blocked by a fabric. D6603 requires fabrics to be labeled with a UPF value between 15 and 50+ and a classification category similar to those used in Australia and New Zealand.

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Are shade structures regulated?No. Neither shade products nor the fabrics they are made of are regulated by the U.S. Food and Drug Administration or any other agency. However, the Federal Trade Commission monitors sun protective claims and the industry encourages shade product manufacturers and marketers to self-regulate and adopt the U.S. standards.

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SUNBURNS AND TANS:

What is a sunburn? A sunburn is an inflammation of the skin caused by overexposure to the sun’s invisible UV radiation. Preventing sunburn is the single most preventable risk factor for skin cancer. Short periods of intense sun exposure, such as sunbathing, are associated with a 2-fold increase in melanoma risk. Sunburns can lead to wrinkles, premature aging of the skin (rough, leathery and loss of elasticity) and skin cancer.

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Is there a safe way to tan? Suntans are not healthy. In fact, there is no such thing as a safe or healthy tan. A tan is your body’s defense mechanism. Your skin is trying to protect itself from damaging UV rays. Artificial tanning is just as or even more dangerous than the sun. The U.S. Department of Health and Human Services determined in a 2001 report that exposure to sun lamps and tanning beds causes cancer. Tanning lamps emit 2 to 3 times more UVA than the sun. On an average day in the United States, more than one million people invest both time and money visiting tanning salons. The use of tanning salons by people under age 25 more than tripled between 1996 and 2003. People who use tanning devices have 2.5 times the risk of squamous cell cancer and 1.5 times the risk of basal cell cancer. And alarmingly, people ages 35 or younger who use tanning beds regularly have a melanoma risk 8-fold higher than people who have never used a tanning bed. The Filante Tanning Facility Act was amended in 2004 to prohibit people less than 14 years of age from using tanning devices, and children between the ages of 14 and 18 must have the written consent of a parent or guardian.

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Do medications make you more susceptible to sunburn? Some medications, including commonly used acne medications and antibiotics, can make skin more susceptible to sunburn. Other medications may cause photosensitive reactions like rashes, redness, and swelling. Physician or pharmacists should be consulted before people using certain medications go out in the sun. Sunscreens are an over-the-counter medication and some people can have allergic reactions to them. Although this has become less common with the removal of PABA from most sunscreens. Still, some people do experience burning, stinging, rash or redness to a particular product. Reactions may occur soon after the sunscreen is applied, shortly after going into the sun, or several days after use. These reactions are often due to the product’s fragrances or preservatives rather than the UV -absorbing ingredients. Switching to a scent-free product with fewer added ingredients often helps.

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RISK FACTORS

What factors increase your risk of developing skin cancer? Your risk of developing skin cancer is a combination of three things: who you are, where you live and what you do to protect yourself. Your genetics determine much of your personal risk. Melanin is the pigment that gives human skin its color. Melanin is also a natural sunscreen. Thus, the more melanin you have, the more protected your skin is naturally. Anyone, even people of color, can develop skin cancer. However, people most vulnerable to skin cancer include people with fair skin, blonde or light-colored hair, green or blue eyes, and those who burn or freckle easily. Other personal risk factors include numerous, irregular or large moles (those larger than a pencil eraser). Not all moles develop into melanoma, but melanoma often develops from a mole. This is because moles contain melanocyte cells where melanoma can get its start. People with many large or irregular moles should be seen by a physician regularly just to be safe. Also, people who have had one or more family members with melanoma may be at higher risk because melanoma can be hereditary in some cases. Another significant risk factor is having 2 or more severe sunburns during childhood.

Personal Risk Factors

  • Fair white skin (perhaps with freckles) that burns rather than tans in the sun
  • Blond, red or light brown hair
  • Blue or green eyes
  • Numerous, irregular or large moles
  • A family history of melanoma
  • Severe sunburns in childhood

You also need to consider where you live in order to determine the amount and intensity of the UV you are exposed to daily. Season, time of day, latitude, climate and elevation all affect how much UV a person is exposed to each day. You need to be especially careful if you live in the south or southwest, live or work at high elevation, spend a lot of time outdoors at midday, or spend a lot of time outdoors in the summer. Each day, the sun’s UV rays are strongest when the sun is highest in the sky. Peak sun intensity hours are from 10:00 a.m. to 4:00 p.m. This is when sun protection should be practiced by those at highest risk. This is true for all seasons even though UV is more intense in the summer when the earth is closer to the sun. Temperature, like the heat of summer, is not always a good indicator of the sun’s UV intensity. The radiation that causes warmth is not the same as the type of radiation that causes skin and eye damage. You can get a powerful dose of ultraviolet radiation without feeling the heat of infrared radiation. Although UV is stronger in the summer it is possible to get a sunburn in the winter. This is especially true at high elevations. It may seem cooler at higher elevations such as in the mountains, yet UV is more intense there. UV increases 4% to 5% for every 1000 feet above sea level. Skiers, hikers, and people living at high elevations need sun protection all year long. Cloudy days also allow for overexposure to UV . Clouds can keep much of the sun's infrared radiation from reaching the earth (so we feel cooler), but they still allow as much as 80% of the harmful UV radiation to pass through. The sun’s rays are strongest closer to the equator. So, the farther south you live, the more intense the UV you are exposed to daily. People living, visiting, or recreating in the south or southwest should practice more vigilant sun protection.

Environmental Risk Factors

  • Sunny climate
  • Season
  • Time of day
  • Low latitude
  • High elevation 
  • Reflective surfaces

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THE UV INDEX

What is the UV Index? An easy way to understand the intensity of daily UV radiation is to check the UV Index. The UV Index is a joint effort between the National Weather Service and the Environmental Protection Agency. It provides a daily forecast of the expected intensity of the sun for dozens of U.S. cities. The Index predicts UV intensity on a scale of 0 to 11+, where 0 means low risk and 11+ means extremely high risk of overexposure. The UV Index is published on the weather page of many daily newspapers. People also can check the UV Index online at http://www.cpc.ncep.noaa.gov/products to help plan the sun precautions they should take each day.

UV Index Exposure Levels

0,1,2 = Low
3,4,5 = Moderate
6,7 = High
8,9,10 = Very High
11+ = Extreme

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SKIN CANCER:

What is the difference between non-melanoma and melanoma? Basal and squamous cell skin cancers are non-melanoma skin cancers. They are very treatable and not generally life-threatening. Basal and squamous cells are located at the base of the outer layer of the skin. Most non-melanoma skin cancers develop on sun-exposed areas of the body, like the face, ear, neck, lips, and the backs of the hands. They can grow fast or slow, but rarely spread to other parts of the body. Often people who have had one non-melanoma skin cancer will develop a new one within five years. They can be removed easily and tend not to spread if treated early. Melanoma, a life-threatening form of skin cancer, is characterized by the uncontrolled growth of pigment-producing cells. Melanomas may suddenly appear without warning, but also can develop from or near a mole. Melanomas are found most frequently on the upper backs of men and women or on the legs of women, but can occur anywhere on the body including melanoma of the eye. Melanoma is very curable when diagnosed and treated early.

What is the cost of treating skin cancer? Data from 1992-95 shows that the total cost per year for treating non-melanoma skin cancer was $650 million. Treatment in a physician’s office (usually a dermatologist) averaged $492 per procedure. Outpatient treatment averaged $1,043 per procedure. Inpatient treatment averaged $5,537 per procedure. Data from 1997 shows that the annual cost for treating melanoma was $700 million or $16,700 per patient. Including indirect costs (productivity loss), the cost rises to $58,475 per patient. The costs continue to increase each year.

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ULTRAVIOLET RADIATION:

What are UVA and UVB? Sunlight consists of two types of harmful UV radiation – UVA and UVB.  UVA rays are long wavelength rays of 320-400 nanometers (billionths of a meter) in length.  They are the “aging” rays that penetrate the skin deeply and cause wrinkles and premature aging of the skin.  UVA is less likely than UVB to cause sunburn, which is why it is emitted by tanning lamps – often 2 to 3 times what is emitted by the sun.  UVB rays are short wavelength rays of 290-320 nanometers. UVB rays are the “burning” rays that are considered the main cause of basal and squamous cell skin cancers as well as a significant cause of melanoma. Recent studies show that UVA may worsen UVB's carcinogenic effects and directly induce skin cancer including melanoma.  Both UVA and UVB rays can cause suppression of the immune system, which helps to protect you against the development and spread of cancer and other diseases.

What percent of UV rays reflect off of different surfaces? UV doesn’t just come from straight above.  Many common surfaces such as water, sand, tile, concrete, and snow are highly reflective.  They can bounce as much as 90% of the sun's rays upwards and sideways.  You may be getting UV without even knowing it.

Ground Reflection of Ultraviolet Radiation
Surface Reflectance
Sidewalk, light concrete 10-12%
Sidewalk, aged concrete 7.0-8.2%
Asphalt roadway, freshly laid (black) 4.0-5.0%
Asphalt roadway, two years old (gray) 5.0-8.9%
Aluminum, dull, weathered 13%
Atlantic beach sand, wet barely submerged  7.1%
Atlantic beach sand, dry, light 15-18%
Lawn grass, summer Maryland, California and Utah 2.0-3.7%

Source:
IARC. (1992). IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Solar and Ultraviolet Radiation. International Agency for Research on Cancer, World Health Organization, Lyon, France 55:1-316.

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SKIN SELF-EXAMINATION:

How do you perform a skin self-examination?  When skin cancer is detected early it can almost always be cured.  According to the American Cancer Society, there is a roughly 95% cure rate for patients whose melanomas are detected at one millimeter or less in thickness.  Less than 50% of patients survive when their melanomas are detected at four millimeters or more in thickness. The most important warning sign for skin cancer is a mole or spot on the skin that is changing in size, color, or shape.  Examine your skin to look for changes in spot, moles, or sores that do not seem to heal.  See a physician if you find anything new or unusual.  The American Cancer Society recommends that you examine your skin once each month using the “Down and Back” method.

How to Perform a Skin Self-Examination

  • Start in front of a wall mirror. You should have a chair and a hand-held mirror. A good time for doing this is just after you step out of the shower.
  • While standing, examine your face, chest and arms (both sides of the arms) and belly.
  • Then, sit down to look at the front surfaces of your legs and feet. Use the mirror to examine the back of your legs and check out the soles of your feet.
  • Stand up again and use the mirror to inspect your buttocks and upper back.

Source:  American Cancer Society

While conducting your self-exam, the American Academy of Dermatology recommends that you become familiar with your birthmarks, moles and blemishes so that you know what they look like and can identify any changes in them. Follow the ABCDE Rule to look for changes in size, texture, shape and color of blemishes or sores that don't heal.

The ABCDE Rule

A is for Asymmetry: One half of the mole or pigmented spot does not match the other.
B is for Border: The edges are ragged, irregular, or poorly defined.
C is for Color: The color varies from one area to another; may have differing shades of brown or black, sometimes white, red or blue.
D is for Diameter: The area is larger than 6 mm (as a general rule, the diameter of a pencil eraser) and is growing larger.
E is for Evolving: Show any changes in size, color, shape or texture of a mole (or any skin changes) to your doctor.

Source:  American Academy of Dermatology

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VITAMIN D:

Do you need sun exposure for vitamin D production? Vitamin D is made in the body by exposure to UV and is also found in some foods. According to the National Institutes of Health, “ten to fifteen minutes of sun exposure at least two times per week to the face, arms, hands, or back without sunscreen is usually sufficient to provide adequate vitamin D.” After initial exposure, sun protection is important to prevent over-exposure and sunburn, especially on high UV days. Vitamin D can also be found in foods such as fish and fish oil, fortified milk and margarine, egg yolks, liver, Swiss cheese, and fortified breakfast cereals. Vitamin-mineral supplements are another sources of vitamin D. To read more about vitamin D, see the Vitamin D Fact Sheet developed by the National Institutes of Health.

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