Living in sunny St. George, Utah, is great. It is a beautiful city with wonderful people and a great heritage. Most recently, we have had an increase of our population as people from all over the world have flocked here to enjoy southern Utah’s approximate 300 days of sunshine per year. However, this beautiful weather comes with a downside: the sunshine has the potential to cause skin damage—also known as photoaging, photo damage, or solar damage—that can occur when ultraviolet (UV) light from the sun hits unprotected skin, harming healthy cells. This damage can build up over time, sometimes taking years to become visible. As it adds up, it can lead to precancerous lesions, skin cancer, wrinkles, and aging skin. I don’t think anyone is going to volunteer to leave St. George to get out of the sun, so what do we need to do to avoid this potential sun damage?

Photo Protection

Let's talk about protection. The three main types of protection from UV induced sun damage are sunscreen, physical barriers/protection, and avoidance. 

The first modern sunscreen was developed in the 1930s. It included zinc oxide and titanium dioxide. Water resistant sunscreens came later in the 1960s, but sunscreens did not become more mainstream until the 1990s and 2000s. There have been many studies showing decreased risk of skin cancer and photoaging if sunscreen is used appropriately. Many questions have risen about whether sunscreen’s absorption into the skin can lead to other types of internal cancers. So far, there has been no statistical evidence showing this, but there has been significant evidence demonstrating the protection received by using sunscreen on a regular basis.

So if sunscreen is so important, what type should we use, and how do we use it? The American Academy of Dermatology suggests the following:

1. Choose a sunscreen that has an SPF of thirty or higher, is water resistant, and provides broad-spectrum (UVA and UVB) coverage. When this sunscreen is also a tinted sunscreen with iron oxide, which helps protect your skin from the sun’s visible light, you should protect your skin from developing dark spots.

2. Apply sunscreen before going outdoors. It takes approximately fifteen minutes for your skin to absorb the sunscreen and provide protection. If you wait until you are in the sun to apply sunscreen, your skin is unprotected and can burn.

3. Use enough sunscreen. Adults need about one ounce of sunscreen—enough to fill a shot glass—to fully cover their bodies. Make sure the sunscreen is rubbed into the skin thoroughly.

4. Apply sunscreen to all skin not covered by clothing. Remember your neck, face, and ears, the tops of your feet, and your legs. Apply sunscreen to your scalp or wear a wide‐brimmed hat. To protect your lips, apply a lip balm with an SPF of at least thirty. Get a friend to help you apply sunscreen to the hard to reach areas, like the back.

5. To remain protected when outdoors, reapply sunscreen every two hours and immediately after swimming or sweating. People who get sunburned usually don't reapply, use too little sunscreen, or use an expired sunscreen.

In addition to seeking shade and applying sunscreen, wearing sun-protective clothing goes a long way toward shielding you from the sun’s harmful UV rays. There are many companies now that focus on producing UV protective clothing as this is another important step to take in safeguarding your skin from the sun. 

One more tip that I like to tell all my patients: if you are going to be out in the sun, do it before 10:00 a.m. or after 4:00 p.m. The UV rays are not as intense or damaging at these times.

Warning Signs of Possible Skin Cancer

Along with discussing how to protect your skin from UV damage, I would also like to discuss the importance of being aware of the warning signs of skin cancer. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma, in that order.

Signs of Basal Cell Carcinoma

• New pink, pearly, or shiny spot that does not resolve and can dip in the center

• Pink, scaly spot that can be near the ear

• Sore that doesn’t heal or that heals and then returns but never resolves

• Scaly, slightly raised area of irritated skin

• Round growth that may be the same color as your skin

• Scar-like mark on your skin that may be skin-colored or waxy

Signs of Squamous Cell Carcinoma

• Rough, reddish scaly area

• Open sore, often with a raised border

• Rapidly growing, tender, pink bump

• Firm, dome-shaped growth

• Wart-like growth

• Tiny, rhinoceros-shaped horn growing from your skin

• Sore developing in an old scar

Signs of Melanoma:

• Changing mole

• Spot that looks like a new mole, freckle, or age spot but looks different from the others on your skin (the ugly duckling)

• Spot that has a jagged border, is more than one color, and is growing

• Dome-shaped growth that feels firm, may look like a sore, and may bleed

• Dark brown or black vertical line beneath a fingernail or toenail

• Band of darker skin around a fingernail or toenail

• Slowly growing patch of thick skin that looks like a scar

When I discuss signs of skin cancer with many patients, I often hear a recurring story: the patients believed they had a new pimple, but after six to eight weeks, they realized the “pimple” never resolved. When they washed their faces at night, the pimple bled slightly or turned into a chronically scabbed sore that never healed. In almost all of these cases, the patients had one of the above types of skin cancer.

In order to reduce your risk of skin cancer and to keep your skin from aging prematurely, it is essential that you use physical blockers, such as clothes and broad-brimmed hats, and apply a high SPF sunscreen. My colleagues and I at Southwest Skin and Cancer recommend a once-a-month skin self-examination to look for any signs of skin abnormality. A regular skin check with a dermatologist is also key. While these skin checks will not prevent skin cancer from developing, they can help to catch it early when it is most easily treated.

For more information about sun protection and skin cancer screening or to schedule an appointment, visit southwestskinandcancer.com or call 435-628-2826.