Practice Tip of the Week: Summer, Sunshine, and Skin Health
Monday, June 19, 2017
By Ellen Martin, PhD, RN, CPHQ
Director of Practice
Texas Nurses Association
Summertime in Texas is synonymous with outdoor fun AND the blazing hot sun. Did you know that with more than 3.3 million people diagnosed each year, skin cancer is the most common form of cancer in the United States? Skin cancer can be disfiguring, affect quality of life, and can sometimes be deadly. There are three main types of skin cancers including melanoma (the deadliest type of skin cancer), basal cell carcinoma, and squamous cell carcinoma. Although Texas has one of the lowest rates of skin cancer in the US, nurses should be aware of risk factors, prevention strategies, and the importance of early detection. The Centers for Disease Control and Prevention has a dedicated webpage with extensive resources on skin cancer prevention.
Skin cancer is also one of the most preventable forms of cancer and highly treatable when detected early. Skin cancer is caused by ultraviolet radiation. People at highest risk are those with fair skin that burns easily. Skin cancer prevention recommendations include regular use of sunscreen (SPF 15 or higher) and protection of exposed skin with long sleeves and a hat. People with prolonged sun exposure are also at high risk. Reflected sunlight is another source of solar radiation and is an important consideration for occupational and recreational sun exposure. Grass has a UV reflectance of less than 5%, concrete is up to 12%, dry sand reflects almost 20%, and fresh snow has the highest reflectance at around 85%.
There is strong evidence that indoor tanning is not safe. According to the American Academy of Dermatology, each year over 400,000 new cases of skin cancer are directly attributed to indoor tanning. This is much higher than the number of new lung cancer cases linked to smoking each year (224,390 in 2016). Many people believe the myth that having a base tan protects a person from skin cancer. According to the US Surgeon General’s Call to Action to Prevent Skin Cancer a “base tan” provides minimal protection equivalent to SPF 3, which basically affords the person a few more minutes of sun exposure before the skins starts to burn.
Sun exposure is cumulative so it is important to start children off right with sun protection. School nurses may be aware of efforts by the CDC in 2002 to increase shade on school playgrounds. One intiative, Sun Smart U provides middle and high school teachers with an educational module, “Rays Awareness: Preventing Skin Cancer” appropriate for grades 6-12.
Early detection is vital to prompt treatment. Skin changes are the most common sign of skin cancer. This could be a change in a mole, a new growth, or a sore that will not heal. The U.S. Preventive Services Task Force (USPSTF) has not recommended routine screening (total body examination by a healthcare provider) unless the person has a history of skin care or is otherwise at increased risk. Any changes to moles or skin lesions should be reported to a healthcare provider.