Swimmers' Sun Exposure and Skin Cancer

Summer is approaching, and that means more outdoor competitions and swimming practices. Yes, making that interval or winning that race is important, but so is protecting your skin from the sun while on the deck and in the pool.

“Skin cancer is a major public health issue in this country,” says Sherrif F. Ibrahim, assistant professor of dermatology and oncology at the University of Rochester Medical Center. His practice is dedicated to the diagnosis, treatment, and prevention of skin cancer. An avid swimmer since childhood, Sherrif swam for MIT in college and is a member of the Rochester Area Masters Swimming Club, so he knows first-hand the dangers of sun exposure to swimmers and our chances of developing skin cancer later in life.

Skin cancer is so common that more people get it than all other types of cancer combined. “One in three fair-skinned people and one in five people overall will get some form of skin cancer in their lives,” Ibrahim says.

Skin cancer typically results from excessive sun exposure and the process of sun-related skin aging. And skin cancer can get its start in childhood or adolescence—most of us will accumulate a lot of sun damage before age 20, but the effects may not be visibly apparent until 10 to 30 years later. This damage may show as visible blood vessels and pigmentation changes on sun-exposed areas, wrinkles, brown spots, and coarse, dry areas.

How Sun Exposure Hurts

Solar or ultraviolet (UV) radiation travels in three wavelengths—A, B, and C. The C wavelength rays are absorbed by the ozone layer and never reach earth’s surface. The A (UVA) and B (UVB) rays penetrate the atmosphere and cause sun damage to unprotected skin. UVA is responsible for most signs of premature skin aging and these rays are so strong, they even penetrate car windows.

UV radiation generates tissue-damaging free radicals. Darkening of the skin or a “tan” results when the skin attempts to ward off the UV damage. Despite the fact that popular culture likes the look of a tan, “no tan is a safe tan,” says Ibrahim. “Any tan signifies damage to the DNA in our skin cells. Maintaining a tan over time just means accumulating more damage and increased risk for all types of skin cancer.” Wrinkles, laxity (loose skin), textural changes, and discoloration result after millions of cells suffer damage. This all builds up to impairment of the skin’s immune system and DNA damage to the cells that can lead to skin cancer.

The good news is that most skin cancer is not melanoma, the deadliest form of skin cancer and the most common cause of death from any cancer in young adults. Although 1 in 82 Americans will develop melanoma during their lifetime, it only accounts for about 5 percent of all skin cancers. The other 95 percent of skin cancers are basal cell and squamous cell cancers, which are less likely to to become deadly, but still can be dangerous. Even though melanoma accounts for less than 5 percent of all skin cancers, it results in 80 percent of skin cancer deaths.

Signs of all skin cancers often begin with a change in color or texture of a mole or or the appearance of a new dark spot on the skin, but the changes can be subtle. “People tend to think of skin cancer as a big ugly black mole, but the more common forms are frequently described by patients as ‘a pimple that wouldn’t go away,’” Ibrahim says.

An Ounce of Prevention

Ibrahim recommends the following skin cancer prevention guidelines, which are also advocated by The Skin Cancer Foundation:

• Avoid the sun between 10 a.m. and 4 p.m. This is a warning most people should be familiar with. Heed it.
• Don’t tan. Tanning beds are another big no-no and can be even more harmful to skin than the sun.
• Cover up. The best way to prevent sun damage on the pool deck is to cover up with clothing—UPF-rated clothing is best—and wear a broad-brimmed hat and UV-blocking sunglasses.
• Wear sunscreen. Wear a broad spectrum (UVA/UVB), waterproof sunscreen with an SPF of 30 or higher when swimming. Use at least two tablespoons of sunscreen 30 minutes before going outside and slather it on all exposed areas. Swimmers may need to use more sunblock since our bathing suits expose more skin to the sun.
• Wear a cap and UV-protective goggles. Ibrahim also recommends using eye protection (goggles or sunglasses) during kick sets.
• Reapply sunscreen regularly. You should reapply sunscreen every two hours or immediately after swimming or excessive sweating.
• Get regular skin checks. Early detection is the best way to keep any skin cancer from spreading. Examine your skin from head to toe on a monthly basis and visit a dermatologist annually for a full skin exam.