Shine Some Light: Skin Cancer Misconceptions

As the world shines its lights on Valletta, Europe’s current capital of culture, the rates of cancer deaths related to sunlight exposure rise. It’s set to be a sunny year on our little island, and while Valletta 2018 brings the golden glitz to our capital, new science shows us there’s nothing fabulous about a golden tan. Yes, one of the best reasons for living in Malta is its sunny environment. But we must be careful about how we expose ourselves to harmful UV rays. However, since Malta is so close to the equator it experiences more UV radiation than its northern neighbours. Despite its minuscule size, Malta is #89 on the World Life Expectancy Index for deaths related to skin cancer. What does that mean? Playing in the Maltese sun is no joke.

One of the foremost authorities on the danger of sun tans in Malta is the Maltese Association of Dermatology and Venereology. Using advice on their website, this article aims to breakdown the most common misconceptions about sun exposure and skin cancer. Get the facts so you can enjoy many more summers than 2018!

« A tan is my body’s way of protecting itself from UV rays. That means tanning is healthy! »

You’re right about one thing: skin develops a tan as a way to protect itself from harmful UV rays. What’s not correct is that this process is somehow safe. Here’s how it goes: (1) skin is damaged by the first impact of UV rays, before any coloration occurs; (2) the skin develops a dark pigment to shield against further exposure; (3) this protection offers just 3-4 SPF against any further exposure. The bottom line? Skin tans are a sign of damaged skin, not healthy skin. Moreover, a tan barely offers any protection against further exposure.

« If I’m swimming I won’t get burnt. If it’s cloudy I won’t get burned. If it’s the early afternoon I won’t get burned. Yay! »

Lies! Lies! Lies! Firstly, do not be conned by the pure, innocent blue of the Maltese waters! The sun is still 40% of its normal strength a half metre below the water. Secondly, the clouds block only 10% of UV rays. Some studies have shown that the clouds actually rebound UV rays back onto Earth, much like sand and cement bounce UV rays back on to people. Thirdly, the sun is strongest from 11AM-4PM. On some days, the sun may actually be stronger later in the afternoon. Check out how strong the sun’s rays are at any time, on any day, by using the Weather Online UV Index for Valletta.

« All skin cancer is a result of sun exposure. »

This assumption is only partly correct. There are three different kinds of skin cancer: malignant melanoma; basal cell carcinoma; and squamous cell carcinoma. Scientists are still uncovering how skin cancer develops. Malignant melanoma, the most dangerous kind, is most closely related to intermittent intense sun exposure: i.e., getting burned while on vacation. It is believed that our childhood burns are the reason for basal cell carcinoma, whereas accumulated sun exposure during adulthood is tied to squamous cell carcinoma. However, all three types of cancer are also related to genetics.

« Having large, irregular moles is the only sign that I might have skin cancer. »

A mole that occurs later in life, changes shape, size, or sensation may be a sign of malignant melanoma. However, the other two types of cancer show different warning signs. Basal cell carcinoma usually appears as a red lump or scaly area. In squamous cell carcinoma a thickened patch of skin turns red and scaly before it spreads to other regions. If you’re worried you may have skin cancer, use these links to find clinical images online for comparison:

• Images of Melanoma
• Images of Basal Cell Carcinoma
• Images of Squamous Cell Carcinoma

« All skin cancer is fatal. »

Malignant melanoma is the most fatal kind of skin cancer. Sadly, it’s also most prevalent in people aged 25-30 years old. Although basal cell carcinoma and squamous cell carcinoma aren’t always fatal, surgery to clear these cancers is invasive and results in scars. This is especially ironic if the surgery is a result of suntanning, no?

« Sun exposure is good for me! It gives me Vitamin D! »

It is true that the sun’s energy turns a chemical in the body to vitamin D, an immunity-boosting pro-hormone. However, this is a short-lived process. The average person requires only 15 minutes of casual sun exposure two or three times weekly to get enough vitamin D. People with dark skin can get more sun; lighter skinned people should get less. What’s better: all people can get Vitamin D in other ways. Check out our article on easy skin supplements to learn how.

« I have a fake tan. That works like sunscreen, right? »

Not really. Most fake tanning sprays are made of a chemical called dihydroxyacetone. At most, they offer SPF 4. You’ll still need to use traditional methods of sunscreen if you’re wearing fake tans.

« If my tan goes away in just a few days then it probably didn’t have a big impact on my skin’s health. »

Here’s another reason why no tan is a healthy tan: the harm done to the skin by sunbathing to the point of damage can be permanent. While malignant melanoma is most easily related to single intense burns, the other two forms can be attributed to regular sun exposure, even without burning the skin. The effects of sun exposure accumulate.

« I’m wearing long sleeves and long trousers and a hat. I’m totally safe! »

Great job covering your skin! Beware that not all clothes offer the same level of protection. The weave in those wares needs to be tight. Hold the clothes up the sun. If the sun shines through, you’ll need different clothes. Wear a hat that actually covers your head, neck, and ears. Five in 100 cases of skin cancer develop on the outer ear! Source: Cancerresearchuk.org.

« I’m on vacation! A little bit of sun won't hurt. »

There’s a reason that Northern European countries have some of the highest rates of death related to skin cancer. Obviously, this is not because of their cold and wintery environments. According to migration analysts, the propensity for northerners to over-expose themselves to the sun when travelling makes them more susceptible to the high-intensity intermittent burning; this is thought to be the culprit of four out of five cases of fatal skin cancer (source: Forbes).

« I’m Maltese so I won’t get sunburned under the Maltese sun. »

Australia and New Zealand have the highest rates of skin cancer worldwide. Many clinicians believe this is because their current populations are made mostly of migrants from the British Isles. Anglos don’t have the natural skin pigmentation to ward off harmful UV rays. On the other hand, nations with the lowest levels of skin cancer related deaths are Arab and Asian countries. Some scientists relate this to the fact that those countries are culturally less likely to sunbathe. In many Asian countries having dark skin is seen as a sign of a lower socioeconomic status. The people in Muslim countries are more likely to cover up. Even if you’re Malti pur, don’t do as the tourists do. Be sun safe!

« I put on sunscreen so I’ll be protected. »

First of all, great job-- you didn’t just slather on baby oil or go without any protection! You’ve taken a step in the right direction. Unfortunately, even SPF 30 may not be enough to keep you protected throughout the day. After recognising how many of their precious citizens were falling victim to overexposure, the Australian government has created a fantastic online calculate to determine just what level of SPF you need and how often to reapply. Find the calculator here.

After reading this article’s advice, you may be bemoaning a boring summer. Do not fret! There is no reason that sun safety should hamper your summer plans. Simply recognizing that the sun presents a danger is the first step; researching the day’s UV rays is an excellent second step. After that, it’s just a case of staying covered, slathering on sunscreen, and consciously planning your agenda. Remember, there is no such thing as a healthy tan. The decisions you make this summer will affect the summers you may enjoy for the rest of your life!