CURE_Paarl_Dangers_Of_African_sun_Article_Dec 2023

THE DANGERS OF THE AFRICAN SUN

Dr Tien De Wet – General PractitionerMB CHB & MFAM MEDIN – University of the Free State | PG DIP Dermatology – University of South Wales

Don’t we have a beautiful country?

Vast breathtaking natural beauty in abundance and of course the never-ending bright sunshine! The sun with its UV rays is essential to life with well-known benefits. The dangers of constant and excessive sun exposure however pose a significant and possible life-threatening risk to all that live in this part of the world.

Here are a few interesting facts about the sun:

  • The sun is the only natural generator of UV rays. What influences the dangers of these rays?
  • The time of day, namely the 4 hours around solar noon is the most dangerous.
  • How direct the rays reach the earth, the nearer the equator the more dangerous it is.
  • Clouds, haze, and depth of the ozone layer are more significant factors, thus meaning where on earth do you live? Many days per year and many hours per day of sunshine. This is certainly true for the southern hemisphere and South Africa.

The elliptical orbit of the Earth places the southern hemisphere closer to the sun during its summer months than the northern hemisphere during its summer. This means that the summer sun in i.e., Australia is 7 to 10 percent stronger than similar latitudes in the northern hemisphere.
Thinning or hole in the ozone layer, referring to the hole in the ozone layer over Australia and of course Antarctica.
Let’s commence with the academic and scientific facts regarding the dangers.

Firstly, PREMATURE AGING.
Rapid breakdown of collagen and elastin, damaging of DNA resulting in uneven complexion, sunspots, pigmentation, redness, and tough hardening causing leathery skin. Wrinkles and sagging are also signs of ageing and can be premature due to sun exposure.

Of course, SKIN CANCERS.

Development of precancerous lesions on areas most exposed, like the face, head, ears, neck, decolletage, and extremities (arms, hands, and legs) will be the result.
These are called actinic keratosis or solar keratosis which present with rough, scaly patches that form on those areas.

Basal cell carcinoma

Basal cell carcinoma appears as a change in the skin, such as a growth or a sore that won’t heal. These changes in the skin (lesions) usually have one of the following characteristics:

  • A shiny, skin-coloured bump that’s translucent, meaning you can see a bit through the surface. The bump can look pearly white or pink on white skin. On brown and black skin, the bump often looks brown or glossy black. Tiny blood vessels might be visible, though they may be difficult to see on brown and black skin. The bump may bleed and scab over.
  • A brown, black, or blue lesion — or a lesion with dark spots — with a slightly raised, translucent border.
  • A flat, scaly patch with a raised edge. Over time, these patches can grow quite large.
  • A white, waxy, scar-like lesion without a clearly defined border.

This malignancy is seldom life-threatening but can grow quite big and if left too late may require extensive plastic surgery to be removed.

Squamous cell carcinoma

  • A skin cancer that develops from the outer layer(epidermis) of the skin.
  • Cutaneous squamous cell carcinoma rarely spreads to other parts of your body (metastasize). If this does happen, it occurs slowly and can be life-threatening if left untreated.
  • Symptoms of squamous cell carcinoma include skin changes like a bump or growth that might crust or bleed and won’t heal.

Melanoma

  • This is the most feared of all cancers and with good reason.
  • It can spread rapidly in the bloodstream unless detected early.
  • It develops out of the pigmented cells in the skin(melanocytes).
  • The exact cause of melanomas is uncertain, but sun exposure and tanning beds hugely increase your risk.
  • A mole that is mostly even in colour and shape which suddenly becomes darker or grows into a bigger mole with roughness and or uneven shape should promptly be evaluated as well as a newly developed pigmented mole.
  • Always be on the lookout for a lesion that changes in colour and size a lesion that never heals, or any rough and bumpy strange-looking area on the skin, and have it checked out ASAP.

Who is at greater risk of developing skin cancers?

  • If you had sun damage at an early age or lead a lifestyle or work that keeps you in the sun for long hours a day.
  • Have a pale complexion with blue or green eyes and reddish or blond hair.
  • Taking some types of oral and topical medicines, such as antibiotics, birth control pills, and benzoyl peroxide products, as well as some cosmetics may increase skin and eye sensitivity to UV in all skin types.
  • Are 65 years and older.
  • Have a weak immune system or an organ transplant.
  • People assigned male at birth (AMAB) are about two times more likely to develop squamous cell carcinoma.
  • People over the age of 50 are most likely to develop this cancer.
  • More adverse effects of the sun:
  • EYE damage namely cataracts.
  • Heatstroke from overexposure to sun.
  • Now we are familiar with all the dangers of the sun.

How do we avoid the above-unwanted effects?

  • Avoid sun exposure when rays are most damaging.
    Between 10h00 and 15h00 but between 12h00 and 14h00 is imperative.
  • Protect yourself with a wide-brimmed hat and sunglasses with UVA and UVB protection. Wear UV-protected clothing that is dark and tightly woven.
  • Avoid tanning beds at all costs.
  • It is important to apply sunscreen.

Sunscreens

There are quite a few misconceptions about sunscreens.

Let’s discuss the essentials of sunscreens.

  • A sunscreen works by absorbing, scattering, and reflecting the sun’s harmful rays.
    Compounds like titanium dioxide and zinc oxide are blockers that scatter and reflect UVA rays.
  • PABA, short for Para-Aminobenzoic Acid, is an antioxidant that can absorb UVB rays when applied to the skin and is an FDA-approved active ingredient in sunscreen.
    There are also sophisticated sunscreens that contain compounds that inhibit oxidative damage to the DNA in the skin and help repair damage already done.
    Liposome-encapsulated photolyase is the active ingredient to look for in those sunblocks.
    What does the number SPF mean?
    People often mistakenly think they can’t get sunburned, or they can be out in the sun for much longer than is safe if they put on SPF 100 sunscreen.

Double SPF does not always mean double protection.

  • A sunscreen’s SPF measures how many harmful ultraviolet rays it absorbs or reflects away from your skin.
  • There are two kinds of UV rays – UVA and UVB. Each penetrates your skin differently. The SPF rating only refers to UVB rays.
  • An SPF 15 sunscreen blocks 93% of UVB radiation, and SPF 30 blocks 97%. After that, the difference in protection is small. SPF 50 blocks 98%, and SPF 100 stops 99% of UVB rays from reaching your skin.
  • Choose a broad-spectrum sunblock, which contains all of the above ingredients.
  • The successful application is the liberal amount, as well as the frequency of sunblock, that is applied. This is more important than the SPF.
  • Thus SPF 30, broad spectrum APPLIED LIBERALLY AND FREQUENTLY is usually enough.
  • Apply 2 mg per square cm, which means 1/4 teaspoon for the face.
  • A practical approach for a woman’s face, first apply a facial product(moisturiser) then sunblock, and lastly makeup.
  • The added effect of preventing DNA and repair damage can be unnecessary and expensive and best used on the most vulnerable regions i.e., face lips and ears.

Applying all the discussed methods means that you are sun smart and can enjoy our lovely climate without succumbing to all the unwanted dangers.

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