Questions and answers

Do I really need to worry about sun exposure in the UK?

Yes. Between about April and September in the middle of the day, UV radiation levels in the UK can be almost as high as those in the Mediterranean; the only real differences are that they do not persist for so long and the brightness and warmth of sun, unimportant as far as skin damage is concerned, may be much less, so making the sun seem less dangerous. This means that you can burn almost as easily at around midday on a British beach as you can on a Spanish one. If therefore you spend a fair amount of time outside during the summer months in Britain – playing sport or gar­dening, for example – or if you have a job that means you are outside for much of the year, you can easily get enough sun to cause skin cancer, particularly if you are fair, and certainly enough to cause photo-ageing, without ever going abroad.

What if I want to get a tan?

You can’t sunbathe without causing some damage to your skin, likely to lead eventually to skin photoageing and an increased risk of skin cancer, however slowly or carefully you build up a tan, so it’s better not to aim for this at all. However, if you have a brown or black skin, you are unlikely to do much harm, but you may not then want to tan! It is a personal choice for you to make, but you should certainly be aware of the risks of sunbathing so that you can make an informed decision.
Sunbathing is at its most dangerous for everyone, but most particularly for fair-skinned people, when the sun is high in the sky – whatever the weather; it is thus relatively safe to sit outside either early or late in the day when the sun is low, even if still warm or bright. Therefore, whether at home or abroad, avoid the sun in the middle of the day where possible, wear suitable clothing to cover you when outside, and regularly use a sunscreen of SPF 15 to 50+. You should also realise that a suntan is actually a response to skin cell DNA injury caused by UV radiation. However, this again applies much more to fair-skinned people, and the deeper the tan in such people, the greater the skin damage that has been caused, and thus the higher the risk of skin photoageing and cancer in the future.
It is also important to realise that melanoma, although previously relatively rare, has become increasingly common, and that it is a potentially very serious form of cancer that can be fatal. It is now one of the major causes of death in people in the 26- to 35-year-old age group. There is also a lot of evidence to suggest that it is repeated bouts of sunburn, which are most likely to happen when you’re sunbathing on holiday, that are particularly important in causing this type of cancer, particularly again in fair-skinned people.
If you want to have a tan, therefore, there is only one way that you can get it safely and conveniently and that is to be born with it or to use a fake tanning preparation! These days, as well as being safe, they can give you a virtually perfect imitation of the real thing.
Nevertheless, if you are going to sunbathe anyway, start with short periods of exposure over a few minutes and gradually build up; also use a sunscreen of moderately high protection factor, say 10–15, and stick with that because, if you do burn, it spoils your tan anyway. Good luck!

Is it safe to use a sunbed?

Sunbeds emit radiation generally very similar to that in midday summer sunlight and therefore have largely the same effects, so you should avoid them. This is because, by using them, you are really just damaging yourself without even being able to enjoy the outdoors at the same time! However, most dermatologists agree that banning them is as inappropriate as banning cigarettes or alcohol; people should rather be made aware of their potential dangers, so they can make an informed choice about using them.
Whether you use the older type of sunbed which emits predom­inantly UVA radiation, or the more modern ones with UVB and UVA together, the effect in terms of skin damage is very similar to that from tanning in the sun. This means that you are risking the same sort of skin damage, which can be very severe and has even, occasionally, been fatal!
There is also a risk of all the following problems when you use a sunbed, just as there is when you sunbathe: polymorphic light eruption, lupus, melasma and drug photosensitivity in the short term, and, in the long term, skin ageing and non-melanoma cancer, as well as an unusual form of increased skin fragility. Although the risk of melanoma from sunbed use has not yet been precisely quantified, it seems likely that this is also increased and people with unusual or large numbers of moles should not use a sunbed at all, just as they should not sunbathe. All in all, sunbeds overall are very similar to sunlight in their potential to cause skin damage and should be avoided. If you do use one, however, you may get away with it, but you should use it for no more than 20 sessions a year to keep the risk at least moderate, and always remember to wear protective sunglasses/goggles.

Is it a good idea to use a sunbed for just two to three weeks a year before holidays to get a bit of a tan and so avoid burning when I get there?

No, it isn’t a good idea to use a sunbed in this way because the damage that you do outweighs the value of any tan or protection that you might achieve, which is virtually always minimal anyway, and equivalent only to a sunscreen of SPF 2–4. Better to use a fake tan and a sunscreen on holiday.

Can sunlight harm my eyes?

Yes, sun and sunbed exposure can be associated with a number of eye problems, including particularly cataracts. For this reason, people having phototherapy for the treatment of skin disease must wear sunglasses; such cataracts occur with long-term exposure over years. You may also get very sore eyes from severe exposure to bright sunlight, particularly in snow, a condition called snow blindness. Looking directly at the sun for more than a few seconds may cause permanent loss of sight! Ideally you should wear sunglasses on a summer’s day to protect your eyes, while of course protecting your skin; however, make sure you buy sunglasses that give you good protection against both UVB and UVA.

If I wear prescription spectacles will this magnify the harmful effect of UV radiation on my eyes?

No. Clear glass or plastic normally absorbs virtually all UV radiation, certainly all the UVB, although obviously allowing visible light to penetrate. You therefore need take no major precautions when wearing prescription spectacles, unless the light is very bright, in which case for comfort you would do best to wear sunglass attachments or else buy prescription sunglasses.

I know I don’t get a suntan from sitting in front of the telly or my PC at work, but am I still at risk from UV radiation?

No, there is no risk from either of these devices because they do not emit this radiation.

I am of African–Caribbean origin and have a very dark skin. Do I need to take any precautions against the sun? Should I be careful with my children in sunlight? Am I at the same risk of photoageing as a fair-skinned person?

You need to take only moderate precautions for yourself at the beginning of summer or a sunny holiday, just to stop early burning, although photoageing certainly does still occur over the years in dark skin and you should thus take reasonable care, as described in this book, if you wish to avoid that; skin cancer essentially does not occur, however. On the other hand, dark-skinned babies can sometimes burn relatively easily and should therefore be carefully protected until older as described in this book.

I seem to have to put a lot of suncream on my skin to cover it properly. Do these chemicals get absorbed into my body and if so can they do me any harm?

No, careful studies suggest that they do not harm you; however, it is probably wise not to use them excessively in babies up to about the age of six months, by which time their skins have generally become fully mature, although there is no definite evidence that such use is damaging.