Avoiding too much sun

By Kay Kemmet

July 11, 2010
(Bismarck Tribune)- As a young and healthy woman, Ashley Johnson didn’t worry about getting a little color during the North Dakota summer months.

But after Johnson’s battle with skin cancer, she now uses her experience as an example to teach others about the importance of sun protection.

Every year brings about 112 new cases of melanoma skin cancer in North Dakota.

Johnson, who lives in Grand Forks, has a darker complexion and rarely burned during a day in the sun. The possibility of skin cancer was not even on her radar.

But when she was 27 years old, in 2008, one suspicious freckle on her abdomen turned out to be melanoma skin cancer.

The first two doctors she saw about the freckle that grew to 1/4-inch in six months said they didn’t think she should be concerned and despite her request, didn’t see the need to remove the spot.

But Johnson was persistent and found a doctor who would remove the freckle. When the pathology report came back, it confirmed that Johnson had skin cancer.

“It’s our responsibility to be aware of what is going on on our bodies,” Johnson said. “I would have went home and let cancer spread throughout my body.”

Now, two years after Johnson had the freckle removed and returned for a second surgery to ensure that all the cancerous cells were removed, she said she applies sunscreen all the time.

“I’m probably a little obsessed about it,” she said.

She also is an advocate for sun care education.

“Smart choices now are definitely going to be beneficial in the long run,” she said.

During Johnson’s childhood and teen years, skin cancer was not something mentioned, and wearing sunscreen was not a big concern.

She was not overexposed to the sun, and said she rarely went to tanning beds. She calls herself the perfect example of someone who thought this couldn’t happen to her.

“I’m definitely way more aware of what is going around me and my sun exposure,” she said.

No matter what skin color or family background, anyone can get skin cancer.

“As long as you know that you are taking the precautions, that is all you can do,” Johnson said.

Now, she applies sunscreen every 30 minutes and wears a high sun protection factor or SPF. She tries to wear a hat and long sleeves and sits in the shade as much as possible. Sacrificing her tan does not feel like much of a sacrifice to Johnson.

“I would rather have my health and my life versus having a darker complexion,” Johnson said.

Six months after Johnson was declared cancer-free, she joined the North Dakota Cancer Coalition. The coalition is a group of cancer clinics and medical professionals working together on cancer education and prevention.

“That is really the goal of the coalition: To educate and begin making people realize that getting a tan is no longer fashionable and can really damage your skin,” said Dubi Schwanz, community outreach coordinator with the comprehensive cancer control program at the Cancer Coalition.

Johnson was involved with other cancer prevention organizations previously because family members have had other types of cancer, but after her own experience, she wanted to do more to help.

In her free time, she works to educate others about sun care and how to watch for skin cancer.

“There is not a day that goes by that I don’t think about my cancer,” Johnson said.

During the sun’s peak hours, it is best to stay away, but during the summer months, it is also the most appealing time to be outside.

In North Dakota, the sun rises around 6 a.m. and sets around

10 p.m. during the summer months. But a lot of people believe that North Dakota does not get as much sun, said William Cornatzer, a Bismarck dermatologist.

“Seven a.m. to 9 p.m. is really when the sun is most dangerous,” he said.

Because of the hours of sunlight during the summer, North Dakotans could be at more of a risk, according to Cornatzer.

“Since we don’t get out in the sun in the wintertime, we want to

During all hours of sunlight and not just on recreational days, Cornatzer recommends using sunscreen as part of an everyday process. The most important sun care precaution is to wear a broad-spectrum sunscreen of at least SPF 30.

“Any higher SPF doesn’t necessarily provide more protection,” said Joyce Sayler, director of the cancer prevention and control program at the cancer coalition.

The higher the SPF, the more costly the product will be without providing much more protection. SPF 30 blocks 97 percent of the sun’s harmful rays, SPF 50 blocks 98 percent and SPF 100 blocks 99 percent.

“No matter what number it is, you need to reapply every two hours. Even waterproof rubs off,” said Schwanz.

Most sunscreens are at their optimum protection for only 40 minutes after being applied, Sayler said, and heavy-duty products can last for a maximum of 80 minutes. Sweating and being in the water will cause the sunscreen to rub off more quickly.

Only broad-spectrum sunscreens block both UVA and UVB rays. Most sunscreens block UVB, but not all protect against UVA.

Sunscreens are considered cosmetic products and are not monitored by the Food and Drug Administration and therefore are not regulated. While many say broad-spectrum, not all fulfill the claim, according to Cornatzer.

The cheapest and easiest to acquire are Neutrogena sunscreens that contain helioplex, Cornatzer said. L’Oreal also produces a good broad-spectrum sunscreen that contains mexoryl but is more costly.

Broad-spectrum sunblocks, which are good to protect against direct sun but are visible on the skin, contain zinc oxide and titanium dioxide and are more of a natural substance, he said.

Another important step is to apply the sunscreen 15-30 minutes before being exposed to the sun. Sunscreen needs to soak into the skin and is not effective until it does.

Hats and sunglasses are also important. Baseball caps, however, are not sufficient. Broad-rimmed hats are the best protection. Sunglasses block the sun’s rays and can help prevent cataracts.

When Johnson was a child, sunscreen was not a must. But today, it has become more apparent that kids of all ages need to be protected from the sun.

“The more years of exposure, you have the greater possibility of melanoma,” Sayler said.

Children under 6 months have extremely sensitive skin. For that reason, shade is the best place for infants, and long sleeves, pants, hats and sunglasses are their best protection.

According to the Cancer Coalition, sunscreen also can be used on small parts of the body like the hands and face. The group recommends testing the sunscreen on the child’s skin first to make sure that it does not cause a rash.

Children under 2 years old absorb chemicals through their skin. For this reason, Cornatzer does not recommend using sunscreen on infants under 2, but no research has confirmed the effect of the absorption.

“Sun-protective clothing is really the best option, and that is the safest thing to use,” Cornatzer said.

A tan or a darker complexion is not protection from the sun. Schwanz explained that a tan is the body’s defense against the sun and is evidence of the damage that has been done.

The same is true for sunburns. Not only can they be painful, but they also are the proof of the damage that has been done. Sunburns raise the chance of skin cancer, according to the cancer coalition.

“You can still get a sunburn when it’s cloudy or in the wintertime,” Sayler said.

And reflective surfaces, like snow, water, cement and sand, double the sun’s effects, Schwanz said.

Johnson encourages people to be aware, be safe and take simple precautions like sitting in the shade when possible and wearing sunscreen while still enjoying a day in the sun.

“Some sun is good for you,” Johnson said.

For more information about sun care, check out the cancer coalition’s website, www.ndcancercoalition.org.

Contact reporter Kay Kemmet at 250-8260 or kay.kemmet@bismarcktribune.com.)

Quick tips for sun care

1. Wear a SPF 30, broad-spectrum sunscreen. Sunscreens containing helioplex are the best and least expensive broad-spectrum products.
2. Apply 15-30 minutes before going outside.
3. Reapply every two hours.
4. Sit in the shade and wear protective clothing and a hat when possible. Don't forget sunglasses, because the sun also is a cause of cataracts.
5. Be aware of your body.