What should we know about skin cancer in South Africa?

Like pretty much everyone around the globe, I’ve had a few experiences with cancer. My high school biology teacher was diagnosed with lymphatic cancer. My great aunt, an avid smoker until the day she died, passed away from lung cancer. Just last year, my grandad passed away from prostate cancer that had spread into his lungs and bones. Possibly the saddest, however, is the fact that I never got to know my grandmother – my dad’s mother – who was claimed, before my parents were even married, by Melanoma, the worst kind of skin cancer.

She was Dutch, beautiful with fair skin, blue eyes and blonde hair. She passed these traits onto my dad, and he married my mom, a green eyed, redheaded, a boere-meisie from the Transvaal. Between the two of them, three sprog were added to the family tree. Myself, a redhead of note, my sister with hair that was once almost white-blonde, and my brother, who has an odd strawberry blonde mix.

We were brought up to revere and fear the sun. We’d heard the stories of what the sun could do to our skin, and how our grandmother had passed away because of what damage it caused. Sunscreen was non-optional in our household. We applied it liberally before heading out of the house every day, and although I came to hate the sticky, oily feel on my face, to set foot in the sun brought almost sheer panic.

Despite this, between myself and my two siblings, we’ve all had run-ins with the sun. In 2010, myself and then-bestfriend headed to the Airshow, but forgot all about the fact that we’d be spending all day in the sun. I was a lovely lobster colour by the time I got home, and so sore from sunburn that I couldn’t even shower without crying. As a kid, my sister spent a day out on the river to come home with blisters under her glasses, all the while promising that she had applied sunblock. To this day, my brother will come home with blisters on his lips after a day out in the sun.

So, I’ve picked up a couple of questions over the years. How much sunblock should we be wearing, and how often should it be applied? How much sun is too much? How many times can you burn before it becomes a serious concern? What should we be on the lookout for? Luckily Maria, who also recently shared her stories about cancer, was able to help me out with a couple Q&A’s after talking to Dr Ellenberger, a medical expert.

Let’s talk a bit about skin cancer, particularly within South Africa? Why is it something we need to be aware of?

The fact of the matter is that skin cancer in children has increased by 100%. Not only was this virtually unheard of in the last century, but skin cancer has always been something that has developed in older people after years of sun exposure, in combination with bad habits such as smoking.

The skin, the largest organ of the body, should have the capacity to protect us. So, why are children falling victim to skin cancer? It all comes down to external factors that compromise our skin’s capacity to protect us. To get to the root of this problem, we need to look at the ozone and the environment in South Africa, which also goes hand-in hand with ultraviolet light.

What is the difference between UVA and UVB?

So, let’s zoom into the different types of ultraviolet light. UVA sends out long light rays, which are far more damaging in the long run. UVB has shorter and hotter rays, and are the reason why we get sunburn in summer and spring. And then there is also UVC, which is supposed to be kept outside of the ozone layer. There are concerns, though, that there are holes creeping through our ozone layer.

How can we avoid skin cancer? Is sunscreen your best bet?

There are a number of measures that can be taken to avoid skin cancer. While wearing SPF is number one, it also comes down to ensuring that you wear clothing that offers enough protection, as well as wearing hats and sunglasses (retina cancer is a reality!). And of course, we need to be smart about when we spend time in the sun. Baking in the mid-day sun is obviously not ideal.

When is it too late? Is there anything we can do to curb effects of too much sun exposure?

It is a common misconception that most sun damage occurs when we are kids. In actual fact, only aout 23% of sun damage occurs before the age of 18. Sun damage is rather cumulative; and it depends on the extent to which we have exposed our bodies to the sun.

We also need to realize that despite everything you do, it’s never too late! The right amount of vitamin A, B and antioxidants feeding the skin can go a long way to reduce abnormal skin damage.

When should we start applying sunscreen as a kid?

So, before babies turn one, they should not go in the sun. That’s a done deal. Afterwards they should always wear sunscreen on their faces to protect them.

Wearing sunscreen can cause vitamin D deficiency?

This is a paradox that is hard to cover. The trick is to effectively juggle vitamin D absorption with sun protection. Yes, it’s super healthy for children to get sunlight. Children need 20 minutes of sunlight per day to generate enough vitamin D for their body to absorb. Well, we source vitamin D from our diet, which is then converted in the skin for the body to use.

However, the older we get, the better it is for our skin to take vitamin D supplements.

It is also interesting to note that darker the skin, the less it is able to absorb vitamin D.

Do we need to wear sunscreen in winter?

Yes, absolutely. We don’t realise that wherever there is light, there are also ultraviolet light, which is one of the main causes of skin cancer.

What is SPF? How do we choose the strength and formula of sunscreen?

So is there a difference between say SPF 15 and say 50? Apparently not much. Where SPF 100 offers 96% protection, SPF 20 offers 93% protection. The only difference is between the amount of chemical in the formulation.

And the SPF level doesn’t necessarily determine how frequently we should apply our sunscreen. For everyday use, an SPF 15 is just fine. When outdoors, we can go for something above 30 and simply reply during our lunch breaks.

What should I do if I have dark spots, moles? How do I know I if need to see dermatologist?

If you like me are covered in moles, you need to look at the acdc test, which is as follows:

A: asymmetry – if forms are irregular
C: colour – redness
D: dark patches – usually bigger than 6mm
C: crusts – that usually do not go away

It’s also advised to look at soles of feet, back of head and unusual areas on the body.

If you’re as concerned about your skin and the prevalence of skin cancer in South Africa, then hopefully we’ve managed to answer your more pressing questions. As for me, I’m going to go buy myself a pair of UV tinted sunglasses.

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