Skin protection matters

I’m Dr Ewan Wilson MBBS, MSc, FRCS(Plast), a UK-trained plastic and reconstructive surgeon specialising in skin cancer care since 2002. I trained at St Mary’s Hospital London and completed further surgical and plastic surgery training across leading centres in the UK and the US, including a UK skin cancer fellowship and an MSc in Trauma Surgery. I see daily the consequences of sun exposure, from benign changes to life-threatening melanoma, so prevention is a central part of my practice.

I offer both surgical and non-surgical care with a focus on melanoma and skin cancer reconstruction, including sentinel lymph node biopsy and lymph node basin dissection. At Nuffield Health I provide mole assessment and removal, skin cancer surgery, sentinel node biopsy, soft tissue lump service and excision of skin lesions. I’m on the GMC specialist register and a full member of BAPRAS. I work as a Consultant Plastic and Reconstructive Surgeon in NHS trusts and my research focuses on melanoma clinical management and the patient experience.

Sun Safety Tips:

Sun safety is paramount in protecting yourself, your friends and your loved ones to decrease the risk of skin cancer. It also helps with the premature ageing of your skin so you can look as young and fresh as possible for as long as possible.

Quite rightly we focus on protecting young children from the sun, but as adults we can forget about ourselves. It is just as important to look after yourself, and other adults as well as children and young people. Use shade, hats and clothing where possible, and of course sun cream, not just on your holiday, but at home when outdoors, especially in outdoor sports, as you are unlikely to be in the shade.

Ensure your skin is fully covered:

By this I mean that all of your body is covered in sun cream. It is very easy to forget certain parts of your body. Bald patches on your scalp, ears, back of your neck, inside of arms and legs, back of your knees, backs of your hand and tops of your feet. Don’t forget in and around where costumes, swim straps etc are located as the garments can move around and leave exposed areas.

Application:

Apply
Re-apply
Re-apply
Re-apply………

The key to being sun safe is to not burn. UV radiation is just that - radiation. Radiation causes damage to the skin cells. New skin cells are constantly being produced and existing cells are constantly being repaired. Radiation damages and traumatises these cells. The more damaged they are, the more difficult they are for the body to repair and the more difficult it is to control normal growth.

This means that the cells become unregulated, uncontrolled and can grow in a cancerous fashion. Re-application will depend on your skin type and activities. If you have very fair skin you may have to apply sun cream as frequently as every half hour to an hour to avoid burning. Even if you have darker or dark skin, you will still need regular re-application which could be as regularly as every 2 hours.

You will also have to be more vigilant in your re-application in areas where the skin is thin and prominent. Nose, cheekbones, lips, points of shoulders, along your shin bone and top of feet. In women pay extra attention to your chest, the skin thins as you get older. In men, bald patches and ears. If you are undertaking swimming or any water sports, the cream will have been washed off after your activity. Re-apply, seek the shade for at least 20 mins and allow it to properly penetrate the skin allowing it to be as effective as possible.

Vitamin D:

Vitamin D is an important vitamin helping to support bones, muscles, teeth and other systems in the body, synthesised in the skin in response to sunlight. Supplementation helps, but also natural synthesis is needed too. People do worry about becoming vitamin D deficient alongside decreasing the risk if skin cancer.

Taking into account all we have mentioned above here is an example of how you can plan a safe day in the sun in holidays:

Morning sun which is more gentle can be enjoyed having a nice breakfast (this should stimulate some vitamin D production).

Come inside and fully cover your body with sunscreen top to toe ready for the day ahead. This gives you a really good base.

What happens next depends on your activity. If it’s a pool/ beach day then as written above regularly re-apply, especially after water activities allowing the cream time to settle in seeking the shade.

If you are out and about around a town/city/village, make sure you have a supply of sun cream in your bag. You can then re-apply as required to exposed areas of skin, but you know you have some base cream all over and clothes covering your body.

Have a siesta at high burning times. In the evening when the sun is more gentle again, you can get a bit more vitamin D.

Aerosol vs Cream:

My preference is for using a cream. Yes aerosol can be convenient (and some is better than none), however, it is more difficult to make sure you have completely covered all the areas you wish to cover effectively.
You almost have to use the aerosol like a cream, creating a concentrated patch of cream on your skin or in your hand and then rub in to ensure an area is covered. As mentioned in the above section it could be used as a ‘top up’ but my preference overall is to use a cream. I hope this tips are helpful to ensure you enjoy your day, in a sun safe way.