Have a sunscreen routine — and remember your ears

What’s your sunscreen routine? Face, shoulders, arms, legs? Maybe ask a friend to get your back? 

Remember your ears, neck and the back of your hands, Dr. Lindsay Gunnell would tell you. Commonly neglected during sunscreen application, these areas give rise to many skin cancers.

To emphasize the point, Gunnell displays a scar on the back of her neck where, nine years ago, an invasive melanoma was cut away. The event informed her career path: Today she is a dermatologist focused on cancer treatment and surveillance at UW Medicine and Fred Hutch in Seattle. 

This month's record-breaking temperatures likely reminded many Pacific Northwesterners of the potency of ultraviolet light, Gunnell suggested. People can become complacent during months of gray days and rain.

“All winter, people typically stay indoors and don’t use any protection on their skin. Then all of a sudden July hits, they're going outside, getting tons of UV rays and getting burned. That intermittent burning especially drives basal cell skin cancer and melanoma. So we tend to see those skin cancers at higher incidences here.”

In the United States, more than two people die of skin cancer every hour, and about 9,500 are diagnosed with skin cancer every day, according to the American Academy of Dermatology. In the Pacific Northwest, incidence is rising, Gunnell said, for melanoma, basal cell, squamous cell and even the very rare Merkel cell carcinoma. 

People have the misconception that, without a sunburn, UV rays are not damaging their skin, she added. 

“They absolutely are. Generally, 80% of UV comes through the clouds, even a thick cloud layer. Even if you don’t burn, you can still get UV damage on your skin.”

Gunnell is aware of recent social media chatter about sunscreen being unsafe. The two white components of mineral-based sunscreens, titanium dioxide and zinc oxide, are generally recognized as safe and effective by the Food & Drug Administration, she says. 

Chemical sunscreens — the clear liquids — “are equally effective and have a long track record of safety,” she added. 

“Concerns have recently been raised about the systemic absorption of these ingredients, and the FDA has asked for additional safety data, but we have never seen any associated ill-effects from the tiny amounts that are absorbed,” Gunnell said. 

The single ingredient that did have more data showing absorption, oxybenzone, has largely been removed from U.S. sunscreen products. Out of an abundance of caution, however, consumers may choose to avoid products containing this ingredient. For toddlers and children, Gunnell recommends mineral-based sunscreens.  

Sunscreen also isn’t your only protection. Find shade and minimize your exposure during the sun’s harshest hours, between 10 a.m. and 4 p.m. And sun-protective clothing significantly lowers the UVA and UVB rays that reach your skin. 

If you are concerned about a brown-pigmented skin lesion, Gunnell says, be mindful of the “ABCDEs” (asymmetry, border, color, diameter and evolving) of a potential melanoma. However, the most common skin cancers — squamous cell and basal cell — can be pink, not brown.

“If you have pink bumps that are scaly, painful, bleeding or don’t go away, you definitely want to get those checked out,” she says. “These are not emergencies, but you want to try to get into a clinic within a month or two of seeing something suspicious.”

Download broadcast-ready soundbites and related multimedia with Gunnell. 

Related:

Dr. Gunnell discussed sunscreen myths on KUOW Radio on July 10, 2024.  
 

For details about UW Medicine, please visit http://uwmedicine.org/about.