We all have melanin, which gives our skin pigmentation. But some of us — because of genetics and ethnicity — have more than others.
In the past, it was believed the more melanin a person had, the less likely he or she was to develop skin cancer. We’ve learned this is false.
According to the American Academy of Dermatology, all types of skin cancers are increasing among people of color in the U.S., including African-Americans and Hispanics. In people of color, basal cell carcinoma is the most common of the skin cancers, and leads to more deaths because of late detection.
We have also learned that people with darker complexions develop skin cancers in the least sun-exposed areas, such as the soles of their feet, palms, toenails and fingernails, and around the mouth. Cancerous moles, freckles, lesions and sores present very differently in darker-pigmented skin. They may be red, purple or black in color. They may change in size quickly or bleed easily.
We should all protect our skin daily by applying sunscreen with a Sun Protection Factor (SPF) of 15 or more. People of color have a natural SPF of 13 from the melanin in their skin, so more protection may be required between 10 a.m. and 4 p.m.
Prolonged Ultraviolet A (UVA) and Ultraviolet B (UVB) ray exposure can lead to skin cancer. UVA rays tend to penetrate the skin more deeply — 50 times more than UVB rays. Prolonged exposure from UVA rays can cause dark patches, wrinkles and premature aging, while prolonged exposure from UVB rays can cause sunburns and eye disorders.
SPF is a determinant of how long it will take UVA and UVB rays to burn skin that is not protected by sunscreen, which can be as little as 20 minutes based on the amount of melanin in your skin. It is theorized that a SPF of 15 protects the skin 15 times longer, and that with it, it can take up to five hours for the sun to burn the skin.
When choosing the appropriate SPF, it is important to note that an SPF of 15 will protect a person from 93 percent of the sun’s UVB rays, an SPF of 30 will protect a person from 97 percent of UVB rays, and an SPF of 50 will protect a person from 98 percent of UVB rays.
Let’s look at a case recently discussed with JU instructors and students.
A 23-year-old African-American female who visited the Dominican Republic for the first time with her friends, Regina was in awe of the mountainous island and its gorgeous beaches. Her group could not wait to walk the sandy beaches and Jet Ski. Regina remembered to pack her broad-spectrum, water-resistant sunscreen lotion with SPF 50.
While on the beach, she and her friends decided to go on a banana boat, an inflatable watercraft. During their adventure, the boat flipped over in the middle of the ocean, and Regina was briefly submerged. Once she came up, she said, “That was fun, let’s do it again!” She and her friends enjoyed the remainder of their time on the island.
A week later, Regina noticed her arms and legs began to itch and flake very badly. “Why is my skin so dry and peeling?” she asked herself.
She went online to research, only to find out she had sunburn. She was surprised, because she had thought African-Americans didn’t sunburn. She spent the next four weeks applying creams to her chafed arms and legs, remembering from a previous biology course that it takes four to six weeks for skin cells to regenerate.
This was a lesson learned. Regina had forgotten to reapply sunscreen after falling in the water. Her original application of SPF of 50 gave her only 80 minutes of coverage. Now, Regina is more aware to:
■ Stay hydrated by drinking at least eight glasses of water daily.
■ Perform monthly self-skin exams by using a small mirror to thoroughly look at all areas of her body.
■ Use daily moisturizing lotions, facial cleansers and foundation makeup that include SPF broad spectrum against UVA and UVB rays.
■ Apply a liberal amount, minimum SPF 15 broad spectrum, when participating in outdoor activities between 10 a.m. and 4 p.m. Apply every two hours and more as needed if participating in water sports or sweating.
■ Wear sunglasses when outdoors. This helps to protect for UV rays produced by the sun, which can cause serious eye disorders.
■ Report any suspicious skin changes (i.e. moles, freckles, lesions, sores) to her health care provider.
■ Review her current medications with her health care provider. Some medications increase sensitivity to sun exposure.
Nursed to Health is an occasional feature in which Jacksonville University School of Nursing faculty discuss symptoms, diagnoses and treatments based on composites of patient cases handled by instructors, students and alumni of JU’s local training programs. Today’s column is by Tiffani N. Mickens, MSN, RN, a JU Assistant Clinical Professor, and appeared in The Florida Times-Union on June 18, 2014.
Information for Nursed to Health is based on actual and composite cases of patients treated by students, alumni and faculty of Jacksonville University’s School of Nursing. Names and specific medical information have been changed to protect private health information, and any similarity is coincidental. For more information about JU’s School of Nursing, visit www.ju.edu/COHS. Readers with specific questions regarding their own health concerns should seek the advice of their healthcare provider.