Focus on skin care
Better weather and more sunshine is one of the big attractions of overseas living for many expatriates, but over-exposure to the sun can also be extremely harmful, causing faster skin aging and potentially lethal skin cancers.  Dr Jace Clarke provides some basic guidance on the health issues expats should consider before going out in the sun – but the golden rule is to consult a health professional if you are in any doubt about your skin health.

There’s no doubt that being out in the sun makes you feel better.  Unfortunately, it’s easy to get to get too much of a good thing and overexposure to the sun can cause serious skin health problems.  Caucasian expats in sunny countries are particularly at risk, especially if they have fair skin, red hair or freckles however anyone can suffer from skin damage or skin cancers.  The key to healthy living is taking sensible precautions to avoid being exposed to too much sunshine and to recognise the signs quickly if something is amiss.

The problem is caused by the ultraviolet rays in sunlight; UVA light causes wrinkles and skin aging and can also damage the deeper skin layers, while UVB causes sun burn and other damage to the skin.  The are a number of conditions caused by too much sunshine, some are minor such as sunburn, but even this can be very unpleasant if severe and sunstroke which can cause headaches, fevers and vomiting.  More serious conditions caused by the sun are premature skin aging, including wrinkling, brown spots, growths and skin cancers.

There are two main groups of skin cancer.  Non-melanoma skin cancers such as Basal cell or Squamous cell cancer, are believed to be caused by sunshine in up to 90 per cent of cases while Malignant melanoma, which is an extremely serious condition is believed to be caused by overexposure to the sun in about 60 % of cases.  Skin cancers can be successfully treated if caught early enough, but Malignant melanoma, if left, can spread around the body and may be fatal.

Prevention is simple and straightforward.  Avoid strong sunlight as much as possible; the sun’s rays are at their strongest between 11am and 3pm in the summer months or all year round in equatorial regions.  If you are outside find as much shade as possible.  Some sun is unavoidable, so cover up and use sunscreen liberally.  Wide brim hats and loose tee shirts provide excellent protection and sunglasses which protect against UV light can help to shield your eyes from sun damage.

Make sure that you apply sunscreen regularly to all exposed areas of the skin, taking care with placed that are easily missed like the lips, ears and neck.  Use a sunscreen with a sun protection (SPF) factor of at least 15+ and reapply it regularly, particularly after swimming; creams and oils with an SPF below 15 do not give much protection.  Experts now believe that using a moderate factor sunscreen with a SPF of 15+ is more effective when applied regularly than higher factor screens used intermittently.  Remember that children are especially vulnerable to strong sunshine and should be kept out of the sun as much as possible and protected with very regular applications of sunscreen.

Like all cancers, skin cancer is most easily treated if it is caught early, so keep a very close eye on your skin.  It is perfectly normal for people to develop more moles in the sunshine however it is important to know the warning signs to look out for if something more serious is amiss.  If you are in any doubt, consult a qualified medical practitioner promptly.

Non-melanoma skin cancers can appear as a new growth or sore that won’t heal, a spot, mole or sore that itches or hurts or a mole or growth that bleeds, crusts or scabs.

For malignant melanoma, the ‘ABCD rule’ is a great way to remember the early warning signs:

‘A’ is for Asymmetry, where the two halves of your mole do not look the same.
‘B’ is for Border, where the edges of your mole are irregular, blurred or jagged
‘C’ is for Colour, if the colour of your mole is uneven with more than one shade and
‘D’ is for Diameter, where your mole is more that 6mm across.

If you notice any of the ABCD signs it is important that you seek medical help without delay.

Being out in the sun should be a pleasure, and by taking sensible precautions to avoid overexposure everyone can enjoy the outdoors life safely.  And don’t forget that the problem is overexposure to sunshine, not heat and the mountains in winter can be just as much a threat as tropical beaches in summer.

Article by William Russell’s Chief Medical Officer, Dr Jace Clarke

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