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Feature Story


When dark gets dangerous

by Adrienne Dy, M.D.

MARCH 2012

Half of a pair of (almost) identical twins, Nathalie, 39, is easily distinguished by a blatant clue: Her complexion is noticeably fairer, since she took sun protection to heart more than her twin. Any encounter with the sun found her “balut na balut, in long-sleeved shirts, even fingerless gloves.”

Nathalie has since relaxed a bit, saying that she has seen the light, so to speak—and even seeks it out: “I’ve since revised my opinion…because [I learned that] sun exposure is actually good for [me].”

There’s nothing like the warmth of a sunny day to brighten our mood, keep our blood flowing well and give a sense of wellbeing. Sunlight is essential for our body’s production of vitamin D for skeletal strength. Doctors have also employed the rejuvenating rays as a treatment for skin conditions like vitiligo, psoriasis and lupus vulgaris. But too much of a good thing can be bad.

When it comes to sun protection, where exactly do we draw the line between light and shadow?

Shun the sun?

Prolonged sun exposure brings a slew of skin-crawling conditions. As many beach lovers attest, sunburns are a painful summer souvenir. UV radiation attacks the upper layer of skin cells, causing mild reddening or erythema, or worse: painful blisters that agonizingly peel off, leaving skin vulnerable to even more damage. On another note, the sun—specifically its UV-A rays—promotes rapid wrinkling and other unsightly signs of skin aging.

Beyond the skin, UV rays also inflict damage on the eyes, causing inflammation of the cornea (photokeratitis) or conjunctiva (photoconjunctivitis). Though painful, these are temporary conditions that do not affect vision. However, UV-B exposure can also promote the development of cataracts—progressive clouding of the lens that need to be surgically removed to restore sight.

The effects of UV rays on our body’s defenses have also been investigated. Some studies reveal that overexposure could lead to increased risk of infection, recurrent cold sores, and an overall decline in human immune response.

But everybody’s biggest concern is the dreaded Big C. UV radiation can cause direct DNA damage to skin cells, which leads to cell mutation and cancer. As Filipinos, we do not fall under the high risk category of the disease the way our fair-skinned friends do. This is not to say we aren’t in danger; sun exposure remains the biggest and most important risk factor for skin cancer—and our kayumanggi skin can make it difficult to detect at early stages.

Beat the heat

“There’s no such thing as a healthy tan!” declares the World Health Organization (WHO). While our skin pigment, called melanin, does shield us from sun injury, it does not protect against long-term UV damage. “A suntan may be cosmetically desirable, but in fact it is nothing but a sign that your skin has been damaged and has attempted to protect itself,” the WHO explains.

“In my recent practice, I’ve encountered more cases of [skin cancer] even in patients as young as 28,” says Vivian Grace Tan, M.D., skin oncologist and dermatopathologist at St. Luke’s Medical Center, Quezon City. She emphasizes the importance of diligent sun protection and timely consultation for “any new [skin] growth, even if you think it’s just a nunal. [Skin cancer lesions] can present as pigmented or skin-colored.” Furthermore, changes in texture is also cause for alarm; actinic keratosis, a precancerous condition that results from chronic sun exposure, usually presents as a small, rough spot that feels a lot like sandpaper.

“If you have a family history of skin cancer, it’s best to visit a doctor regularly. Screening doesn’t have to begin as late as in your 50s,” advises Dr. Tan. Like most cancers, it is caused by both genes and lifestyle. We can’t do much about the former, but we do have a say in how much sun frolicking we do. Like they say: better safe than sunburned.

For more expert tips on sun protection, check out HealthToday’s pre-summer issue, out now in bookstores and newsstands.

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