It is undeniably one of the perks of living in the UAE: year-round sunshine. The good weather here is one of the magnets for many expats to fly to these shores, especially those from Europe. And, whether it be days on the beach, relaxing by the pool, or hosting friends for a barbecue, many of us can’t get enough of spending time soaking up the rays.
But experts this summer say westerners are creating a possible time bomb of skin cancer cases by not protecting themselves in the sun.
Already the World Health Organisation estimates more than 60,000 people die from overexposure to harmful rays each year. Now, the concern is that figure will only rise – not least here in the Gulf region.
‘Many expats think they have won the lottery of life when they move out here, and quite right too: it’s a wonderful place,’ says Dr Ikramullah Al Nasir, founder of Dermacare Skin Centre in Jumeirah, consultant to several Bollywood stars and a member of Friday’s experts’ panel. ‘But these people are playing a lottery with their health if they do not understand how dangerous the sun is. I do not say this lightly: it can be deadly.’
Such warnings are, of course, nothing new. The dangers of the rays have long been known. Yet dermatologists are increasingly of the opinion that the next few years are critical for raising awareness in this region. That’s partially because of the sheer numbers of Europeans – the group most vulnerable to skin damage – arriving here; and partially because many of those Europeans continue to be obsessed with a golden tan.
‘We’re now looking at a huge population of westerners living in the UAE,’ says Dr Al Nasir. ‘If just a small fraction of them don’t listen up and continue to spend days in the sun without adequate protection – and the anecdotal evidence suggests many are doing just that – then we are without doubt looking at a skin cancer epidemic.’
This is a warning echoed by Dr Zbigniew Ruszczak, head of dermatology at Al Noor Hospital in Abu Dhabi. He has called for a nationwide skin cancer screening programme, and education campaigns to highlight the risks.
‘Some nationalities – Asian, Japanese and Filipino – protect themselves better because they are more aware and they also perceive white skin as more attractive,’ he says. ‘But the western world is putting itself in danger because being tanned is associated with beauty. They love to be brown. They want to look nice now – but what happens in 20 years? This is the habit we need to change.’
Clearly steps must be taken. So today, with the help of experts, we answer all the questions you could possibly have about staying safe in the sun. Please read on – and look after yourself this summer…
Why is the sun dangerous?
The simple answer is it emits ultraviolet radiation, and it’s these UV rays that cause skin cancer.
That’s because exposure to such rays damages the DNA in our skin cells, and, if too much DNA gets damaged over time, it causes cells to grow out of control. This leads to cancer.
That explains why burning is bad news. The reddening is an explicit sign our DNA has been damaged.
‘Getting sunburnt doesn’t mean you will develop skin cancer,’ says a spokesman for the UK-based charity Cancer Research. ‘But getting it a lot does mean you have a higher risk of the disease.’ Indeed, the figure is startling: suffering painful sunburn just once every two years can triple your risk of melanoma, the most deadly form of skin cancer (the other two major types – both also caused by exposure to sun – are basal cell carcinoma and squamous cell carcinoma).
The dangers of the sun are not just limited to cancer either. Too much can also cause cataracts of the eyes and, recent studies suggest, suppress the body’s immune system, making us more likely to suffer from a range of other illnesses.
How long can you stay out in the sun unprotected?
This depends on your skin type, but the short answer for everyone is: not long.
Europeans and people with fair skin should limit their time to eight to 10 minutes. Those of darker complexion can stretch that to 15 but any more unprotected, for anyone, is dangerous.
‘This particularly applies during the sun’s peak hours, when it is at an angle to earth of between 45 and 135 degrees,’ adds Dr Al Nasir, who is originally from Pakistan but has lived in the UAE for more than 20 years. ‘In Dubai, in summer, that’s roughly between 11am and 5pm.’
It’s also worth remembering that you’re still susceptible to sunburn even if it doesn’t feel warm outdoors. UV rays do not transmit heat so, just because there’s a breeze or the sun seems a little cooler than usual, it can still be searing your DNA.
What clothing should you wear to stay safe?
Contrary to popular belief, not all clothing is equal when it comes to protecting us from the sun.
Three factors in particular make a difference.
Firstly, more is better: high collars, long sleeves and wide-brimmed hats all help keep the burning rays off a greater area of our skin and , thus, reduce, our chance of overexposure.
Secondly, colour is important. Dark materials will absorb harmful UV rays, lighter shades will block it, and brighter tones will go further by actually reflecting them away. ‘The more vivid the colour, the greater the protection,’ is the advice offered by Dr Peter Gies, senior research scientist at the Australian Radiation Protection and Nuclear Safety Agency.
Thirdly, and arguably most significant, is the type of material.
All fabrics are made of tiny fibres woven together, and if these fibres aren’t knitted tight, it essentially means the garment has tiny, sometimes invisible holes that UV rays can pass directly through and reach the skin. As such, the tighter the weave, the more protective the item. Merino wool, polyester and nylon are all good weaves. Cotton and silk less so.
Indeed, as research into this has increased, some clothing now comes with a UPF (ultraviolet protections factor) rating. A shirt with a UPF factor of 50, for example, allows in just a 50th of the sun’s harmful rays to penetrate it. ‘These ratings are useful and my advice is to use them if possible,’ says Dr Al Nasir. ‘But if that proves impossible, sensibly following the guidelines on colour, material and coverage will certainly keep you safe.’
What about moles and freckles?
People with lots of moles or freckles are at a higher risk of getting skin cancer than average and they should, accordingly, take extra care in the sun.
As well as using sunscreens of no lower than factor 15 and seeking the solace of shade more often than others, they must – absolutely must – make regular checks for changes in moles, growths or lumps.
‘Any changes that are found should be reported to a reputable skin doctor as soon as possible,’ says Dr Al Nasir. ‘I cannot stress this enough: skin cancer is much easier to treat if it is found early.’ He suggests regular mole mapping and mole screening appointments.
What about sun cream?
Clothing and shade are the best line of defence against the sun. But, inevitably, when sat around the pool or at the beach, some people do like to uncover a little. Which poses an altogether new question: of all the different types of sun cream on the supermarket shelves, what should we be using? And then, how precisely should we be using it?
‘This can be very confusing,’ admits Dr Al Nasir. ‘There are hundreds of products and hundreds of slogans, and often people simply do not know what to buy for the best.’ His advice is to use products from companies that specialise in sun protection – such as Neutrogena, Sunsense and RoC – rather than cosmetic firms that also do a sideline in sun lotions. Look for key words such as ‘broad range’, which will offer protections against UVA and UVB rays, both of which can cause skin cancer.
Additionally, go with fragrance-free products (‘because chemicals within fragrance can reduce their protection abilities’), and opt for creams instead of sprays, as rubbing them into the skin creates a greater resilience to rays.
When it comes to SPF (sun protection factor) numbers, go higher the lighter your skin colour. But, counter-intuitively, perhaps, Dr Al Nasir reckons that there is generally no need to go for anything above SPF 40.
‘No cream is 100 per cent effective at blocking the sun,’ he explains. ‘Factor 40 is about 95 per cent. After that the increases are really very minimal. It becomes an exercise in marketing: this company says it does SPF 100 so another will say it does SPF 110. There is no real difference.’
More advice? Apply half an hour before going into the sun so the skin has time to absorb; cover all exposed areas, including the face, neck and ears; and don’t combine it with any make-up as the chemicals may react and cancel each other out.
Perhaps most importantly, reapply at an absolute minimum of every three hours – and that applies even if the product claims to be ‘once-a-day’.
A UK study, carried out just last month by a consumer group called Which?, found the protection offered by many such creams had ‘significantly dropped’ after six to eight hours. Indeed, in Australia, which has one of the highest skin cancer rates in the world, ‘once-a-day’ claims have been banned over safety fears.
Along similar lines, reapply cream after every dip in the water – even if the product says water-resistant. ‘There is no controlled study that has found any sun cream to be completely waterproof,’ says Dr Al Nasir. ‘Always reapply as a priority.’
Finally, use generously. ‘It’s vital that you use enough product,’ is the advice of Samar Maatouk, of UAE-wide cosmetic skincare centre Silkor. ‘Roughly one teaspoon per limb is required. If you use too little product, using SPF 15 could be more like using SPF 4.’
But what if you do get sunburn?
It can’t be stressed enough that allowing yourself to become sunburnt is entirely dangerous and is ultimately a sign that we are making ourselves more susceptible to skin cancer.
Moreover, there is nothing you can do to put right any damage once you’ve allowed it to take place.
However, to soothe the pain, the best advice is to take yourself out the sun immediately and cool the skin by sponging it with cold water. Apply a cold flannel to particularly sore areas, apply a water-based emollient or petroleum jelly to keep the skin moist, and consider taking painkillers.
Most importantly though, do learn your lesson and try not to allow it to happen again. The long-term consequences could be far worse than just some mild discomfort.