Sun care

About skin damage caused by sunlight

Some sun exposure within safe levels can be beneficial because our skin uses it to produce vitamin D. Vitamin D is important for bone health. It may also help to reduce your risk of certain other diseases, including a number of cancers, although more research needs to be done to be certain. However, too much sun is harmful and can damage your skin, putting you at serious risk of skin cancer. It's important that you get a balance between reducing your risk of skin damage from burning and enjoying the benefits of the sun.

The sun gives out ultraviolet (UV) radiation that is made up of three types of rays: UVA, UVB and UVC. UVC rays from the sun can't get through the ozone layer but UVA and UVB rays can. UVA can cause wrinkles, and UVB can cause sunburn and skin cancer.

Short-term skin damage

Sun tan
A tan is actually a sign that your skin has been damaged and is trying to protect itself. UV radiation stimulates your skin to produce more pigment (colour), which protects against damage. Your tan will fade, but the damage to your skin remains.

Sunburn
Short-term overexposure to the sun can burn your skin, usually making it red, hot and painful. People often think that sunburn is only a problem on holiday in hotter countries, but most sunburn actually happens in the UK.

You can soothe sunburnt skin with general lotions such as aqueous cream, aloe vera lotion or other aftersun lotions. If your sunburn is severe, you may need medical treatment.

Heat exhaustion and heat stroke
Heat exhaustion is when your body becomes overheated after too much sun or by getting sunburn. You may have the following symptoms:

  • a headache
  • feeling or being sick
  • feeling faint or dizzy
  • heavy sweating
  • hot skin
  • high temperature (between 37 and 39˚C).

If you think you have heat exhaustion, get to a cool place as soon as possible and drink plenty of water. If the symptoms don’t get better, or get worse, you should seek medical advice.

Heat exhaustion can lead to heat stroke, which can be fatal if it's not treated.

Long-term skin damage

Ageing and infection
Ageing of your skin is a result of the UVA rays penetrating it, causing wrinkles and sagging. UV rays can also cause damage to the eyes. Too much sun exposure may even damage your immune system, increasing your risk of becoming ill.

Skin cancer
The exact causes of skin cancer aren't fully understood at present, however your risk of skin cancer increases if you have exposed your skin to UV rays by spending a lot of time in the sun. You may also be more likely to get skin cancer if you have fair skin.

There are two types of skin cancer - melanoma and non-melanoma. Melanoma skin cancer is the most serious form, but it can be treated if found early. Getting badly burned can increase your risk of melanoma, especially as a child.

There are different types of non-melanoma skin cancer — basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Your risk of BCC is increased if you had repeated sunburn, especially as a child. You may be more likely to get SCC if you are exposed to sun throughout your life, for example if you work outdoors.

Preventing sun damage

Spending frequent short spells in the sun during summer without sunscreen should be enough to give you the vitamin D your body needs (the exact time you need is different for everyone, but is typically only a few minutes in the middle of the day). However, do not let your skin redden. To protect your skin, do not spend long periods of time in the sun without wearing sunscreen between 11am and 3pm, when the sun's UV rays are strongest. Look for shady areas under trees, and use umbrellas or canopies.

Watch the UV index

The UV index describes the strength of the sun's UV radiation. It's usually shown as a number in a triangle on a weather map. The numbers range from one to 11+ and the higher the number, the stronger the UV radiation. Depending on your skin type, you might need protection when the UV index is anything over three.

In many countries, the UV index is reported alongside the weather forecast in newspapers, on TV and on the radio.

Cover up

You can protect your skin by wearing long-sleeved tops and trousers. Choose materials that have a close weave as these block out the most UV rays. Wet clothing stretches and lets more UV radiation through to your skin. You can now buy sun protection factor (SPF) clothing and sunsuits, which help to protect your skin from UV radiation.

Wearing a wide-brimmed hat can reduce the amount of UV radiation reaching your face.

Sunglasses help to protect your eyes and eyelids. Wraparound sunglasses will also protect the skin around your eyes. You should choose a pair of sunglasses that has the following labels:

  • 100 percent UV protection
  • UV 400 — this means it protects from both UVA and UVB rays

If you're buying a pair of sunglasses in Europe, check that they also carry the European Standard CE mark and the British Standard (BE EN 1836:1997).

Wear sunscreen

Always use broad spectrum sunscreen. This means that it protects your skin against UVA and UVB rays. Make sure it has a SPF of 15 or higher. The SPF tells you how good the sunscreen is at filtering out the UVB rays. UVA protection is measured with a star rating. Sunscreens can have between zero and five star UVA protection — opt for one with at least four stars.

Sunscreen can't give you complete protection since some UV rays will always get through, but you will get more than 90 percent protection from UVB rays with SPF 15.

Use sunscreens generously. You should use about two teaspoons of sunscreen for your head, neck and arms, and two tablespoons for your whole body when wearing a swimsuit. Re-apply sunscreen every two hours or more often if you go swimming, or sweat a lot. Water reflects the sun's rays so you need to apply sunscreen before swimming.

Cloud doesn't stop the sun's UV rays getting through so you should protect yourself even if it's cloudy. Haze (from thin clouds or mist) can even increase your UV radiation exposure because the rays are scattered.

Check moles

You should check your moles regularly for changes that may indicate skin cancer. Most changes are harmless, but you should see your GP if you notice:

  • growth of an existing mole — especially over 7mm (a quarter of an inch) in diameter
  • a mole with an uneven or ragged edge
  • a mole of varying shades of colour
  • a mole with an inflamed or red edge
  • a mole that bleeds, oozes or crusts
  • a mole that feels different, painful or itches

Don't use sunbeds

Sunbeds mimic the effect of the sun and give out artificial UVA and UVB radiation. Exposure to artificial UV radiation can also damage your skin. Sunbeds have been linked to premature wrinkles and an increased risk of skin cancer. They can also damage your eyes.

An artificial tan from a sunbed doesn't protect your skin against sunburn on holiday; it's similar to using a sunscreen with SPF 2 to 3.

There are no regulations relating to the use of sunbeds, but the World Health Organization (WHO) recommends that you should never use a sunbed if you:

  • are under 18
  • have sunburn, burn easily or had frequent sunburn as a child
  • have a lot of moles
  • tend to freckle
  • have pre-cancerous or cancerous skin lesions
  • are wearing cosmetic products (these may make you more sensitive to UV radiation)
  • are taking medication (you should seek medical advice to check whether your medication will make you particularly sensitive to UV radiation)
  • have someone in the family who has had skin cancer

Winter sun

You can't feel UV rays. The warmth you feel on your skin is actually caused by the sun's infrared radiation. So just because you can't feel the hot rays of the sun, it doesn't mean you won't get sunburnt.

The amount of UV radiation is generally lower during the winter but snow reflects most of the sun's rays, so you can still get sunburnt. If you're high up in the mountains, there is less atmosphere to block out the UV rays, so make sure you use sunscreen.

Protecting children from the sun

Young skin is sensitive and very easily damaged by the sun. Getting sunburnt as a child is known to increase the risk of developing a dangerous form of skin cancer as an adult.

It's usually safe for older children to spend short spells in the sun, as long as it's not enough for them to burn. However, if your child is going to be in the sun for longer than a few minutes, you will need to protect their skin from burning. Make sure they stay in the shade when possible. Dress your child in loose-fitting clothes that cover up their arms and legs. A hat with a brim at the front and a cloth flap that covers the neck provides good sun protection. Sunglasses will help to protect your child's eyes.

Use water-resistant sunscreen with SPF 15 or higher — the higher the better — on all exposed areas of your child's skin and apply generously every couple of hours. If you take your child swimming, re-apply the sunscreen after towel drying. UV protection swimwear is also a good way of protecting your child.

You should be more careful with babies and toddlers as they can burn very easily. Keep your baby in complete shade. Pop-up shelters are a good way to protect your child from the sun on the beach or in the garden. Canopies and parasols for prams and buggies protect your child when you're out and about.

Fake tans

Fake tanning lotions are a popular alternative to sunbathing and sun beds. The tanning lotion reacts with your skin and produces a brown pigment. Fake tan needs to be re-applied regularly if you want to maintain your tan, because your outer skin cells are shed naturally as your skin grows.

Some fake tanning lotions contain sun protection but the SPF is usually very low, so you should also wear sunscreen with an SPF of 15 or higher when you're out in the sun.

Although fake tanning lotions aren't known to be dangerous, they can sometimes trigger an allergic reaction. Always test the lotion on a small area of your skin first to see if you have a reaction.

How much sun is safe for my skin?

Answer

Although excessive sun exposure can be damaging to your skin, a small amount of sunlight can be beneficial, as it helps you to produce vitamin D.

Explanation

Getting some sun can be beneficial as it helps your body to get the vitamin D it needs. You produce vitamin D when your skin is exposed to sunlight. Vitamin D is essential for bone health and it may also help to reduce the risk of a number of cancers, although more research needs to be done to be certain. In the UK and other countries at a similar distance from the equator, it's common for many adults to have inadequate levels of vitamin D.

However, it's still important not to get too much sun as this can be damaging to your skin, causing early ageing and can lead to cancer. You shouldn't stay out in the sun long enough to let your skin redden. 

You may be able to get enough vitamin D during the summer by spending frequent short spells in the sun without wearing sunscreen. Typically, a few minutes of exposure to the sun in the middle of the day without sunscreen is enough to give you the vitamin D you need and shouldn’t be harmful. However, the exact amount of time you need is different for everyone, and depends on many things including how dark your skin is, how much skin you have exposed, the time of day, the time of year and your location. The darker your skin, the more time you may be able to spend in the sun without burning.

Do not let your skin redden, as this is a sign that you have had too much. Get to know how much sun you can tolerate without burning. If you are expecting to be in the sun for longer than a few minutes, you should always follow the usual sun care advice – stay in the shade, cover your skin and apply sunscreen if your skin is exposed.

The table below shows the approximate amount of time you may need to spend in the sun to produce adequate vitamin D on three different dates in three locations in the UK, assuming you are out in the sun around 1pm (British summer time), in clear conditions, with your face, arms and hands exposed.

Location Skin type Date
1 April 21 June 1 Sept
 London
  
Caucasian (fair skin tone)  11 mins  5 mins  9 mins
Asian or Mediterranean (medium skin tone)  20 mins  9 mins  16 mins
Black (very dark skin tone)  46 mins  20 mins  36 mins
 Manchester
 
 
Caucasian  13 mins  5 mins  10 mins
Asian or Mediterranean  23 mins  9 mins  18 mins
Black  52 mins  21 mins  40 mins
 Glasgow
 
 
Caucasian  15 mins  5 mins  11 mins
Asian or Mediterranean  28 mins  10 mins  20 mins
Black  1 hr 1 min  22 mins  46 mins

               Approximate time needed to produce adequate vitamin D per day
               
A child's skin can be easily damaged by the sun, so it's very important not to let your child's skin burn. It's ok for older children to spend short spells in the sun, as long as it's not enough for them to burn. However, you need to be more careful with babies and young children, as they have very sensitive skin and can burn easily. Always keep babies and toddlers in the shade, or cover them up.

If you are unable to get much sun exposure and particularly during winter months, taking up to 25 micrograms of vitamin D a day (two high-strength, 12.5-microgram tablets) can help to make sure you get enough.

Always read the patient information leaflet that comes with your supplements and if you are pregnant or breastfeeding, ask your pharmacist or GP for advice first. Talk to your GP before taking vitamin D supplements if you are taking diuretics for high blood pressure or have a history of kidney stones or kidney failure.

I have found a new lump on my skin — what should I do?

Answer

Most skin lesions such as moles, cysts, warts or skin tags aren't cancerous. If you have a new mole or lump, or if an existing one has changed, you should see your doctor.

Explanation

There are many different types of skin lesion, most of which aren't cancerous. These include those listed below.

  • Moles are small, dark areas of skin. You can be born with moles but most develop during your life.
  • Keratosis is scaly skin that can be brown or pink.
  • Warts are small, rough lesions that are caused by infection with the human papilloma virus (HPV).
  • Skin tags are small, flesh-coloured bumps on your skin. They often form in places where the skin creases or gets rubbed such as your neck, armpits and groin.

Skin cancer usually forms in areas of your skin that are exposed to the sun. There are various types of skin cancer and each can look different.

  • Non-melanomas such as a basal cell carcinoma, for example, can start as a small red, pink or shiny lump.
  • Squamous cell carcinomas often appear as small scaly or hard areas of skin with a red or pink base.
  • Melanoma usually starts as a dark spot or mole on your skin. If a melanoma spreads to other parts of your body, you can develop other symptoms such as swollen lymph nodes (glands throughout your body that are part of your immune system).

Symptoms that may indicate skin cancer include any mole or lesion that:

  • gets bigger — especially over 7mm (a quarter of an inch) in diameter
  • changes shape — look for an irregular edge
  • changes colour — if it darkens, becomes patchy or multishaded
  • becomes inflamed
  • is itchy or painful
  • bleeds or is crusty

These symptoms don't necessarily mean you have skin cancer, but if you have any of them you should visit your GP for advice.

How can I tell if my child has heatstroke and what should I do?

Answer

If you think your child has heatstroke (sometimes called sunstroke) you should get him or her out of the sun and into a cool, shady place as soon as possible. Give your child enough fluids to stop dehydration. If he or she has a temperature of above 39ºC (you can use an oral thermometer to measure your child's temperature), you should seek immediate medical help.

Explanation

Heat exhaustion and heat stroke are conditions caused by hot weather. Heat stroke often occurs in children who have been outside on a very hot day, without enough protection from the sun.
Heat exhaustion occurs when your body becomes overheated soon after you have been exposed to too much sun, or you get sunburnt. Generally, symptoms include nausea, headaches and cramps, and a temperature between 37 and 39˚C.

If you think your child may have heat exhaustion, take him or her to a cool place as soon as possible. Give your child enough fluids to drink as this will help prevent dehydration. You can help to cool your child down by using a sponge or cloth soaked in lukewarm, but not cold, water. Severe cases of heat exhaustion can lead to heat stroke.

Heat stroke is a more serious condition caused by a failure in your body's natural temperature regulation. Heat stroke has similar symptoms to heat exhaustion but is more severe and your child may seem confused or aggressive, have a fit or lose consciousness. You can wrap your child in a wet sheet to help cool them down but don't use iced or cold water. If your child has a temperature above 39˚C, or if his or her skin has become dry and flushed, you should call for emergency medical help.