Do you remember your mom or granny putting on baby oil and frying in the sun for hours? Maybe some lemon juice or Sun-in on the hair, and cotton balls over the eyes? I can recall mine doing a couple of those things, vividly. Often, I would join, and usually end up with an unpleasant sunburn.
I’ve never seen my mother with a sunburn, but I’m sure she had some in her younger days of lifeguarding. Interestingly, she’s never had skin cancer!! How is that, when we are hearing about the rising incidences of it, daily? Are all the 80’s and later babies seriously snowflakes, or...half-vampires? (That really is a joke, but really, why are the younger generations riddled with these cancers that were once thought of as only accompanying old age?)
Although there are actually multiple factors for the increased skin cancer epidemic, the one I’m looking at today is something that affects every single person on the planet. No gender, race, religion, or socioeconomic status can escape this - the Ozone. Perhaps you thought I was going to say the sun? That would have been a fair assumption, so I’ll rewind a bit and discuss the sun first.
Some Sun 411
You probably already know that the invisible energy rays coming from the sun are called Ultra Violet (UV) Rays.There are three types of these Ultra Violet rays, A,B,& C.
Only UVA & UVB Rays are long enough to reach the earth. (Good thing, because UVC is actually the most dangerous!!)
During normal conversation about the sun and it’s effects on life, there’s not always talk of these UV Rays, only a general reference to “sun exposure”. It is important to understand, however, that these UV rays from the sun do different things. For example, there’s a common debate about how much “sun exposure” is needed to get vitamin D levels high enough, often with no clarity of which UV spectrum that involves. The same applies when Seasonal Affective Disorder is talked about, or sun damage and aging skin. Generally referencing all the sun’s energy components is fine, but a deeper understanding may help avoid heartache and expenses later.
The benefits of sunlight are universally known. Warmth, stimulated blood circulation, uplifted spirits, and vitamin D production are all reasons we send our kids outdoors, right? They need that Vitamin D for its important function of increasing calcium and phosphorus absorption from food, as well as it’s crucial role in skeletal development, immune function and blood cell formation.
There’s no question that sunlight is important, the curiosity centers on how much is needed, and it’s variance with geographic location and skin color? Seemingly to address this issue, many countries started supplementing common foods with vitamin D. Pediatricians suggest babies who are exclusively breastfed receive vitamin D drops, because it’s assumed that the average lactating woman doesn’t have enough in her system to pass it to her baby via her milk.
We have also seen benefits from UV radiation treating a number of diseases. Rickets, Psoriasis, Eczema, and Jaundice are just some that are commonly improved by real or artificial “sunlight”. I’m reminded of this every time I hear someone argue that if the sun could hurt you, Physician’s wouldn’t utilize these methods for therapeutic use.
While there is a dark side to all these benefits, physicians normally weigh the risks. Hopefully there are no jaundiced babies getting sunburns, and that psoriasis patients are receiving full disclosure on the possible damage they could be receiving with their treatments, and to cease self medicating with tanning beds and laying out. Ideally, physicians are up to date on where the benefit of UV exposure stops, and the danger begins.
The World Health Organization gives a great summary of how UV negatively affects the human body:
UVA activates melanin pigment already present in the upper skin cells. It creates a tan that appears quickly but is also lost quickly. Furthermore, UVA penetrates into the deeper skin layers, where connective tissue and blood vessels are affected. As a result the skin gradually loses its elasticity and starts to wrinkle. Therefore, large doses of UVA cause premature ageing. Furthermore, recent studies strongly suggest that it may enhance the development of skin cancers. The mechanisms of this UVA damage are not fully understood, but a popular hypothesis assumes that UVA increases oxidative stress in the cell. Recently, the interest in the effects of UVA on the immune system has been growing. It is believed that UV radiation is absorbed by a molecule located in the skin. This leads to changes in the distribution and activity of some of the key molecular and cellular players of the immune system. An altered balance of the immune response through cells and antibodies may reduce the body's ability to defend itself against certain diseases.
UVB stimulates the production of new melanin, which leads to a heavy increase in the dark-colored pigment within a few days. This tan may last a relatively long time. UVB also stimulates the cells to produce a thicker epidermis. Therefore, UVB is responsible both for the darkening and thickening of the outer cell layers – these reactions are the body's defense against further UV damage. However, higher doses of UVB cause sunburn which increases your likelihood of developing cancer. The exact mechanism of how UVB initiates or promotes cancer is not yet known. In people suffering from Xeroderma pigmentosum, a rare pigmentation disease, the ability to repair DNA damage caused by exposure to UV radiation is impaired. The much-increased rates of skin cancer in these patients suggest that direct UV damage of DNA may be the mechanism that links exposure to the development of cancer.
As with effects on the skin, the various incoming sun rays penetrate the eye to different depths. While UVB is fully absorbed by the cornea, UVA passes through these surface layers to the lens. Among adults only 1 per cent or less of incoming UV radiation reaches the retina because of the filter function of cornea and lens. In contrast visible light easily penetrates through to the retina, where it activates photoreceptors and starts the chain reaction of biochemical processes to produce a visible image.
~who.int (World Health Organization) FAQ
Although UVB Rays are the culprits behind sunburns, UVA Rays penetrate deeper, and can cause as much damage.
Mother Earth’s Sunscreen
What does any of this have to do with your mom or granny and the baby oil? Sorry, I may have digressed too much...but their sun exposure versus ours is actually very different, because they were under the safety net of Mother Earth’s sunscreen - The Ozone layer. The beauty of ozone is that it absorbs part of the UVB before it can make it earth-side! (It’s transparent to most UV-A, so most of that radiation still reaches the surface.)
As you may have heard, this amazing “sunscreen” for the earth has undergone some changes through the years. Unlike the unpopular topic of global climate change, the topic of a depleting ozone was widely accepted when it was presented in the 80’s to the public. No one wanted to imagine a world fraught with skin cancer, or of people getting sunburned within 5 minutes of stepping outdoors. (Sounds like a bad sci-fi movie!) These scare tactics were enough to engage the whole world in making environmental changes.
At the time, the blame for the depletion was placed mostly on an increase of man-made ozone depleting substances, like CFC’s (chlorofluorocarbons). Remember back in the late 80’s and early 90’s, when we heard constantly that we needed to save the whales, rainforests, and Earth? The Ozone Hole (The most obvious and well know sign of ozone damage, or depletion) was grouped in those daily admonitions. It was growing larger, and we needed to ban ozone-depleting substances!!! The world rallied together and a treaty, known as the Montreal Protocol, was signed in 1987. The United Nations calls it “the most successful treaty in UN history.” Essentially, it would limit the amount of ozone-depleting gases countries can emit. It was ratified by all United Nations members, as well as Niue, the Cook Islands, the Holy See, and the European Union.
NASA describes some specifics of what scientists were finding that led to the Montreal Protocol:
Stratospheric ozone is typically measured in Dobson Units, (DU) which is the number of molecules required to create a layer of pure ozone 0.01 millimeters thick at a temperature of 0 degrees Celsius and an air pressure of 1 atmosphere (the pressure at the surface of the Earth). The average amount of ozone in Earth’s atmosphere is 300 Dobson Units, equivalent to a layer 3 millimeters (0.12 inches) thick—the height of 2 pennies stacked together.
In 1979—when scientists were just coming to understand that atmospheric ozone could be depleted—the area of ozone depletion over Antarctica grew to 1.1 million square kilometers, with a minimum ozone concentration of 194 Dobson Units. In 1987, as the Montreal Protocol was being signed, the area of the hole reached 22.4 million square kilometers and ozone concentrations dropped to 109 DU. By 2006, the worst year for ozone depletion to date, the numbers were 29.6 million square kilometers and just 84 DU. By 2011, the most recent year with a complete data set, the hole stretched 26 million square kilometers and dropped to 95 DU.
These maps show computer model predictions of how the ozone layer would look in 2064, without (above left) and with (above right) the Montreal Protocol. (NASA photo credit)
We Didn’t Start The Fire
Yikes!! Basically in 2011, the thickness of the ozone layer was less than a third of what it should’ve been.That’s a big jump from 1979!! Is it any wonder that between 2008-2018, the number of new Melanoma cases diagnosed annually increased by 53%? Mother Earth was totally skimping on her SPF, and even though the ban took place, and improvements along the poles have been documented, we are not out of the woods yet.
In 2018, a study published in the Journal of Atmospheric Chemistry and Physics reports that the ozone layer might still be thinning. That discovery led researchers to surmise that the lower level of the ozone layer, which lies between 15 and 24 kilometers (9 and 15 miles) above the Earth’s surface, is still getting thinner. (this part of the layer usually has the highest density of ozone) Perhaps there’s not as much compliance with the Montreal Protocol as there should be? Or maybe it’s finally being acknowledged that Global Warming has an effect on ozone depletion? (Check out the newspaper article below from 100+ years ago...Global Warming is totally not a new concept, and it directly affects the ozone, therefore it affects skin cancer rates!)
Photo credit from @iflscience -Instagram
My overall point? The UVA & UVB rays that tanned our oiled up relatives were not as intense as they are today. By far, we’ve gotten the worst of it over the last 3-4 decades, and it’s not necessarily improving everywhere. I cringe when thinking about the amount and severity of sun exposure my oldest got before I “woke up” in 2013. Growing up in the age of environmental awareness, I’m ashamed I never thought more of it. Honestly, after the hype in the 90’s died down, I didn’t think twice of the ozone. I thought the problem had been fixed, and the world had moved on.
Doesn’t it seem there should be a lot more publicity about it? How did this just quietly go away? Even if scientists and governments aren’t concerned about the time it’s taking the ozone to heal, aren’t they worried about all the potential problems caused by decades of depleting? We get some sun safety and skin cancer awareness tossed at us here and there, but nothing close to the real-time-appropriate info it should be. I think it should go something like this:
Anyone born in the early 80’s and later should be extremely vigilant in watching themselves, their children, and their grandchildren for signs of skin cancer, especially Melanoma. Yearly visits to a Board Certified Dermatologist should be viewed as important as bi-annual dental exams. All healthcare providers, medical and non, should be up to speed on recognizing indications of skin cancer on patients. All physicians and educators should be aware of and teach sun safety to children and parents.
The World Health Organization recognizes that, for the general population, sun exposure to unprotected skin beyond 5-10 minutes is not necessary for Vitamin D production, and is most likely harmful. (This is variant in relation to skin tone and locational UV index levels.) Schools should all have shaded play areas - hats and sunscreen should be mandated, or at least encouraged. Public safety education signage should be placed in all outdoor recreational areas. Most of all, it should be stressed that EARLY DETECTION SAVES LIVES.
The public should be fully educated on the extent of damage the sun can and does cause. There’s been numerous campaigns over the years to teach on the dangers of poor habits such as smoking, drug use, sexually transmitted diseases, etc. Being exposed to the sun while outside working or at school recess isn’t even a habit! Of course, recreational activities such as swimming or beach-going fall more into the category of intentional habits. Do we think of taking our kids to the pool without sunscreen in the same respect as exposing them to secondhand smoke? Nope. I used to love to bake in the sun for hours, my sunburns always turned into tans...When my son appeared to have the same skin tone as me, I naively assumed he would be ok to burn a little, because his would also develop into a tan shortly after. Looking back now, at the bad habits I exposed him to, I feel sick.
2008 swimming attire (left) vs 2019 (right)
Knowledge Is Power
Learn as much as you can, and teach your children. Support non-profits and companies that are trying to save lives by educating on sun safety and skin cancer awareness. Demand changes in the education system, not just to teach about healthy sun habits, but to actually offer them by way of sun protection on the playground.
Teach and practice early detection habits. Examine your own skin, and have it professionally examined. (Click here to read about the warning signs of skin cancer.) I recently found a company that makes an online mole tracking & assessment program; Etta Epidermis. While some may accuse these types of businesses of trying to take over the need for Doctors, others realize it does the exact opposite. Many people don’t get the medical care they need for skin cancer because they won’t go to a dermatologist, and their Family Physician isn’t adequately trained on the topic. Having an (affordable) artificial intelligence like Etta to alert patients to a suspicious mole can increase the need for Physicians, and hopefully help save more lives by early detection.
Congrats if you made it through this whole post! Find your favorite sun protection methods, (Check out mine!) book your appointment with the Dermatologist, leave the baby oil in the nursery, and teach your kids to do better, and know better. Hopefully one day the Ozone Hole will be back to how it should be...but that’s probably a long way off!