Skin safety is made in the shade

Photo by: MARK ROY
Relaxing on a sun lounge in Sihanoukville is a pleasant way to wile away the hours, but the effects of the sun on unprotected skin include wrinkles, age spots, loss of elasticity and cancers.

The Phnom Penh Post
http://www.phnompenhpost.com

Written by Nora Lindstrom
Friday, 29 May 2009

The burnt, pink skin of foreigners is often a source of hilarity among Cambodians – but if precautions are not taken, the long-term effects of sun damage are anything but amusing

Avoid, avoid, avoid, avoid is the best advice when it comes to preventing sun damage to the skin.
Unless you live above the polar circle during the winter months, it is a near impossible dogma to follow.

In a tropical climate where the sun is constant and intense, precautions are essential. Through repeated and excessive exposure to the sun you can seriously damage your skin and even develop cancer.

Dr Christoph Bendick, Senior Lecturer for Dermatology and Sexually Transmitted Diseases at the Faculty of Medicine at the University of Health Sciences in Phnom Penh says the sun can be quite harmful, particularly to those from other countries living in tropical climates.

"Many of us have skin types which are not adjusted to the amount of sunlight we are getting here," Bendick says. "It's not without reason that Cambodians who are born here usually have darker skin.

"The darker the skin is the more protected it is against the harmful effects of sunlight. The whiter it is, the more it is prone to damage."

Fair-skinned Caucasians are prime targets for sun damage, while the skin cancer rate among those with darker skin is significantly lower.

The science
The sun emits three kinds of ultraviolet radiation: UVA, UVB and UVC.
Of these, the effects of UVC are negligible, while UVA is most harmful for the ageing of the skin, and UVB is what mainly causes DNA damage which in turn can cause skin cancer.

The sun can also temporarily weaken the immune system and give rise to viruses such as herpes of the mouth. Furthermore, existing skin diseases can be aggravated through sun exposure.

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The skin doesn't forget any damage we have inflicted upon it.
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It's not all bad news though, as sunlight can have a positive effect on mood and promotes important vitamin D production.

Nevertheless, skin aging - complete with wrinkles, age spots and loss of elasticity - is undesirable, and the risk of skin cancer should be enough for everyone to slap on some sunscreen and keep in the shade.

Alas, many don't. Bendick says that during his 15 years in Cambodia, he has seen skin cancers "very frequently" mainly among the expat population, many of whom don't take the necessary precautions.

Skin cancer also comes in three main types: basal cell carcinoma, squamous cell carcinoma and melanoma.

Of these, melanoma is the least frequent, but also the most dangerous. Left untreated, it leads inevitably to death.

"What we know today is that it is particularly the sunburns in childhood which make us more susceptible to the development of malignant melanoma," Bendick says.

"The other skin cancers are more produced through the cumulative effect of lifelong daily sun exposure."

He is quick to remind parents of their responsibility to keep their children protected from the sun.

"The skin doesn't forget any damage we have inflicted upon it, so every sunburn is stored in the cumulative memory of the skin," he says.

Be safe
Though it is difficult for a layman to diagnose skin cancer, certain observable changes in the skin may mean a visit to a qualified dermatologist is in order. "You should consult a dermatologist whenever you have a new lesion that you cannot easily attribute to an insect bite, scratch or pimple," Bendick says, "especially if this lesion doesn't heal after a suitable time."

In addition, should you notice a new (or existing) mole that is particularly black, bleeding, itchy, irregular or growing, it is recommended you have it checked with a professional.

Prevention, however, is key.

"The wheel can't be turned backwards so it's best to avoid damage from the very beginning," Bendick says. He cites shade, sunscreen and protective clothing as suitable precautions against harmful sunlight.

Many people complain wearing sun screen is uncomfortable and cosmetically undesirable.

However, a cursory glance through the better pharmacies in Phnom Penh reveals a wide variety of lotions, gels and sprays to suit every need and wallet. Though quality brands may provide enhanced protection, any sunscreen with both UVA and UVB protection is better than nothing.

It is advisable to avoid oily lotions, as these can clog the pores in your skin and stop sweat evaporating.

"I know that in our culture, it is preferential to be tanned," Bendick says, while noting many Cambodians aspire to the exact opposite.

Yet while a bit of colour may have a positive effect on one's self-esteem, red peeling skin after a week's holiday on Sihanoukville's beaches is surely redundant.

Follow these easy steps
There is no need to go to extreme measures to avoid direct sunlight. Small measures and a bit of forethought is all it takes to keep on the safe side of pink skin.

Bendick highlights the following:

- Avoid the sun, especially during the most intense hours of 10am-2pm
- Don't expose yourself unnecessarily - seek shade
- Cover up with clothes and hats
- Wear sunscreen every day, whether it is cloudy or sunny
- Choose a high SPF factor and sun-screen that protects you against both UVA and UVB light
- Apply sun screen 30 minutes or more before exposure, and reapply after swimming or sweating.

we asked some westerners 'Do you take precautions against the sun?'

Laura Mitchell
Almost 1 year in Cambodia

“I think I’ve used sunscreen maybe twice in the last month. My excuse is my olive complexion. But I know I should because I worry about aging. When I first came to Cambodia, I did use sunscreen, but you sweat so much it’s useless. I do, however, seek shade when I’m out and I don’t go sun tanning.”

Bruno Maltoni
5 years in Cambodia

“No, I don’t. I don’t use sunscreen – I’m Italian so we’re used to the sun. I don’t go tanning though. I don’t worry about skin cancer or any other harmful effects of the sun.”

Jean-Luc Marliere
2 weeks in Cambodia

“I was born in Rwanda and lived there for 8 years and got too much sun then, so I have to be careful now. Usually, I use sunscreen on my face, arms and legs when I’m in a hot climate. I also seek shade and wear a hat when I work in the sun. I go to the dermatologist for check-ups regularly.”