Here in the office of Ohio’s Country Journal and Ohio Ag Net, it is painfully clear that I’m the youngest employee around. From the jokes about millennials to the life stories I have yet to relate to, let’s just say the age gap is, well, noticeable.
Now that my inexperience is on full display, let’s talk something I have faced that’s unique for my age. Skin cancer has been found on my body twice in my life so far. Both times it was melanoma, the deadliest form of skin cancer. The discovery is a bit out of the ordinary for a 23-year-old like me as the average age for melanoma diagnosis is 63, according to the American Cancer Society. We’ve kept a close eye on it ever since and that vigilance has brought me a better understanding of the dangers and precautions associated with sun exposure, something we should all keep in mind.
It’s in that spirit that we recently spoke with Ohio State University Dermatologist Dr. Alisha Plotner. She said for farmers especially, the subject is too vital to overlook.
“It’s an extremely important topic because we know that farming is one of the highest risk occupations when it comes to skin cancer. The reason for this primarily is just that on a normal day, there is lots of UV exposure to be had by the farmer who’s working outdoors. Whether it’s continuous outdoors in the field or in and out for buildings, there’s just a lot of cumulative UV exposure, which we also know as one of the greatest risk factors for skin cancer. It actually is the greatest risk factor — that combined with skin type,” she said. “We also know that people who have fair skin and light eyes are at particularly high risk for developing skin cancer. So it’s really critical that people in these high risk occupations are aware of the risk of skin cancers.”
Plotner said no matter an individual’s background, a general knowledge of skin cancer risk is a must-have.
“There are three most common types of skin cancers. Two are very clearly related to excessive UV exposure over time. That’s your most common — basal cell skin cancer and also your squamous cell skin cancer, your second most common type. Then we have melanoma, which we also know that UV exposure is a risk factor for the development of melanoma,” Plotner said. “Melanoma is a particularly concerning type of skin cancer because it can be deadly, especially when it’s invasive and so it’s very important for farmers to be aware at the health risk of the occupation.”
Unlike many cancers, there are easy steps to lower the risk for such complications down the road.
“Make time for a reduction of UV exposure and there are really three ways to do that,” Plotner said. “Sun avoidance, I tell all my patients, is first line. But that’s not really practical in most cases on a normal day-to-day basis because the job requires you spend some time outdoors. I encourage my patients to do UV intense activities earlier in the morning and later in the afternoon and evening if possible. If you’re arranging your work day, try to do those UV intense activities earlier in the morning, before about 10 o’clock in the morning or after 3 o’clock in the afternoon if your job would allow you to do that. Number one is just UV avoidance.”
Plotner said, if possible, choose to work under some sort of shaded area like a tree or other structure offing a break from the sun in the heat of the day.
“The second thing that you can do is sun protective or UV protective clothing. Unlike sunscreens, these UV protective clothing are UPF instead of SPF rated. You want to look for something that has a UPF 50. Over the years, these have really evolved — they’re very lightweight clothes. Often times my patients will be worried they’ll be hot, but we find sometimes quite the opposite by keeping UV off of skin, sometimes they’re even cooling,” she said. “So I recommend a wide brimmed hat that has at least a 3-
inch brim all the way around the head to reduce UV exposure to the face and the neck. Also, I really like sun protective clothes like a long sleeve sun shirt which would provide protection for the arms and the neck as well. By wearing a sun shirt, it eliminates the need to put on a greasy sunscreen.
“And then finally I recommend sunscreen for exposed areas, so I would really encourage all of our farmers to just make it a part of their regimen when they’re getting ready for the work day in the morning, just to put at least a SPF 30 or higher sunblock on the exposed areas. Ideally we recommend reapplication throughout the day.”
Plotner said she is commonly questioned on which sunscreen to wear and what SPF is best. She said surprisingly, a higher number isn’t always the best.
“SPF stands for Sun Protection Factor and it’s a measurement of the degree a sunscreen’s able to reduce a patient’s threshold to burn,” Plotner said. “SPF 30 is the level recommended by the American Academy of Dermatologists. What an SPF 30 sunscreen does is it blocks about 97% of UVB, which are the burning rays. Now you can go higher on your sunblock. If you go to an SPF 50 or 70, you’re blocking maybe about 1% or 2% more rays but there is no sunscreen that blocks 100% of all of the UV rays.”
Plotner said SPF 30 with reapplication every two hours stands as the general recommendation.
“There are some patients who may have sun sensitive skin conditions, what we would call photosensitivity. In some cases, we’ll recommend those patients go higher and maybe choose an SPF 50 or 70, but for the general population, SPF 30 blocks 97% of UVB rays and that’s what we recommend,” she said.
As far as which type of sunscreen to choose, Plotner said the “one that they’ll actually wear.” She noted that since the FDA now regulates sunscreens, there are uniform requirements sunscreens across the board now have to meet. Anything from a stick to a lotion is acceptable and sprays are also fine if used liberally enough.
“There are so many different formulations of sunscreen available that I recommend the patient experiment with the different types and find one that they’ll like and that they’ll use,” Plotter said. “Several years ago, the FDA came out and regulated sunscreens and the nice thing is that there’s now some standardization so if you go to the drugstore and you pick something that’s listed as a sunscreen, then it has to meet certain minimum criteria.”
“How much sunscreen should I use? The simple answer is more than you think. Most people apply sunscreen too sparingly.”
Approximately a shot glass full of sunscreen is the recommend amount to cover the entire body of an adult at the beach. Plotner said the amount would be less for farmers whose skin would be mostly covered by clothing. A quarter of a shot glass full is enough to spread between the arms face and neck.
“Essentially you want to put on a layer of sunscreen that’s so thick that you can see it when you first put it on the skin and that you really have to rub in so that it evaporates.”
After getting in the rhythm with those precautions, Plotner said that self skin checks are still recommended.
“We recommend that you check over your own body and if you see any spots that are sore, any non-healing spots, any spots that look like persistent pimples, spots that are evenly persistently itchy or scaly that aren’t going away within a matter of weeks — those could be signs of a basal cell or a squamous cell type of skin cancer and you should have those checked,” she said. “The other things to look for on your own skin would be moles that are irregular in shape, that are large in size, that are of irregular color — so if they have multiple color throughout or if they have dark colors like blacks or blues — and then any mole that is changing. So if it just doesn’t feel right to you, it always makes sense to err on the side of caution and to get it checked.”
A baseline skin exam should never be out of the question, Plotner said. Though there are some more predisposed to a checkup. Those that have personally had skin cancer should be checked at least once a year. Individuals who have a family history of melanoma or a strong family history of other types of skin cancers should be examined as well.
“Just sun protect. It’s really going to pay off down the road. I mean there’s so many people in their sixties and seventies that are growing multiple skin cancers in areas that you don’t want to be thinking about having a surgery on like the nose, by the ears, the ear,” she said. “Some of these patients just say if I only would have known. An ounce of prevention is worth a pound of cure.”