Understanding the impact of the sun on the skin

Stepping out to a bright and sunny day is par for course in most parts of India, for the better part of a year. The sun, while no doubt a boon, also had its flip side. What many people do not realise is that the sun’s rays could be silently harming your skin. While there has been a lot of awareness recently about the importance of sunscreen and skincare, often, this advice is not taken very seiously.

To understand why this is important, we must first understand the effect of the sun’s rays on human skin. The occasional exposure to harsh sunlight a sunburn or temporary tan may seem harmless, but the effects can go deeper. Ultraviolet rays silently harm your skin, breaking down collagen, speeding up wrinkles and leaving behind dark spots that don’t just fade away with time. You may not even notice the damage until years later.

Think of your skin as a diary that keeps track of the days that you skipped sunscreen. Whenever you stepped out without sun protection, even for a short while, it has affected your skin. At first, this doesn’t seem like a big deal but over time, all of this exposure adds up. Before you know it, your skin starts showing signs of premature ageing, sunspots and in serious cases, even skin cancer. So, the next time you step out, ask yourself: Is my skin really prepared to take the heat?

Understanding UV Rays

The sun emits ultraviolet (UV) radiation, which is divided into two types: UVA and UVB rays. Both types can cause cause damage to your dermis (the middle layer of your skin) and they do so in different ways.

UVA rays penetrate deeply into the skin, affecting its deeper layers. Over time, this damage weakens the skin’s structure leading to premature aging with signs like wrinkles, fine lines and sagging. UVA rays are present throughout the day and can even penetrate through windows, meaning you’re at risk whether you’re outside or inside.

While UVB rays don’t penetrate as deeply as UVA rays, they are responsible for the visible effects of sun exposure such as sunburns. UVB rays are stronger in the summer months and are most intense between 10 a.m. and 4 p.m. Sunburns caused by UVB rays can result in red, inflamed dermis that is often painful. Repeated sunburns increase the risk of skin damage and even skin cancer.

What are the types of skin cancer?

There’s no doubt that our skin is exposed to a lot of factors — pollution, weather changes and ultraviolet (UV) rays from the sun. Too much exposure to these rays over a long time, can damage the DNA in our skin cells, causing them to grow abnormally, which ultimately leads to skin cancer.

Some of the main types of skin cancer include: Basal Cell Carcinoma (BCC) – This most common form of skin cancer which usually appears as a shiny bump, pinkish patch, or an open sore that doesn’t heal. It is a slow-growing cancer but can cause serious damage to your skin if you ignore it. Another type is Squamous Cell Carcinoma (SCC) – This is a little more aggressive and often looks like a scaly, red patch or a wart-like bump. If untreated, it can spread to other parts of your body. The third type is Melanoma – This is the most dangerous of the skin cancers, and can develop in the shape of a mole, which means you may not realise what it is, as it is is only in very rare cases that one notices a new, oddly-shaped dark spot. Melanoma spreads quickly, making early detection crucial.

Other types of skin cancer include Merkel Cell Carcinoma and Primary Cutaneous Anaplastic Large Cell Lymphoma (C-ALCL).

The Indian scenario: protective effects of melanin

The rate of skin cancer in India is generally lower compared to that of other countries, and the reason is the presence of melanin. Indian skin is so rich in melanin that it not only blocks UV radiation from entering deep into our dermis but also absorbs and scatters UV radiation, reducing DNA damage. Therefore, lack of melanin is also a cause of skin cancer.

Furthermore, there is a balance between melanin’s protective effects and the body’s need to produce vitamin D from sunlight. People with darker skin have more melanin, while those with lighter skin have less. The former requires more sun exposure to produce adequate amounts of vitamin D compared to the latter. And so, skin protection entails finding the right balance between UV exposure for vitamin D production and protection against skin damage.

There are two kinds of melanin – Eumelanin and Pheomelanin. People with darker skin typically have more eumelanin which offers more protection against UV radiation, which makes individuals with darker skin tones less prone to developing skin cancer. Lighter-skinned individuals tend to have a higher proportion of pheomelanin, which provides less protection against UV radiation. Also, pheomelanin may increase the risk of skin damage as it can generate harmful reactive oxygen species (ROS) when exposed to UV light, thus contributing to skin cell damage.

The risk of skin cancer in India depends upon several factors including geographic location, skin type, exposure to the sun and more. For instance, it is observed that the risk is comparatively high in North India compared to South India due to the difference in skin tones. Additionally, those who work in coastal and high altitude areas (for example, farmers and fishermen) are exposed to significant amounts of UV rays, which in turn increases their chances of getting skin cancer.

Increasing awareness therefore, as well modification of some lifestyle choices are essential to reducing the rates of skin cancer in India. .

The importance of skin care

Your skin is your body’s first line of defence, A few mindful habits can help safeguard your skin and reduce the risk of skin cancer. Prioritise the application of sunscreen: a broad-spectrum SPF 30+ sunscreen should be part of your daily skincare routine and not just for outdoor activities. Apply it generously and reapply every two hours, even during winter and monsoon, as UV rays can still reach you. Limit sun exposure during peak hours – the sun’s rays are strongest between 10 a.m. and 4 p.m. Try to seek shade whenever possible and plan your outdoor activities accordingly. Wear protective clothing – Your clothes can act as a powerful shield against deadly UV rays. Wear long-sleeved tops and shirts, wide-brimmed hats, along with sunglasses that come with UV protection which provide an effective barrier against the harmful sun rays. Monitor your skin regularly – always check for new or changing moles, spots, or lesions. The earlier you detect these odd patches, the more effective your treatment can be. Stay hydrated and maintain good health – Proper hydration and a nutrient-rich diet will support skin resilience and overall health. Also remember to go for your regular check ups with a dermatologist.

Protecting your skin is a lifelong commitment that ultimately pays off in the long run. By incorporating sun-safe habits, staying vigilant about bodily change and seeking immediate medical attention when required, you can significantly reduce the risk of skin cancer. Additionally, prevention and early detection are key to maintaining a healthy skin, thus ensuring both safety and well-being for years to come. Lastly, your skin is always changing with time and age so if something looks unusual, don’t just ignore it: get yourself checked.

(The author is a consultant and clinical lead for medical oncology at Narayana Health City, Bengaluru. dr.nidhhitandon@gmail.com)