Staying safe in the sun

Dr Jane Wilson-Howarth answers the ten key questions about staying safe while you’re having fun in the sun

8 mins

Q. Do I really need to bother with sunscreen?

A. Yes. Sunburn can strike after as little as 30 minutes of sun exposure and treatment may not be covered by your travel insurance. More seriously, malignant melanoma is strongly linked to excessive sun exposure, sunbed use and sunburn. Nearly 13,000 new cases of malignant melanoma are recorded in the UK each year, and numbers are rising steadily. There are currently 2,200 deaths from the disease each year. Cure rates are improving: 84% of men and 92% of women survive five years. Other sun-related kinds of skin cancer account for a further 550 deaths in the UK annually.

Q. Will a high SPF sunscreen protect me all day?

A. Sadly, no sunscreen is that good. Reapplying sunscreen is the only way to stay protected. Unfortunately it isn’t easy to say how many times a day you need to reapply it – that will depend on how many times you swim, how sweaty you are, whether it gets wiped off with a towel or rubbed off on the sand.

Evidence suggests that a middle-strength sunscreen (SPF 15-25) reapplied a couple of times during the day will give good protection in most circumstances. But do buy new sunscreen each year – it becomes less effective if it’s been hanging around in your bathroom cabinet. Using ‘stronger’ sun protection stops you burning, but it doesn’t completely protect from the wavelengths causing ageing and cancer. The potential pro of using ‘weaker’ sunscreens is that the discomfort drives you into the shade – and, of course, more bog-standard products are cheaper than SPF 50 or ‘total’ sun blocks.

The University of Strathclyde has developed a simple sun dosimeter – a wristband that changes colour to indicate that the wearer has been exposed to a certain amount of radiation. However, I feel that those most at risk of burning are not likely to spend money on this.

Q. If I continuously reapply a high-SPF sunscreen, is it OK to lie out in the sun all day?

A. No. You shouldn’t, even with sunscreen on. Even if you are lucky enough not to burn, you will be increasing your risk of skin cancer, and damage will be done to the skin that makes it look prematurely aged. It is also quite easy to get over-heated and dehydrated – this can lead to kidney stones, which are simply excruciating. Hats and good sunglasses are sensible additional summerwear; these also slow the development of cataracts.

Note that the skin can become supersensitive to sun exposure if you’re taking certain medicines – pack the information leaflet of any medicines you’re taking. Also, some plants can sensitise the skin including: angelica, bergamot, cashew fruits, cow parsley, dill, figs, giant hogweed, mango sap and St Johns Wort.

Q. Sunstroke, heatstroke, heat exhaustion – what are the differences and how do I recognise them?

A. Sunstroke is a misnomer, but it’s the same as heatstroke. You don’t need to be out in the sun to get heatstroke, but it creeps up on you when you get too hot, don’t drink  enough and try to do too much. Heat exhaustion precedes it. Symptoms of heat illnesses start with feeling nauseated and faint. That’s when you need to get yourself somewhere cool to rest and drink plenty of non-alcoholic beverages.

You need to drink enough so that you pee a reasonable volume of light-coloured urine at least three times in 24 hours.

The important message is to slow down to the pace of the people around you. If you’re in pre-monsoon Delhi and try to rush around as you would at home, you’ll just keel over and – at best – feel very ill. At worst the results are brain damage or death.

Q. Why is the risk of food poisoning higher in hot countries?

A. The risk of food poisoning is significant when you travel – and even when you eat out in your home town. Research suggests that on a trip to northern Europe or the northern part of the Americas you have about a 4% risk of gastroenteritis, whereas it might be nearer 30% in the hottest part of the year in the Mediterranean. If venturing to the tropics, the risk is higher still.

Food degrades faster in hot climates, and some tropical destinations also have the additional challenge of intermittent power (and refrigeration) as well as more flies. Freshly cooked foods will be far safer than salads, and thin soups are rehydrating and surprisingly refreshing when the climate is hot.

Q. Are other ailments more likely in the heat?

A. Cuts and grazes can be more problematic. The more you sweat and the more flying insects there are, the more likely it is that any scrape will fester. Once infection has started, it seems to spread faster when skin in warm and full of blood. Pack an antiseptic: Savlon Dry iodine spray is small, portable and excellent for stopping wound infections.

Q. I have heard reports of campers being poisoned in their tents. How does that happen?

A. This issue is more pertinent to those spending summers in Britain or cooler regions. Gas or disposable barbecues (and poorly maintained gas heaters and boilers in rented cottages or hotels) produce significant amounts of poisonous carbon monoxide when they burn. It stupefies, brain-damages and kills. There have been a number of sad accidents where people have died as a result of barbecues being brought into tents so that cooking could still happen despite poor weather, or to provide warmth. This risks poisoning and the possibility of fire. Feeling unusually drowsy or headachy can be a first sign. Never bring a barbecue inside.

Q. How do you know a dodgy diving school from a good one?

A. It is vital to be cautious when signing up to any hazardous sport when away from home. Some disreputable outfits may hard-sell scuba diving to people who can barely swim, with equipment that may not be well maintained and under the supervision of unqualified instructors or dive-leaders. If you don’t understand how buoyancy works you could sink like a stone, fatal if you are diving into water more than 30m deep.

Check the paperwork before trusting your life to others; the most widely recognised qualifications are through PADI. Start in shallow waters.

Q. How likely are you to be harmed by or on a jetski?

A. If indulging in high-adrenaline holiday activities, it is important to be aware of the risks. Fortunately jetski accidents are few (fewer that road accidents, for example), but when they do happen the injuries can be grave.

Swimmers must observe notices that may serve to segregate them from boat-users. Most importantly, anyone hiring a jetski should be aware that there may be other incompetent drivers around.

Q. Should I be worried about jellyfish?

A. That depends where you are. Australian jellies have a deservedly bad reputation but lifeguards trawl for them and warn bathers. Wearing tights for protection – one pair conventionally and a second on your top, with your head through a hole cut in the crutch. Away from the Antipodes, jellies are unpleasant rather than a big risk, but be wary after storms or if there is a lot of weed in the water – jellyfish stingers can still sting when broken off the animal, and swimming in weeds seems to be a good way of encountering them.

Sting treatment varies according to where you are. Acetic acid is best in Australia; most northern hemisphere species are best inactivated by alkaline solutions. Showering in freshwater makes things worse.

More information

The Cancer Research UK SunSmart site is home to lots of useful information on staying safe in the sun.

More information

The British Association of Dermatologists offers info about skin and skin diseases including sun awareness and how to check for signs of skin cancer.

Sunburn the numbers:

20% of Brits don’t plan for the weather and get caught out without sunscreen

66% of women use sunscreen of at least SPF15
37% of men use sunscreen of at least SPF15
50% more men than women forget to protect their skin
75% more men than women are not worried about getting sunburned

Source: Cancer Research UK

Dr Jane Wilson-Howarth’s travel memoir A Glimpse of Eternal Snows is enjoying some success in North America as well as on this side of the pond; 

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