Young athletes at high risk for developing skin cancer

Aug 15 2005

Thousands of young athletes are at such high risk for developing skin cancer, a University of Cincinnati (UC) dermatologist says, he dreams of the day "when sunscreen is right up there in the locker room next to the Gatorade."

What's more says Brian Adams, MD, a sports medicine specialist at UC and a part-time high school coach, the risks are so high that sunscreen use should be compulsory in outdoor sports.

Dr. Adams says he applauds one rowing coach who benches any crew member who appears for practice sunburned. That, he believes, gets the message across.

According to the American Cancer Society, most of the more than 1 million cases of nonmelanoma skin cancer diagnosed yearly in the United States are sun related. Melanoma, the most serious type of skin cancer, will account for about 59,600 cases of skin cancer in 2005 and about 7,800 of the 10,600 deaths due to skin cancer each year.

Unfortunately, says Dr. Adams, a study he did recently with medical student Erica Hamant revealed that most young athletes ignore the danger.

Reported in the August edition of the Journal of the American Academy of Dermatology, the study showed that 85 percent of 186 NCAA soccer players and cross-country runners at four Cincinnati-area colleges used no sunscreen during the previous seven practice days. Ninety-four percent admitted they used sunscreen on fewer than three days during the previous week.

"The NCAA has medical guidelines for wrestlers, football players and others," said Dr. Adams, "but using sunscreen in outdoor athletics, which is very, very important, just isn't part of the culture.

"The well documented consequences of not using sunscreen all point to the fact every locker room should have sunscreen right up there next to the Gatorade."

What is part of the culture, Dr. Adams laments, is "the tan."

Although a tan wasn't "hip" in earlier times, he said, "unfortunately today if you have a little color you're perceived as being healthy or better looking.

"The problem is that a tan is a bad response. It's the body's last attempt to protect itself against ultraviolet (UV) light damage and the subsequent mutations that UV rays induce in the skin cells. It's your skin's way of saying please stop the madness!"

Forty-six percent of 139 athletes who gave reasons for not using sunscreen blamed lack of availability, and 33 percent thought they didn't need it because of various misconceptions. Others said they didn't consider the weather hot enough for sunburn.

However, said Dr. Adams, only 1 percent of the athletes said they didn't use sunscreen because it hurt their eyes, commonly thought to be the reason they ignore it.

The American Academy of Dermatology Web site recommends avoiding sun exposure from 11 a.m. to 4 p.m., "exactly the times when most teams are out practicing, be they soccer players, long-distance runners, or tennis players," Dr. Adams pointed out. "They're getting an enormous amount exposure to UV light."

Outdoor athletes are also in double jeopardy, because sweating exacerbates their risk, Dr. Adams said. Perspiration on the skin lowers what's called the minimal erythema dose, the lowest UV exposure needed to turn the skin barely pink.

"You've already set yourself up for trouble by not using sunscreen," Dr. Adams said, "and now by sweating you're making it worse. Think about that the next time you see all those men jogging around town without their shirts on.

"Nearly 20 years ago when I was in college running at 3 p.m. and getting burned and tanned, there wasn't as much knowledge about the risks as we have now, and there weren't as many sunscreen products--especially for sports enthusiasts.

"Today there are plenty, so there's no excuse for this risky behavior, on or off the sports field."

Skiers have it even worse, Dr. Adams says. Not only is 11 a.m. to 4 p.m. prime time for lift tickets, but UV light on the high slopes isn't "filtered" by the pollution found in the atmosphere at sea level, and it's even intensified by the white snow.

Studies have shown that sun exposure at noon in Vail equals that at the same hour on a Florida beach, said Dr. Adams. "Because it's cold on ski slopes, people who typically have their face and hands exposed tend not to wear sunscreen. Whereas on the beach they feel hot and are more aware, and they're influenced by the fact that everyone around them is using sunscreen."

The solution, Dr. Adams suggests, is relatively simple and could cost organizations like the NCAA--with its 250,000 outdoor athletes--very little or even nothing.

"All the NCCA and the other conferences, colleges and clubs need to do," he said, "is install a huge container of sunscreen in the locker room, where it's impossible to avoid. Manufacturers would probably donate product for the promotional value."

Infrastructure is already in place through the various sports organizations for educating outdoor athletes about the risk, Dr. Adams said. Preventive programs could easily be integrated into daily practice and competition regimes.

And enforcing a sunscreen rule should be a snap.

"Young athletes are at the right age to learn good habits that they can take into adulthood," he said, "and most kids heed their coach more than they do their parents."