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No amount of tanning is healthy or safe, warns NICE in latest guidance
Health watchdog the National Institute for Health and Care Excellence (NICE) has issued revised guidance on sun safety to help health practitioners and the public understand how to reduce their risk of developing skin cancer.
NICE is recommending that all adults use a minimum factor 15 sunscreen, and crucially, that enough sunscreen is applied to achieve the correct coverage – 35ml or six to eight teaspoons for adults per application, alongside advice on avoiding vitamin D deficiency.
NICE says that babies, children and those with fair skin - particularly those with freckles or moles and/or a family history of skin cancer - should take extra precautions when it comes to being out in the sun and the correct use of an appropriate factor sunscreen.
Skin cancer is responsible for around 2,100 deaths each year in the UK, with rates steadily increasing since the 1960s. It is thought that in the interim, the popularity of foreign holidays, outdoor pursuits and the use of sunbeds could have contributed to this increase. The risk of developing a melanoma is said to be doubled in those who have a history of sunburn.
However, in view of the fact that many UK adults are said to be vitamin D deficient, NICE hopes to inform the public to enable them to weigh up the benefits of acquiring vitamin D from sunlight against the risk of skin cancer.
Professor Gillian Leng, director of health and social care at NICE, says: "How much time we should spend in the sun depends on a number of factors including geographical location, time of day and year, weather conditions and natural skin colour.
"People with lighter skin, people who work outside and those of us who enjoy holidays in sunny countries all have a higher risk of experiencing skin damage and developing skin cancer.
"On the other hand, people who cover up for cultural reasons, are housebound or otherwise confined indoors for long periods of time are all at higher risk of low vitamin D levels."
Alongside the new guidance, NICE hopes to clarify some common misconceptions about sunlight exposure, including:
- Even if it is cool or cloudy, it is still possible for skin to burn. While solar UV levels are reduced by cloud cover, they can still be intense enough to cause sunburn
- There is no safe or healthy way to get a tan from sunlight and having an existing tan provides minimal protection against subsequent exposure to sunlight
- The use of higher factor sunscreens does not mean that people can spend longer in the sun without burning nor leave longer gaps between re-applications
- Sunscreen should be applied 30 minutes prior to sun exposure, and then re-applied after being in the water, after towel drying or if sweating
- It is not possible to get enough vitamin D by sitting next to a closed sunny window, since vitamin D inducing UVB rays do not pass through glass. However, harmful UVA rays can pass through glass and can cause skin damage
- It is not possible to get adequate vitamin D from sunlight between October the end of March in the UK, therefore a diet that includes vitamin D rich foods or a supplement should be considered.
How can I source enough vitamin D?
Vitamin D is added to some breakfast cereals, margarine spreads and infant formula milk and can also be sourced naturally in foods such as eggs, meat and oily fish. However, experts say these amounts are typically small and not usually sufficient to prevent deficiency.
The NHS currently recommends at-risk groups including pregnant and breastfeeding women, babies and children aged between six months and five years and adults over the age of 65 take a vitamin D supplement.
The Scientific Advisory Committee on Nutrition (SACN) is currently analysing the results of the 2015 consultation on vitamin D and health, the results are expected in the coming months.
For more on vitamin D and the impact of deficiency, see our previous article 'UK urged to take vitamin D supplements to prevent bone disease'.
Keep an eye on your skin
NICE also recommends that all adults regularly check their skin for any possible signs of skin cancer. It says changes to check for include new moles, a growth or lump, or any moles, freckles or patches of skin that change in size, shape or colour. If you notice any unusual or persistent changes, consult your doctor.
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