Introduction

Exposure to sunlight is influenced by geography, climate, and time of day and year. Countries near equator and at higher elevation receive more ultraviolet (UV) rays. Sunlight exposure is highest during summer. The sun is strongest between 1000 and 1600 hours.

Outdoor activities whether on snow and light-coloured sand, reflect UV light and increase sunburn risks (UV rays from above and below). Many drugs (e.g. diuretics, Tetracycline, Doxycycline, sulfa antibiotics and non-steroidal anti-inflammatory drugs, etc.) may increase sensitivity to sunlight and risk of getting phototoxic rash (similar to sunburn). In addition to the skin, eyes can get burned from intense sun exposure.

Those who have outdoor occupations or recreations (e.g. golf, gardening, skiing or sailing) are at risk.

Sign & Symptoms

Sun induced skin damage is cumulative. A tan is a sign that the skin is trying to protect itself from further damage.

Exposure of the eyes may result in acute keratitis (eg: snow blindness)

Complication

Long term adverse effects

• Development of skin cancers (carcinomas and malignant melanoma)
• Development of cataracts after long term damage.
• Accelerated ageing of the skin, mainly due to UVA radiation which penetrates more deeply into the skin

Treatment

• Drink plenty of water to prevent dehydration.
• Apply moisturizer on the dry skin.
• See doctor for advise and treatment

Prevention & Precautions

Specific advices to prevent adverse effects of sun exposure include:-

Protection through sunscreen

• Apply sunscreen at least 20 minutes before going out into the sun. Reapply at least every 2 hours and every time after getting out of the water or on sweating. Never stay in the sun for excessive periods of time in the belief that sunscreen will offer unlimited protection. Sunscreens alone cannot prevent cancer. Minimum strength usually used is SPF 30.

Protection through clothing

• Wear protective attire – sunglasses, clothing of tightly woven fabric and a sun hat covering neck, ears and back of neck. To avoid prickly heat, keep children in the shade as much as possible in loose, 100% cotton clothing.

Protection through life style changes

Some people consider a good tan to be ‘fashionable’. However, simple lifestyle changes, as well as ‘everything in moderation’ can help people lower risk of skin cancer. Avoid the sun between 1000 and 1600 hours.

At destination, gradual exposure to the sun is far safer. Seek natural shade in the form of trees or other shelter especially for children below 6 months old. Drink plenty of non-alcoholic drinks while in the sun, to prevent dehydration. If on any medication, check whether it can make the skin more sensitive to the sun.

References organisation/ support

International Travel & Health, WHO 2006

www.dph.gov.my/cdc/childhoodimmunisation