Summer Sun Exposure: A Q&A with Abrar Qureshi, MD

June 23, 2014

Abrar Qureshi, MD, chief of dermatology at Rhode Island Hospital, recently had a paper published regarding the impact of severe sunburns in adolescence on the incidence of melanoma in adulthood for women.

Since it’s summer, we thought this would be the ideal time to share his findings, and remind you to wear sunblock. Be sure to slather it on your children as well.

Child at BeachHow bad/pink does a sunburn have to be in order to be considered dangerous?  

Sun damage to the skin occurs even when the skin is pink or red after sun exposure, long before a blistering sunburn develops. 

The dose of ultraviolet radiation that produces redness of the skin within 24 hours of exposure is called the minimal erythema dose (MED) and we can measure a given person's MED. The MED varies from person to person, depending on their skin color (amount of skin pigment) and their ability to make more pigment in response to sun exposure.

A blistering burn implies sudden massive dose of sun exposure which can be severely damaging to cells in the skin.

When should someone have their skin looked at for possible melanoma risk?  

There are no current national guidelines for melanoma screening in the U.S. The general recommendations from the U.S. Preventive Services Taskforce state that “clinicians should remain alert for skin lesions with malignant features noted in the context of physical examinations performed for other purposes. Asymmetry, border irregularity, color variability, diameter greater than 6 mm (ABCD criteria), or rapidly changing lesions are features associated with an increased risk for cancer. Biopsy of suspicious lesions is warranted.”

Note, a physical examination of the skin by a non-dermatologist is not considered sufficient. In general, fair-skinned men and women older than 65 years, those with atypical moles, and those with more than 50 moles constitute known groups at substantially increased risk for melanoma. Other risk factors for skin cancer include family history and a considerable past history of sun exposure and sunburns.

Is risk of melanoma genetic, or is it based solely on sun exposure?  

The risk of melanoma seems multifactorial and both genetic traits as well as sun exposure are considered risk factors.

What number SPF is best, and do you need to put a sunscreen with a higher SPF on young children or teens?  

The FDA has recently made recommendations for sunscreen use. In general, sunscreen should be broad spectrum, up to SPF 50 and should be reapplied every two hours if outdoors or if sunscreen washes off with swimming or sweating.

Anything else we should know about this research?

Sun exposure is a known risk factor for skin cancer. Severe sunburns early in life as well as continued excessive sun exposure later in life can increase risk for skin cancer.