1. Sun Protection for Runners Lindsey Goddard, MD & Mona Malakouti, MD

2. UV Light’s Effect on Your Skin Sunburn Aging Skin cancer Immune suppression

3. UVA UVB Skin aging Skin cancer Passes through window glass Tanning booths Skin cancer Skin aging Sunburn UVA vs. UVB

4. Sunburn

5. Photodamage Chronic inflammatory response to UV light

6. Photodamage

7. Ground-Surface Reflection Overhead sunlight protection on eye from upper eyelid Only one significant exposure needed  “Snow-blindness” Reflection values stratified  Low- green grass, foliage  Moderate- sand and asphalt  High- snow

9. Fact Any change in skin color is a sign of damage from UV radiation

10. Fact More than 90 percent of the visible changes commonly attributed to skin aging are caused by the sun The most potent anti-aging product is sunscreen

11. Fact The major risk factor for developing skin cancer is ultraviolet light

12. Actinic keratoses

13. Incidence Skin cancer (abnormal growth of skin cells) is the most common form of cancer in the U.S. More than 3.5 million skin cancers are diagnosed annually 1 in 2 men and 1 in 3 women in the US will develop NMSC in their lifetime By 2015, 1 in 15 Americans will develop melanoma in their lifetime

14. Most common skin cancers Basal cell carcinoma  80% of all non-melanoma skin cancers Squamous cell carcinoma  20% of all non-melanoma skin cancers Melanoma

15. Basal cell carcinoma Intermittent, intense sun exposure (sunburns; blistering) Fair complexion Red hair Tans poorly Family history

16. Basal cell carcinoma Spread to other organs is rare (0.0028-0.55%) But can be locally destructive

17. Squamous cell carcinoma 2 nd most common skin cancer Chronic long-term sun exposure

18. Higher risk of spreading to other organs (0.5-5.2%) BCC and SCC have cure rates of 95% if detected and treated early Squamous cell carcinoma

19. Melanoma

22. Melanoma survival 5 year survival rates for melanomas detected and treated prior to spread to lymph nodes is 95% Drops to 7.5% for distant metastatic disease 75% of skin cancer deaths are from melanoma

23. Other risk factors Light complexion Light eyes Blonde or red hair Many freckles Tan poorly/sunburn easily Many moles Genes Indoor tanning Blistering sunburns  Men’s backs  Women’s lower legs Cumulative exposure to UV radiation  Face  Tops of hands  Tops of forearms

24. Are runners at increased risk? 210 runners vs. 210 non- runners Runners had:  More atypical moles  More BCCs and SCCs  More solar lentigines  All risk factors for melanoma The more miles runners ran, the more skin lesions they had Only 56% of runners reported regular sunscreen use

25. What you can do Avoid peak sun exposure  10 am – 4 pm Wear a hat Wear UV-blocking sunglasses Seek shade Wear UV-protective clothing Sunscreen

26. What does SPF mean? SPF = Sun Protective Factor Measures how long it takes you to BURN with sunscreen compared to without sunscreen If you normally burn within 5 minutes without sunscreen, you would burn within 75 minutes wearing a sunscreen with an SPF of 15

27. Reflectant Absorbent Physical blockers Reflect UV radiation Zinc oxide Titanium oxide Chemical blockers Absorb UV radiation before it seeps into your skin Avobenzone Sunscreens

28. Which is the best sunscreen? The one you will wear!

29. Sunscreen Look for SPF 30 or higher Look for broad-spectrum (UVA & UVB protection) Apply 15-20 minutes prior to exposure Apply before you put on your running clothes You need more than you think: one shot glass or golf ball per adult Have to reapply every 2 hours No such thing as waterproof; sunscreens can be water resistant for 40-80 min

30. Sport Sunscreens Sport sunscreens that get the Skin Cancer Foundation's approval include:  Banana Boat UltraMist Sport Performance Continuous Spray Sunblock SPF 30  Coppertone SPORT Sunscreen Stick SPF 30  Hawaiian Tropic Sport SPF 45  NO-AD Sport SPF 50 Active Sunblock Lotion  Ocean Potion Oil Free Sport Xtreme Sunblock SPF 30  Rite Aid SPF 30 Sport Continuous Spray

31. FDA Sunscreen Regulations Labeling for “Broad Spectrum” covers UVA and UVB  B for Burns! At least SPF 15 to protect against  sunburn  skin cancer  early aging! Water resistance for only 40 or 80 minutes The SPF 50+ rule Oils, creams, lotions, gels, butters, pastes, ointments, sticks, and sprays

32. UV Protective Factor UPF: A shirt with an UPF of 30, for example, means that just 1/30th of the sun's UV radiation can reach the skin www.coolibar.com www.sunprecautions.com www.cabanalife.com www.spfstore.com REI Other sports stores

33. Have a great run!