Take care when out in the sun

Frank Dunn
Frank Dunn

Heart of the Matter, by Dr Frank Dunn

I am sure George Gershwin did not have the West of Scotland in mind when he composed that classic melody.

This has not been our best summer, and hence relatively few of our local gentlemen have had their “taps aff”.

None the less, we must prepare for the odd sun drenched day in Scotland while many head for the warmer sunnier climes. I remember as a young man sustaining sun burn to my feet and though it was over a small area, I felt very unwell and fainted that evening in a restaurant. It makes me shudder to even think of it.

Much has been written about the degree of protection that sun lotions provide, and we now must assess their protection against both Ultraviolet(UV) A and B. A numerical rating reflects the degree of protection against UVB whereas the back of the tube provides a star rating on the protection against UVA. The main difference between UVA and UVB is that the longer UVA rays cause ageing of the skin, whereas the UVB burn the skin’s superficial layers. Both types predispose to cancer.

Classically it is the burning effect of UVB that is associated with melanoma, but there is mounting evidence that UVA may also have a role in this and other skin cancers. UVA can travel through glass and this is a factor which is infrequently emphasised. Studies have shown that office workers who work with one side of the face towards the window show more signs of ageing on that side.

There are some key messages, should you be fortunate enough to come across warmer sunnier weather this year. Hydration is important, particularly for those of us in the seventh decade and beyond. The combination of heat and dehydration will drop blood pressure. This can be accentuated in patients already on blood pressure lowering pills, including fluid removing tablets, and therefore particular caution is required.

Some drugs exhibit a property known as photosensitivity which increases the likelihood of sun burn. This can happen even in cloudy weather, and both high protection sun lotions and protective clothes, such as a brim hats are necessary. An example of this is a drug to control or prevent irregular heart rhythms, known as Amiodarone, but there are many others.

Some people have innately sensitive skins to sunlight. The most common locations include the “V” of the neck, the back of the hands, the outside surface of the arms and the lower legs. In rare cases, the skin reaction may be severe, producing hives or small blisters, that may even spread to skin in clothed areas. The best approach is prevention, by covering up all exposed skin, and applying high factor lotions.

The are quite a number of medical causes of photosensitivity.

Two examples are systemic lupus erythematosis(SLE) and a rare inherited disorder of iron metabolism known as porphyria. If you observe your skin becoming more sensitive to the sun, it is best to inform your doctor.

One other hazard of the good weather is using alcohol as a means of rehydration, and also to wash down our barbecued food.

There is nothing more enjoyable than a glass of Sauvignon Blanc outdoors. From bitter experience I have learned to go easy. I can only claim partial success. Fortunately for my liver, the balmy sunny evenings are few and far between!