Slip, slop, slap: Staying sun safe as an older person

Key points:

• Older people are more likely to develop skin cancers because they have had more time to be exposed to ultraviolet (UV) radiation

• Sunscreen should be your last line of defence, the best action is covering your skin with clothes

• Your medication can make your skin more sensitive to UV and lead to worse sun damage outcomes

However, Heather Walker, Former Chair of the Skin Cancer Committee for Cancer Council Australia, said you should always make an effort to protect your skin against harmful ultraviolet (UV) rays.

In the 80s, the highly successful Sun Smart campaign from Cancer Council Australia started, leading to a reduction of melanoma in under-40s age groups. However, many older people didn’t grow up in the sun-smart era and didn’t know how to reduce their risk.

“The [older generation] missed out on the sun smart message for some of their lives, but it is never too late, and it is really important to reduce that further damage adding up,” explained Ms Walker.

“It might be that older people think, well, the damage has been done in the past. You hear horror stories of people using oil, oiling themselves up and roasting in the sun perhaps before realising the dangers.

“It is really important to mention that even if damage has been done in the past, you can prevent further damage at any age.”

Older skin and UV radiation

Older people are already more at risk of skin cancer because they have lived longer and had more chances of being overexposed to UV radiation.

“With any cancer risk, just like smoking, the more you are exposed to the risk the more likely you are to then develop problems that lead to cancer,” explained Ms Walker.

Every time your skin is exposed to damage, the skin can repair a lot of that damage. However, the more damage your skin takes, the harder it is to repair.

When you see skin peeling from a really bad sunburn, it means your skin is damaged beyond repair, so your body is getting rid of those damaged cells rather than repairing them.

Over time, your body may be less able to combat skin damage, which could lead to skin cancer.

“It depends on the dose [of exposure] and because the rest is accumulative, the older we are, the more chance we have had risk from the sun,” she said.

There are many ways that UV rays can affect an older person’s skin or cause more serious conditions, which can include:

• solar (actinic) keratoses, also known as sunspots or rough/scaly patches;
• increase the number of wrinkles on a person;
• reduce skin elasticity;
• non-melanoma skin cancers, such as basal cell carcinoma and squamous cell carcinoma – which is very common in Australia with over a million treatments for these types of cancer every year; and
• lead to the more deadly, but less common, melanomas with roughly 17,756 cases estimated in 2022.

Ms Walker added that people think a tan is a sign of health, however, she said there is nothing healthy about a tan.

The Cancer Council wants people to be mindful that incidental exposure is really common, which includes gardening at home, walking to get a coffee, or having a backyard BBQ.

“It is the same sun and it is still the same UV that can do the damage. It’s important to not just be concerned about burning but also that exposure leads to tanned skin because tanning is a sign that your skin is already damaged and trying desperately to protect itself against further damage,” explained Ms Walker.

Risk factors for sun damage

All people are at risk of UV exposure, however, some people can be more at risk of getting sun damage or skin cancer including:

• older people due to their age;
• people who have worked outdoors for long periods of their lives and have been exposed to more UV radiation;
• family or personal history of skin cancer;
• having fair hair, light-coloured eyes — like blue or green — or fair skin;
• a history of bad sunburns;
• medications that increase photosensitivity; and
• someone who is immunocompromised.

If you are at high risk of developing skin cancer or more susceptible to sun damage, talk to your health professional about surveillance plans, for example, how often you should get your skin checked by a professional.

People with average risk should get to know their skin and monitor for any skin changes. If you notice anything unusual, go to your GP to get it checked out.

The five steps of sun protection

While everyone knows the slip, slop, slap motto, Ms Walker found that people tend to think of sunscreen first when they hear the phrase ‘sun protection.’

However, sunscreen should be the last line of defence when it comes to protecting yourself from the sun.

Here are the five steps to sun protection:

1. Wear sun-protective clothing

Covering as much skin as possible with clothing is really important as your body will be less exposed to UV rays. This is considered the first line of defence, as applying sunscreen incorrectly is easy whereas it’s hard to put on a shirt incorrectly.

2. Slap on a sun smart hat

While people like to wear baseball caps, they do not protect your neck and ears from being exposed to the sun. Cancer Council Australia recommends wearing either a broad-brimmed hat, bucket-style hat or legionnaire hat, which all provide adequate protection from UV rays.

3. Put on shades

Sunglasses are a great way to protect the skin around the eyes and your eyes from UV rays. The Cancer Council recommends wearing close-fitting, wrap-around style sunglasses to protect more skin on your face.

4. Find shade to sit under

If you go to the beach or the pool, try to sit in the shade under an umbrella, a gazebo or a tree. However, be mindful that the sun moves across the sky, so you may need to reposition yourself when the sun moves.

5. Apply sunscreen correctly and regularly

Use sunscreen that is SPF (sun protection factor) 30 or higher, is broad-spectrum, which means you are protected against both UVA (leads to skin ageing) and UVB (leads to skin burning), as well as water-resistant. 

Apply sunscreen 20 minutes before you go outside and reapply every two hours with other measures as well. If you are swimming, sweating or towelling off, you should reapply sunscreen more often than every two hours.

Ms Walker added that sunscreen can give people a false sense of security because when applied incorrectly, it can put you more at risk.

Medication and sun exposure

Many people don’t know that certain medications can actually make you more photosensitive, this means your skin is more sensitive or has unusual reactions when it is exposed to UV radiation.

This sensitivity can put you more at risk of sunburn or rashes and you are more likely to experience these issues even if you only have had limited exposure to UV radiation.

Common medications that can cause photosensitivity include:

• Antibiotics
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• Antipsychotics
• Target therapies
• Certain other drugs

It is important to check with your GP or pharmacist about any photosensitive side effects you may experience from medication and take extra care when putting on sun protection.

Sun safety to remember

A lot of people don’t realise that just because the sun is out doesn’t mean there is UV radiation. Similarly, just because a day is overcast it doesn’t mean there is no UV radiation.

You need to be mindful that UV can be present during certain hours of the day. It could be a really hot day at 5 pm in the afternoon but the UV radiation is really low by that point, whereas at 1pm in the afternoon in summer the UV rate will likely be quite high. This is why it is important to know what times you should be protecting yourself and implementing sun protection.

You should be implementing sun protection strategies if there is a UV index of 3 or above.

Cancer Council Australia has a free Sunsmart app, which can be downloaded from Google Play or the Apple AppStore, that can give you daily readings of UV levels, along with explanations on what you should be wearing or how much sunscreen you should apply.

Another important factor to consider is that UV rays can reflect off of surfaces, like water, concrete and snow.

Ms Walker added that older people undertaking sun protection are also great role models for grandchildren as young children tend to mimic adults and what they do. Promoting sun protection not only protects yourself, but also instils good sun-safe behaviours in the younger generation from an early age.

Do you make sure to slip, slop, slap during the summer? 

Let the team at Talking Aged Care know on social media. 

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Related content:

Preparing for hot Australian weather
Staying safe during long heatwaves
Hydration for elderly people and the dangers of dehydration