Skin Cancer Awareness with Lupus Patients
Each year over one million cases of skin cancer are diagnosed and this number has been on the rise for the past few decades. The main cause of the disease is excessive exposure to UV rays from the sun. It is the sun burning ultraviolet B (UV-B) rays in sunlight that are particularly bad for lupus patients. What most people may not realize is that while skin cancer is the most common form of cancer, it is also the most preventable.
It is important to note the sun’s UV rays are broken down into three categories.
1. UVC, which does not reach the earth.
2. UVB, which are the “burning rays,” of which 90% are blocked by the ozone layer (or what is remaining of the ozone layer!)
3. UVA, which are the “tanning rays,” are present throughout the day and are not blocked by the ozone layer.
Dr. Saperstein states, “We used to feel that only UVB was important for skin damage.  However, new evidence is showing UVA to be as important, if not more so, in the development of skin aging and skin cancer.  It is the UVB rays which are the most important rays responsible for lupus flares, but some patients react to UVA as well.”
There are two types of skin cancer: melanomas and non-melanomas. Non-melanomas include basal cell cancers and squamous cell cancers, which are the most common skin cancers. Non-melanomas rarely spread to elsewhere in the body and are not likely to be fatal. Nonetheless, they should be treated. Otherwise, they can lead to large growths and cause scarring and disfigurement.
Melanoma is much less common than non-melanoma skin cancers, but it is likely to be much more invasive. However, like non-melanoma skin cancers, it is treatable if it is caught in the early stages. It is also more likely to spread to other parts of the body if it is left untreated.
With UV rays causing premature aging, wrinkling, pre-cancerous conditions and skin cancer. Exposure to UV rays can also increase the risk of cataracts and other eye problems, as well as, trigger flares in SLE patients. It isn’t possible to avoid sunlight, but exposure to UV rays should definitely be minimized by everyone. 
Here are just a few ways you can protect yourself from the UV rays of the sun:
Limit your outside activities during the peak hours of the day between 9:00 a.m. and 3:00 p.m.
Stay away from reflective surfaces, such as sand, snow and concrete that increase exposure to UV light, reflect an additional 85% of the UV radiation.
An overcast sky does not reduce the UV substantially and only provides minimal photo-protection from the UV rays (80% of ultraviolet rays get through on a cloudy day).
Wind and high altitude increase your ultraviolet radiation.
Some clothing can effectively block UV rays.  The tighter the weave, the better the protection with the thickness of the clothing being more important than the color.
Stay covered by wearing a hat, long sleeve shirts and pants.  Thin, loosely woven materials allow UV light to penetrate through to the skin.  If you are very sensitive to the sun, there is also specially designed UV-protective clothing available.
There is FDA approved fabric with an SPF 30+ manufactured by Solumbra (1-800-882-7860) that both blocks greater than 97% UVA and UVB rays and has been recommended by thousands of doctors.
Umbrellas can also provide protection.
Wear Sunglasses with 99-100 percent UV-A/UV-B absorption to protect your eyes and eyelids.  
Use a sun block with a minimum of SPF 15.
Use sun blocks and sunscreens that contain zinc oxide, titanium dioxide, and red veterinary petrolatum that block both UV-A and UV-B light.  
If sensitive, use a sun block that is PABA-free (para-amino benzoic acid). Use a chemical free sun block (containing Titanium dioxide) if very sensitive or if one is younger than 6 months of age.
Apply sunscreen 30 minutes prior to going outdoors, in order to allow it to be absorbed by the skin, to all areas of the body that will be exposed to the sun. 
Re-apply sunscreen every two hours and after going into the water. If your sunscreen is waterproof, reapply as well. Waterproof and water resistant sunscreens only offer 40-80 minutes of protection. UV rays can also pass through water.
Replace your sunscreen products at least every 2 to 3 years. Check the expiration date on the container. Sunscreen products lose their effectiveness over time.
If you wear makeup, try hypoallergenic brands that include UV protection.
For the face and chest, use a product which is noncomedogenic (does not block the pores) and is hypoallergenic.
The best way to provide protection against the sun for your lips is to apply a lipstick, gloss or balm that contains sunscreen.
Did you know that many cases of skin cancer and melanoma link back to bad sunburns and exposure as a child? Children especially need to stay out of the sun, wear sunblock and other protective clothing like hats. 
Seek the shade, not only to keep you cooler, but it will reduce your exposure.  Practice the shadow rule and teach it to your children.  If your shadow is shorter than you, the sun’s rays are at their strongest.
Remember that glass only blocks out UVB completely.  Adding a tinted filter will block out UVA as well.
Also limit your exposure to fluorescent and halogen light bulbs, which also give off UV light. This includes tanning parlors that are dangerous today but even worse for your tomorrows.
Contact your doctor immediately if any rash or sore appears or gets worse.
Remember, have fun and embrace a physical outdoor life, but always use good sun sense, sun protective clothing, and a sun block.  “The less sun your lupus and skin get, the healthier you will be,” states Dr. Saperstein.
Harry W. Saperstein, M.D., member of Lupus International’s Medical Advisory Board, UCLA Pediatric Eursion of Dermatology Chief of Adult and Child Dermatology, Cedars Sinai Medical Center