Slip, Slop, Slap is the motto for using sunscreens

Cover up, wear a hat and use a high sun screen for protection.

Following Valerie O’Connor’s recent column on sunbathing, the president of the Irish Association of Plastic Surgeons, Margaret O’Donnell, warns of the dangers of not using sunscreens.

I would like to correct some erroneous, and potentially dangerous, statements included in a recent article in this newspaper — “Safe sunbathing: Why we need to get out a bit more in the healthy sunshine”, on June 4.

Contrary to what was suggested in the article, the Irish Association of Plastic Surgeons (IAPS) would strongly endorse the use of sunscreens, and the use of other measures to try to prevent skin cancer.

“Skin cancer is the most common cancer in Ireland. Just over 10,000 new cases were diagnosed in this country in 2013. Most cases are caused by UV rays from the sun.” 

This is a quote directly taken from the website of the Irish Cancer Society. 

These numbers far, far, exceed the annual numbers of patients diagnosed with Vitamin D deficiency.

Every day, members of IAPS see and treat patients with skin cancer. It is probably the single most common condition treated by plastic surgeons in Ireland. 

It is of the utmost importance that members of the public take sun precautions if we are to reduce the incidence of skin cancer in Ireland.

The incidence of the two commonest forms of skin cancer (basal and squamous cell carcinoma) has been significantly reduced in Australia by following the very successful public health campaign “Slip, Slap, Slop” which originated in the 1980s.

The motto is: Slip on a shirt, Slop on the 30+ sunscreen, Slap on a hat. It is deeply concerning that the article suggests that a rise in skin cancer is linked to a rise in the use of sunscreens. 

An important scientific study, published as far back as 2002, concluded that skin cancer increases could not be associated with the use of sun creams and recommended continued use of sun protection campaigns as a means to reduce melanoma risk.

While there is no evidence that sun creams cause cancer, there is substantial scientific evidence confirming that skin cancers are caused by exposure to sun. 

Basal and squamous cell carcinoma are the commonest forms of skin cancer and largely attributed to sun exposure. 

This does not simply mean exposure abroad in hotter climates.

It is particularly common in those who spend time outdoors, through work or leisure. 

It is most commonly due to the ordinary, everyday, cumulative sun exposure experienced in Ireland. 

One does not need to become sunburnt, to have received a dangerous dose of sun exposure. 

Those in outdoor occupations, walkers, gardeners, golfers, sailors and cyclists are strongly urged to use sun protection, even on dull days. 

For the same reasons, the Irish Association of Plastic Surgeons would strongly advise against the use of sunbeds.

Melanoma is a more serious form of skin cancer and often related to a history of sun-burn in childhood. 

The Irish Cancer Registry shows a higher than expected incidence of melanoma along the south and east coast. It’s lower in the northwest. 

This increased incidence is directly related to the hours of sunshine per annum (1800 hours per annum in Waterford and Wexford, compared to 1400 in the northwest).

There is no scientific evidence to back the irresponsible suggestion that coconut oil, or buttermilk would suffice as a method of sun protection.

The World Health Organisation advice regarding Vitamin D, is to get 5 to 15 minutes of casual sun exposure to hands, face and arms, two to three times a week during the summer months.

This can be stored by the body for 30-60 days, and can be supplemented in winter months by foods containing vitamin D, and supplements, if warranted.

This level of sun exposure happens during the normal daily routine, nipping to the shop, or collecting the kids, or waiting at a bus stop, and is enough to make a difference. 

Quoting from the Irish Cancer Society website, “extra time outdoors doesn’t equal more vitamin D, but it does increase skin cancer risk”.

No-one would deny the feel-good factor of the sun, but using sun protection allows us all to experience it, address our Vitamin D supply, while keeping our risk of developing some type of skin cancer as low as we can.

Margaret O’Donnell MB FRCSI FRCS (Plast) Consultant Plastic Reconstructive and Aesthetic Surgeon, President, Irish Association of Plastic Surgeons


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