Why outdoor athletes should be wary of skin cancer

By Pete Estabrooks and Chris Welner

Cruising on our feet with the wind in our hair and warm sun breathing life into our bodies is one of the best things about running. For those of us in the northern climes, there are times the only fuel for running on nasty winter days is the thought you are just keeping your conditioning together for those glorious days of spring and summer, when we wear as little as possible to run as long as possible.

But runners always need to be cautious when the sun shines bright.

While there are few studies directly linking long-distance running to skin cancer, the evidence is clear overexposure to, and under-protection from, the sun may lead to problems. Rates of skin cancer in Canada have doubled in the past 20 years, says Vancouver dermatologist Jason Rivers. One in 425 Canadians will face skin cancer and it will kill almost 1,000 people a year, according to 2008 data from Health Canada.

One man who is part of that ominous statistical group is Canadian track medallist Jeremy Deere, owner of Strides Running Store in Calgary and an avowed outdoor athlete. About four years ago, he noticed flaky white skin just inside his hairline near his temple that turned out to be cancer. 

“How could I have skin cancer? I’m barely 30 years old!” Deere says.

Years of running in the sun without sunscreen or a hat placed Deere with an increasing number of relatively young, athletic people to be diagnosed with skin cancer.

A 2006 study by Austrian dermatologist Christina Ambros-Rudolph found runners could be at greater risk of skin cancer because of increased sun exposure, and exercise-induced suppression of the body’s immune system.

In the Austrian study, runners who trained the hardest had the highest rates of skin lesions. The data also suggested exercising on sunny days could be more harmful to the skin because sweat increases the chance of sunburn.

Vancouver’s Rivers, himself a runner, says to be wary of melanomas around the head and neck, which tend to be much more aggressive cancers.

“Clearly people who are runners – athletic people who do outdoor activities – have chronic sun exposure. It is a difficult task to cover up a runner,” says Rivers, a physician at Pacific Dermaesthetics. “If spots change in size, shape or colour, have it looked at by a doctor.”

Calgary doctor Greg Storwick has two approaches to getting the most fun and sun out of your runs with the least damage. Storwick’s initial advice is to run in long-sleeved clothing, with light, ankle-length pants, a hat and a handkerchief covering the back of your neck. After that, any exposed skin should be protected by a layer of 60 SPF sunscreen applied at least 20 minutes prior to exposure.

“If you run outside with your body exposed to the sun, your skin gets damaged,  and that increases your risk of skin cancer,” says Storwick. That risk increases  along with the level of the intensity of the runner’s training schedule as heavy, prolonged exertion can be linked to depressed immune systems.

The UV Index is at its highest when the sun is overhead between 10 a.m. and 2 p.m. Try to avoid UV prime time and lather on the sunscreen. Pay attention to the top of the ears, the nape of the neck, the back of hands and the chest.

Calgary dermatologist Ken Alanen is a advocate of more sunblocks are being made today to withstand the rigours of exercise.

“I am an enthusiastic advocate of zinc, silica and titanium products. They block the widest range of ultraviolet light, especially Ultraviolet A — the wrinkle wavelength,” he says. “They are ideal for the outdoor and athletic types as they don’t sweat off and don’t need to be constantly reapplied.”

Hair is protection. Hair reflects ultra violet light, which means hairy leg runners have it easier in shorts. Athletes who shave their legs require sunscreen on the back of their legs. But hairy, or not, on top, every runner should wear a hat under the sun.

What gets lost is skin cancer’s lag time. Today’s exposure may not be an issue for five or 10 years. The typical runner’s skin cancer takes the form of basal or squamous cell carcinomas – not the type to kill you, but they do require surgical removal. Storwick performs dozens of these procedures every week.

Athletic equipment manufacturers have dialled in to the issue in recent years, with most technical running wear carrying an SPF or UPF rating. Runners should look for clothing that carries a rating from 30 to 50.

Pierre Perron, international marketing director with Louis Garneau in Newport, Vt., says every fabric his company uses has rigid standards it must pass.

“About 90 per cent of our jerseys now are rated at least 30-50 SPF,” says Perron. “But when the market is looking for super- light mesh, breathable material, it’s tough, but we don’t compromise. We try to reach that level.”

Knitting fabric with a tighter weave is the best way to increase its sun protective quality. Manufacturers are also adding special material such as carbon fibres into clothing, Perron says.

Liz Braund, director of performance at the The North Face, says consumers are becoming more aware of the need for sun protection. It’s given rise to products such as neckwear and arm warmers that shield the sun.

“Covering the skin is the most important factor. Even with a high-UPF fabric, if skin is showing then there is protection lost,” says Braund. “Colour also plays a role with white and light colours offering the lowest ratings and colours testing much higher.”

Make sunscreen a habit, the first step as you don your gear. A pre-run ritual includes tying laces, filling water bottles, returning for the keys you left on the counter, feeding the dog, setting your Garmin, re-tying your laces and hitting the trails. That’s an easy 20 minutes for sunscreen absorption. Sometimes sunscreen and sweat don’t mix well, so look for products that are sweat-resistant and won’t drip into your eyes. Rivers says wiping a lip balm onto your forehead can be a good way to avoid the sunscreen sweat-drip.

Deere checks in twice a year with Storwick. In December, a second basal cell carcinoma was discovered on his temple that had to be removed.

“Skin cancer really can affect anyone at any age,” says Deere. “A lot of us grew up not wearing hats, not wearing sunscreen. Not anymore. I’m going to make sure I protect myself and my kids.”

March/April 2011 Issue