Sun damage 101

Sun damage 101

Give your skin a better future.

It’s the perfect time for a skin audit. The holidays are over and you may have resolved to take a little better care of your skin this year. We chatted to Dr Janine Ellenberger about the sun, ageing, melanoma risks and a healthy regime for the new year…

What are some of the myths about sun damage?

‘Not all sun damage is done before the age of 18, as many people think. Just 23% of skin damage is sustained in the first 18 years of life; 47% up to the age of 49; 75% up to the age of 69, and 100% by the age of 90.’ The good news is that even from your 40s, you can turn around your skin’s future by adopting better habits.’

Did you know? 

Mauritius, Hawaii and Palau are just some of the islands that have banned the use of chemical sunscreens due to
their damaging effects on coral reefs. Oxybenzone and octinoxate are among the problem ingredients, and they’re
found in 3 500 sunscreens worldwide. They cause coral bleaching and disrupt coral DNA, threatening marine life.

  • 5 sunburns in your lifetime up your risk of melanoma by 50%.
  • 97% of melanoma victims under 30 have used sunbeds.

Staying out of the sun can affect our vitamin D levels. What are some of the symptoms of vitamin D deficiency?

‘Fatigue and depression, among others. Deficiency can also lead to autoimmune disorders and cancers. It’s important to know your levels, just as you do your cholesterol levels. You do still need to avoid being in the sun between 10am and 4pm, even though it’s the best time for vitamin D absorption: the UV rays are just too strong. Rather go out into the sun after 4pm, or take a 400iU vitamin D supplement. As our absorption of certain vitamins becomes less efficient after 50 (especially B, C and D), check your levels at your next blood test, and supplement if needed.’

As some of us age, we notice what looks like white freckles on our skin. Are these dangerous?

‘These are cases of hypopigmentation, meaning there is no melanin in that area. Melanin is there to protect your skin so, effectively, there’s no protection in these spots. Those areas need extra protection. Sometimes white spots on the skin are a fungal infection known as tinea versicolour, slightly larger and sometimes dry and flaky. This is where the fungus is actually feeding on the melanin. The condition is easily treated with anti-dandruff shampoo.’

South Africa has the highest incidence of melanoma, although Australia tops the list for the greatest ozone risk. This speaks to late detection. Why are we still battling this problem when the message is so well covered in the media?

‘South Africa is a very sunny country. You need year-round protection in most parts of it. Furthermore, many people don’t have adequate medical cover, so many don’t act on their concerns in time. Then as you age, your eyesight worsens, so many older people are at risk of late detection. There’s also a higher risk among single people. If you aren’t in a relationship, changes to your skin, particularly on your back, may not be noticed.’

Risk factors for melanoma include:

  • Sunbed use
  • Sun exposure
  • Genetics (family history of melanoma)
  • Red hair
  • History of sunburn
  • Patient history of any other cancer

Did you know? 

Bob Marley died of melanoma. He had a tiny spot underneath his toenail, but by the time they caught it, it had spread
to his brain, liver and lungs. He was just 36. Darker skin tends to get melanomas on the soles of the feet, hands, under the nails, areas with less melanin, as well as the eyes. It’s very important to wear proper sunglasses, because you can get melanoma of the eye, and then it spreads straight to the brain.’

Is black skin any less susceptible to melanoma?

‘The incidence of melanoma among black South Africans is 1-2%, and when melanoma occurs, it can be more aggressive. As potentially dangerous moles are less visible on darker skin, you don’t always see them in the early stages, so mortality also tends to be high.’

What can you do to heal sun damage?

‘There’s no quick win, and you have to start with a good sunscreen. Then focus on healing your skin, giving your skin
time to recover from sun exposure and inflammation. Stop the mechanism of damage entirely for six months. After a few skin cycles (each cycle lasts around 28 days), your skin’s DNA will have normalised. If you then begin a course of peels or laser the results will be so much better than on damaged skin. Use a good sunscreen during the day, a cream containing topical vitamin A and antioxidants at night, and a vitamin C and E containing cream with antioxidants to use both day and night.’

Are there any illnesses that make you more prone to sun damage?

‘Medications certainly can. Anyone taking antidepressants, thyroid medication and antibiotics needs to take extra precautions in the sun. And because chemotherapy drugs suppress the immune system, cancer patients are also
especially vulnerable.’

What have been some of your more surprising melanoma cases?

‘I had a patient, a nine-year-old boy with dark skin. We couldn’t figure out what was wrong with him, but eventually,
we discovered melanoma on his scalp. A 46-year-old male was another puzzling case. His melanoma had started on his retina, and then spread to the brain.’

Why are melanoma rates skyrocketing, when we’re using more sunscreen than ever before, and the hole in the ozone is closing?

‘Nobody asks this. Perhaps it’s a false sense of security? We’re also putting a lot of chemicals on our skin, and it absorbs 60% of what we put on it. Chemical sunscreen works by absorbing the sun’s rays and pushing free radicals into the skin. Free radicals are charged, abnormal molecules, and they cause inflammation. Physical sunscreens reflect the sun’s rays, and good ones are packed with antioxidants to counter free radicals. Used correctly, you won’t
burn, and you also won’t get inflammation on the skin. I created Gr8|Skn for my daughters, who have red hair (a melanoma risk factor) – I wanted them to have a sunscreen that contained only good ingredients, to protect their skin from the Miami sun. Now my aim is to provide people with a skincare range that has healthy ingredients, and to make it affordable.’

Best antioxidants for your skin?

Shop for lotions containing vitamins A, C and E as well as coenzyme Q10, resveratrol, glutathione, flavonoids, and

Dr Janine Ellenberger was born in SA. She acted as medical director at Environ before moving abroad to London and settling in Miami, USA. Dr Ellenberger is the founder and CEO of Gr8|Skn, which she started when looking for the perfect sunscreen for her red-haired daughters. Gr8|Skn is available at Dis-Chem.


Janine Collins

About Janine Collins

Editor of Your Family magazine. As a mom of three, nothing much phases me anymore except heights, waves (the ocean kind, not the hair kind), spiders, green peppers and apostrophes where there shouldn’t be apostrophes. Just about everything else, I’m good.


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