The term "healthy" tan is as contradictory and dangerous as "friendly fire." Sun exposure is the main cause of skin cancer. Yet millions of sun-worshippers still flock to beaches, refuse to use protective sunscreens and go to tanning salons to get a little glow. Don't let vanity ruin your health. Find out how to protect yourself from the sun's harmful rays.

The results of our national preoccupation with tanning are not pretty. According to the National Cancer Institute, there are about 700,000 new cases of skin cancer each year--that's about the same number caused by breast, lung, prostate and colorectal cancer combined. No one is saying that you have to be a hermit to prevent skin cancer and other sun-related problems such as wrinkles and cataracts. But you do have to use a little sun sense to protect yourself.

How Does a Suntan Lead to Cancer?

It's long been known that tanning is the body's attempt to shield itself from the sun. But researchers have only recently discovered that, paradoxically, these protective measures sometimes cause cancer. Ultraviolet light (radiation from the sun) does not simply brush the skin's surface with color. It penetrates the upper layers of skin and damages basic units of genetic material (DNA) inside skin cells. When this happens, the cells dispatch special repair enzymes to get rid of the injured DNA and help generate new DNA. These repair efforts, however, can go awry and lead to cancer. Simply put: That "healthy tan" you get is your body's plea to get out of the sun. In fact, damage can occur before you even get a dusting of color.

What is Skin Cancer?

Cancer is really a number of diseases caused by the abnormal growth of cells. Even skin cancer is a general term for several different forms of the disease. Basal cell carcinoma, which usually affects the face and ears, causes about 75 percent of all skin tumors. It is slow-moving and does not generally spread to other parts of the body. Squamous cell carcinoma, responsible for about 20 percent of skin tumors, grows slowly too, but it does spread more often than basal cell cancer. Malignant melanoma is the most harmful because it can spread quickly and be fatal if it's not treated early. The incidence of melanoma is rising faster than that of any other malignancy, and the mortality rate from it has risen about 2% annually since 1960.

Who Gets Skin Cancer?

Skin cancer used to be considered a disease of old or middle age, but the number of cases in younger people has risen steadily due to increased exposure to the sun. Some researchers believe depletion of the atmosphere's protective ozone layer, which allows more of the sun's rays to hit the earth, is also responsible for the increase in cases of skin cancer. Artificial sources of UV radiation, such as sun lamps and tanning booths, can cause skin cancer as well.

People with any of the characteristics listed below are at higher risk for skin cancer and they should be particularly careful of sun exposure.

• Fair skin. Although anyone can get skin cancer, the risk is greatest for people who have fair skin that freckles easily-- a description that often includes redheads or blondes with blue or light-colored eyes. Light skin is most vulnerable because it has less melanin, the pigment that helps prevent burning.
• Place of residence. People who live in areas that get high levels of UV radiation from the sun are more likely to get skin cancer. In the United States, for example, skin cancer is more common in Texas than in Minnesota, where the sun is not as strong.
• Long-term exposure to UV radiation. People who work outdoors, such as farmers and construction workers, and those who go boating often, play a lot of outdoor sports, or sunbathe, are at highest risk of developing skin cancer. Keep in mind that even though most skin cancers appear after age 50, the sun's damaging effects begin at an early age. Therefore, protection should start in childhood.
• Sudden and intense sun exposure. People who work indoors all week and then bask in the sun for hours on end over the weekend are also at increased risk of developing melanoma.
• Moles. Certain moles make it more likely that a person will develop melanoma. See a doctor if you have a mole with any of the following characteristics: It is asymmetrical (one half is unlike the other half); its borders are uneven or irregular; it has uneven coloring (varying shades of brown, black and pink within a single mole); its diameter is over 6 mm (the diameter of a pencil eraser). Some moles which are present at birth and often dubbed "birthmarks" are also linked to melanoma.
• Family history. Those with close relatives who've had skin cancer are at greater risk of developing it themselves.
• Diet. As early as 1939, animal studies indicated that mice fed a high-fat diet who were exposed to UV radiation developed cancer at higher rates than those on a lower fat regimen. About a decade ago, researchers at the Baylor College of Medicine in Houston, found that humans who have a high-fat diet also are at greater risk for pre-malignant tumors and skin cancers associated with UV exposure.

Other skin-protective dietary measures include eating more foods rich in antioxidants (found in a wide variety of fruits and vegetables) and selenium (in whole wheat flour, mushrooms and tuna).

• Exposure to x-rays. Professionals who use x-rays in their work, such as dentists and radiologists, and people who have had x-ray treatments for acne or other conditions are at increased risk for skin cancer.
• Exposure to certain industrial compounds. Long-term contact with coal tar, pitch, arsenic, and other industrial compounds can cause skin cancer. Strong government regulations have mostly eliminated the threat from such compounds, but arsenic may still be present in some well water.

How Can I Avoid Skin Cancer?

Your first line of defense is to avoid direct sun exposure as much as possible. The sun's rays are the strongest from 10 a.m. to 3 p.m., so be especially careful during that time of day. Some health experts suspect that skin cancer rates are increasing because sunscreens provide a false sense of security. People who use strong sunscreens with an SPF of 15 or more don't feel the effects of sunburn as quickly and spend more time basking in the sun and exposing themselves to damaging rays. Don't fall into this trap. The American Academy of Dermatology now says sunscreens are only one component of sun protection. Other measures include staying in the shade and wearing wide-brimmed hats and tightly woven, loose-fitting, light-colored clothes. Sunglasses that block UV light can reduce the risk of eye disease (look for labels that have a UVB or UVA sticker).

Whenever you are exposed to the sun, be sure to slather on a sunscreen or moisturizer with a sun protection factor (SPF) of 15 or higher. Apply products generously at least 20 minutes before going outside. Reapply sunscreen after swimming and exercise (sweat reduces its effectiveness). To protect against both UVB and UVA rays (UVA creates wrinkles and splotches and may play a role in melanoma) turn to products that contain zinc oxide or titanium dioxide.

Look for products containing some of the latest skin-saving ingredients. A new plant antioxidant called alphaglucosylrutin (AGR) can now be found in some lotions. AGR nutralizes damaging molecules, eases sun rash, and may prevent wrinkles. After-sun lotions with ultrasomes and photosomes can actually help repair some of the DNA damage caused by UV rays.

Catching Potential Problems Early

Aside from being sun-smart, it is important for you to be aware of early trouble signs on your skin. The best time to do a self-exam is after a shower or bath in a well-lit room using both full-length and hand-held mirrors. Start by noting where your birth-marks, moles and blemishes are and what they usually look like. Check for anything new or a change in the size, texture, or color of existing moles. Also, be on the look out for sores that don't heal. It's important to scrutinize all areas of your body. The American Cancer Society suggests the following step-by-step guide:

1. Look at the front and back of your body in the mirror. Then raise your arms and check out your left and right sides.
2. Bend your elbows and examine your palms, forearms (including the undersides) and upper arms.
3. Inspect the back and front of your legs. Also look between the buttocks and around the genital area.
4. Sit and closely examine your feet, including the soles and the spaces between the toes.
5. Look at your face, neck and scalp. You may want to use a comb or a blow dryer to move hair so that you can see better.

If you notice anything unusual, see your doctor right away. Catching skin cancer early can save your life.