How to stay safe in the heatwave - tips from an expert oncologist

Spending time in the sun is one of the reasons many of us enjoy a summer holiday. Sensible sun exposure is a good way to top vitamin D levels but too much can cause permanent skin damage. Sun burning, in particular, is linked to premature aging, cataracts, wrinkles, thin unhealthy skin and cancer.

Every year 200,000 people in the UK require treatment for the common skin cancers called basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). Most of these are successfully treated with surgery but can leave disfiguring scars. More concerning, sun burning when young substantially increases the risk of melanoma which killed 2500 people in 2023 and death rate is increasing by 140% each year.

This article addresses at the wider links between sun, diet lifestyle and skin damage but before start it is worth recapping practical tips to reduce excess sun exposure which include:

• Avoiding intense sunshine between 10am and 3pm
• Shade with umbrellas and under cover in cafes and restaurants
• Sun cream with >SPF 30 or even higher for cheeks and ears and shoulders
• Supervise children or apply cream yourself to ensure areas are not missed
• Wide-brimmed hats are better that caps which miss the ears and neck
• Sunglasses with UV blocking lenses will reduce the risk of cataracts
• Wind cools the skin giving the impression you are not burning, take extra care
• Sea activities will also mask the heat and reflects the sun more powerfully

Slipping on a T-shirt, slapping on a hat and slopping on the sun cream is still important but it's only half the story. Dietary and other lifestyle factors have a substantial impact on the risks of sun damage. After the initial genetic damage by the UV rays, a series of mechanisms determine whether the effected cell eventually takes root as a cancer. These include DNA repair, oxidative defences, inflammation and the immunity.

Reducing skin cancer risk

Enhancing these cellular defences will considerably reduce the risks and can help you enjoy the sun more safely. Here are the more important factors:

Regular exercise helps to reducing excess inflammation, enhances the formation of antioxidant enzymes and strengthening the immune system. So, try not to say no to swimming, beach volleyball or even going for a cycle or jog whilst on holiday.

Olive oil has the amazing ability of supporting DNA repair mechanisms. This was demonstrated in one experiment in which hairless mice exposed to sun had significantly lower levels of skin cancers, skin damage and markers of DNA if they had olive oil massaged on the skin compared to those who did not.

Good after sun lotions should include olive oil but you can always boost their potency by adding more cold-pressed olive oil to a cream applying to your skin, especially if you have sunburnt. Increasing olive oil in the diet is also protective.

Red wine resveratrol has been shown to inhibited skin damage and decreased skin cancer risk. It is harder to find resveratrol-containing creams, but the good news is that drinking a glass of good-quality red wine could carry the same benefits. If you don't like red wine, however, supplements containing resveratrol are available.

Be careful of too much alcohol which can be metabolised to acetaldehyde that has carcinogenic properties. Heavy alcohol consumption also contributes to weight gain, poorer gut health and lower mood and motivation to exercise.

Dark chocolate and coffee contain natural flavonoids and phytochemicals which upregulate anti-oxidative pathways essential for protecting the skin cells. Several studies have shown that a small amount of dark chocolate every day can reduce skin damage but, like red wine, more is not better.

Too much sugar can damage gut health, promote inflammation and cause weight gain so 100% no sugar options would be safer. One study found that coffee in moderation could reduce skin cancer rates including melanoma.

Other phytochemical rich foods include fruits, mushrooms, vegetables, salads, herbs, spices, teas, nuts, berries, seeds and legumes. These foods are also rich in vitamin C and minerals which are also essential building blocks for oxidative defence pathways. Typical western diets are often deficient in phytochemicals, meaning we need to try and eat a lot more of them, preferably with every meal of the day.

For many, however, in the busy world we live in, it may be difficult to prepare fresh healthy meals on a daily basis. In this case, a Phytochemical rich supplement, can be a convenient way to increase intake especially getting a lot of exposure to sun.

Oily fish and other foods rich in omega-3 have been shown to reduce sun-induced inflammation and enhance immune response against genetic UV damage.

Gut health influences the immunity and inflammation in the body, including the skin. Foods which damage gut health and harm the skin include processed sugar and processes meat. Foods which enhance gut health include kimchi, beans, mushrooms and kefir.

Cigarette smoking whilst in the sun accelerates inflammation and increases oxidative stress in the skin, further adding to the stress cause by the sun itself. Many scientist agree that if you want to look five years older, smoke. If you want to look ten years older, smoke while sunbathing.

Pick your sun lotions carefully as the last thing the skin needs when coping with the stress of UV rays is a cream full of hydrocarbons, preservatives, parabens, colours and perfumes, which are present in many commercially available sun tan creams. These may cause more irritation, inflammation and the toxins can add to the oxidative stress.

Sun tan creams made from natural plants scented with essential oils are available but harder to find - usually from small independent producers such as 0-sun or Upcircle.

For the areas which get the most intense sun, such as the cheeks which often get reflected UV from sun glasses and the top of the ears, a zinc based sun block provides the best protection. Some of these have been implicated with damage to coral reefs as they contain oxybenzone, nano titanium and zinc oxides but it is possible to buy sea friendly versions.