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Skin - the athlete’s largest organ

By Logan D’Souza, M.D., Resident Member of the American Academy of Dermatology Sports Committee, University of Connecticut Health Center

Most sports involve some sort of protective gear to guard against injury. However, an often-overlooked part of the body that withstands daily damage if not properly protected is the body’s largest organ – the skin. Data shows that more than 90 percent of NCAA student-athletes participating in outdoor sports do not use sunscreen.

Practice and competition schedules commonly take place in the midday sun, a major risk factor for all skin cancers. Outdoor student-athletes are at a particularly higher risk compared to the general population for multiple reasons, including sweating that both increases the skin’s photosensitivity and washes off sunscreen. Additionally, ultraviolet (UV) radiation is amplified by reflecting off most training grounds, including water, sand, concrete, light-colored surfaces and snow. Alpine and winter student-athletes are even more susceptible to sun damage given that harmful UV rays are less absorbed by the atmosphere at higher altitudes. Notably, intense training can also temporarily weaken the skin’s immune system and increase the risk of some types of skin cancer.

Knowing these risks is vital, to educating student-athletes, coaches and athletics healthcare staff of the dangers of skin cancer. More than 3.5 million skin cancers in more than 2 million people are diagnosed in the United States annually, including about 137,990 new cases of melanoma, the most serious form of skin cancer. Current estimates show that one in five Americans will eventually develop skin cancer; a projected one in 50 Americans will develop melanoma during their lifetime.  A recent study found that basal cell carcinoma and squamous cell carcinoma are increasing in men and women under 40. Melanoma, it is the most common form of cancer for young adults 25 to 29 years old and the second most common form of cancer for adolescents and young adults 15 to 29 years old.

Because exposure to ultraviolet light is the most preventable risk factor for all skin cancers, the American Academy of Dermatology encourages everyone to protect their skin. Examples of safe skin practices include:

  • Apply a broad-spectrum (UVA and UVB rays), water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or more and reapply every two hours;
  • Seek shade and avoid training and competing when the sun’s rays are strongest between 10am and 2pm;
  • Use extra caution near water, snow and sand that can augment the damaging rays of the sun;
  • And avoid tanning beds that can cause skin cancer and wrinkling.

Tips for coaches and athletics healthcare providers:

  • Serve as a sun safety role model.
  • Improve access to sunscreen for student-athlete use at every outdoor practice and competition.
  • Encourage sunscreen and protective clothing (e.g., long sleeve shirts, hats and sunglasses) as indispensable as sports equipment during outdoor practice.
  • Consider access to UPF protective clothing for practice and competition uniforms in outdoor sport athletes.
  • Make sun safety behaviors routine, so that wearing protective clothing and taking time out to reapply sunscreen become as much a part of athletics practices and competitions as water breaks.

Additionally, be on the lookout for warning signs of melanoma, including changes in size, shape or color of a mole or other skin lesion, or the appearance of a new growth on the skin.  

The importance of early detection is paramount, as most skin cancers can be easily treated with high cure rates when found promptly. It is essential to know your risk factors. These risk factors should prompt regular evaluation by a dermatologist, which include: a high amount of intermittent sun exposure; exposure to tanning beds; having more than 50 moles, atypical moles, light skin, freckles, or a personal or family history of melanoma. Individuals with a history of melanoma should have a full-body exam by a board-certified dermatologist at least annually and perform regular self-exams for new and changing moles. Know your spots and be aware of your skin, and if you see a spot that is changing, see a dermatologist – it could save your life!

NCAA Sun Safety and Heat Illness Resources

American Academy of Dermatology Skin Protection Resources