BY ALAN OLDHAM
PHOTO BY PETER SPURRIER

Summer has finally arrived, and despite the unexpected challenges of 2020, one undeniable aspect remains: the warmer weather brings an abundance of sunshine. For many rowers, this season signifies a much-anticipated return to the water, whether it’s in singles or larger crews, provided they stay within their quarantine bubbles. For others, summer training may involve moving the erg from the basement into the fresh air of their backyard or apartment balcony, allowing them to enjoy the outdoors while keeping up with their fitness routines.

Among those navigating these new summer training dynamics is Gevvie Stone, a two-time U.S. Olympic sculler. She has had to rethink her plans for a post-Olympic return to medical residency this August. For her, summer represents a pivotal moment in figuring out what her training will look like as she prepares for the postponed Tokyo Olympics, which are now just a year away, yet again.

Regardless of how you choose to enjoy the outdoors, basking in the sun offers both advantages and drawbacks, particularly for rowers. Gevvie Stone elucidated the unique challenge of rowing, stating, “Rowing is a doubled sun exposure,” referring to the direct sunlight above and the intense reflection off the water’s surface. This dual exposure underscores the need for effective sun protection strategies for all athletes.

In addition to Gevvie, I consulted with two industry experts: Jim Walker, a former Canadian Olympian and semi-retired dermatologist, and Lisa Kottschade, the chief operations officer of the Midwest Melanoma Partnership. This organization has recently collaborated with USRowing to enhance awareness about melanoma and promote safe sun care practices among rowers, highlighting the importance of education in preventing skin-related health issues.

Understanding the Risks of Sun Exposure

For centuries, the healing benefits of sunlight have been celebrated by figures ranging from Hippocrates to Florence Nightingale, emphasizing its importance for both physical and mental well-being. Modern research has further validated the connection between sunlight exposure and health, notably as a significant source of vitamin D, which is crucial for numerous bodily functions. However, despite these benefits, excessive sun exposure poses serious risks, including skin cancer, which remains a prominent concern for outdoor athletes, particularly rowers who face unique exposure challenges.

While the advantages of sunlight are well-documented, we must also acknowledge its potential dangers. The risk of developing skin cancer is heightened with prolonged exposure, but it is not the only reason why safeguarding your skin is essential. Historically, various cultures have utilized plant-based sunscreens for centuries to protect against the sun’s harmful effects. The last 200 years have seen rapid advancements in the science of sun protection, leading to the creation of more effective and accessible sunscreens since the mid-20th century.

Blending Rowing and Dermatology Expertise

During a recent conversation with Jim Walker, I delved into his unique experiences that intertwine rowing and dermatology. Our initial formal exchange quickly evolved into a friendly discussion, highlighting the shared passion for both sports and skin health. Walker’s journey in rowing began at the Leander Boat Club in Hamilton, Ontario, back in 1968, spurred by encouragement from his high school friend Al Morrow, Canada’s long-time women’s team coach.

As Walker progressed in rowing, he simultaneously pursued his medical studies, balancing the demands of both disciplines. He vividly recalls attending the Munich Olympics in 1972 while still in medical school, taking advantage of the summer break between his second and third years to compete. Upon returning, he found himself behind in his studies, making it increasingly challenging to commit to a rowing crew.

Following his elite rowing career, Walker dedicated himself to the field of medicine, specializing in dermatology, where he has leveraged his background in athletics to educate fellow athletes about skin health. Over the years, he has remained connected to the rowing community, offering informational seminars and collaborating with athletes and coaches at Canada’s national team level, thus contributing to the intersection of sport and health awareness.

Essential Sun Protection Strategies for Rowers

In light of the heightened risks associated with sun exposure—especially in our current era of climate change and a depleted ozone layer—Walker remains optimistic about the growing awareness among rowers and their coaches regarding the significance of sun protection. He notes, “When I’ve spoken to athletes, there is pretty good awareness,” though he acknowledges the logistical challenges of applying sunscreen while rowing. Walker emphasizes that effective sun protection requires a comprehensive approach beyond just sunscreen. He shared a crucial three-point sun-protection checklist:

1. Minimize Sun Exposure During Peak Hours.

“For rowers, training schedules can be adapted to avoid peak sun intensity, which typically occurs between 10 AM and 4 PM,” Walker advises. “While it’s easier to plan training sessions early in the morning or later in the evening, regattas often require participation at any time of day. Therefore, being mindful of when you row is essential for skin health.”

2. Create Shade or Seek Shelter.

“When on the water, rowers must take the initiative to create shade using hats and appropriate clothing,” Walker continues. “Wearing a hat is crucial every time you’re out rowing. Additionally, during regattas, make sure to find other forms of shade between races to protect your skin from excessive sun exposure.”

3. Apply Sunscreen Generously on Exposed Areas.

“While applying sunscreen, be cautious, as sunscreen applied to the forehead can run into the eyes when sweating,” Walker explains. “Hats can effectively shield the scalp and top of the face, but it’s vital to apply sunscreen on all other exposed skin. Additionally, be mindful of your hands; wash your palms after applying sunscreen to avoid any slippage while rowing.”

4. Evaluate Your Skin Type and Personal Risk.

Individuals with lighter skin tones are at an increased risk for developing sun-induced skin cancer. Dermatologists often utilize the Fitzpatrick scale to assess skin type and its corresponding risk levels regarding sun exposure. Type I skin, which always burns and never tans, carries the highest risk, while Type VI skin, which rarely burns, presents the least risk. Nevertheless, regardless of your skin type, it is imperative to adopt protective measures, including sunscreen application and appropriate clothing.

The Science of Sunlight: Understanding Light and Its Effects

The sunlight we perceive is known as the visible spectrum, which appears colorless until it interacts with prisms or rain droplets, revealing a stunning array of colors. The visible spectrum, however, represents only a fraction of the vast electromagnetic spectrum. Violet light has the shortest wavelength and the highest energy, while red light boasts the longest wavelength and lowest energy. Beyond these visible ranges lies ultraviolet (UV) radiation, which is crucial for us to consider for skin health.

Fortunately, Earth’s atmosphere provides a natural barrier, blocking most harmful solar radiation. However, the invisible threats that we must be cautious of daily primarily stem from ultraviolet (UV) and infrared (IR) radiation. Understanding these forms of radiation is essential for effective sun protection.

Understanding UV Radiation and Its Dangers

UV radiation can cause significant harm to our skin and overall health. According to Kottschade, a nurse practitioner and associate professor of oncology at the esteemed Mayo Clinic, “Skin cancer remains the most significant risk associated with excessive sun exposure.” Furthermore, premature aging and skin damage are additional consequences of prolonged UV exposure, emphasizing the need for diligent sun care.

Dispelling Common Sun Exposure Myths

Kottschade addresses several prevalent misconceptions regarding sun exposure:

• I won’t get a sunburn on cold days.
• FALSE. “Sunburns can occur even in winter conditions, such as during skiing.”

• I won’t get a sunburn on cloudy days.
• FALSE. “UV rays can penetrate through clouds, leaving individuals vulnerable to skin damage even when it’s overcast.”

• People have been exposed to sunlight for millennia; it’s not a concern today.
• FALSE. “With the diminishing protection from the ozone layer, sun intensity has increased. Currently, the majority of skin cancer cases are diagnosed in individuals aged 60 to 80 years. A century ago, many people didn’t live long enough to develop such conditions.”

Types of Skin Cancer Linked to Sun Exposure

Sun exposure can lead to three primary types of skin cancer: basal cell carcinoma, squamous cell carcinoma (both common), and melanoma, which, although less frequent, is the most lethal. Walker emphasizes, “All these cancers are clearly linked to sun exposure.” He further explains that one of the most significant risk factors for developing skin cancer is experiencing sunburn, highlighting the importance of sun protection to lower cancer risk exponentially.

It’s crucial to recognize that skin cancer is not solely a concern for older adults; young people can also be affected. Walker notes, “Melanoma is associated with a considerable loss of life, as it can occur in individuals as young as 35.” This underscores the importance of taking skin health seriously, regardless of age.

“Skin cancer can affect young people as well. You can find 35-year-olds with melanoma who end up dying, and that is a lot of lost life.” – Jim Walker

Key Indicators of Skin Cancer to Monitor

“A new or changing skin lesion is typically the most common indicator of skin cancer,” Kottschade explains. The appearance of such lesions can vary widely among individuals. Walker elaborates, stating, “A lesion refers to any abnormality on your skin, including moles; however, not all cancers originate from moles.”

He warns that skin cancers can manifest as multi-colored spots, persistent red nodules, or ulcers that refuse to heal. While most skin cancers are more prevalent among older masters rowers, melanoma is particularly concerning, as it can emerge in younger individuals. “If you notice a lesion that changes, displays multiple colors, or grows and persists for more than three to four weeks, it’s crucial to seek medical evaluation promptly,” Walker advises.

“Skin cancers often develop in areas that are either chronically exposed, like the face and hands, or intermittently exposed areas that have experienced sunburn. In younger people, melanomas are commonly found on areas exposed to the sun, such as the trunk and shoulders for men and the back and legs for women, who often cover their chests.”

“It’s important to note that melanoma can also occur in areas shielded from sun exposure,” Walker cautions, emphasizing that the sun is not the sole cause of skin cancers; they can develop in regions that have never directly faced sunlight. Fortunately, when detected early, skin cancer can be effectively treated, and for those who have recovered, enjoying the sun again is possible, but enhanced protective measures are crucial.

The Impact of Sunlight on Premature Aging

Ultraviolet light interacts with the skin at varying depths, with shorter wavelengths penetrating the skin surface and causing significant damage. Walker explains, “The surface cells of the skin experience the most cancer-related damage due to UV exposure, while deeper penetration leads to other effects, such as premature aging.”

“The skin’s strength is derived from collagen, while elastin provides elasticity. Both of these vital proteins suffer damage due to prolonged exposure to longer wavelengths of ultraviolet radiation, leading to signs of aging and diminished skin resilience over time.”

Understanding Sunscreen Types and Their Importance

Walker underscores the efficacy of sunscreens, stating, “When applied correctly, most sunscreens are excellent at preventing burns.” However, not all sunscreens are created equal. There are two primary categories: physical blockers, which reflect sunlight away from the skin, and chemical blockers, which absorb radiation before it reaches living skin cells. While concerns about the safety of newer chemical blockers still exist, physical blockers have a long track record of safe, effective use, making them a reliable choice for sun protection.

“Physical blockers typically contain two main ingredients: zinc oxide and titanium dioxide, which reflect light away from the skin,” he explains. “Zinc oxide appears white, while titanium dioxide has an orange hue.”

Decoding UVA, UVB, and SPF Ratings

Understanding sunscreen effectiveness relies heavily on the labels found on sunscreen bottles. UVA and UVB represent “Ultraviolet A” and “Ultraviolet B,” respectively, indicating the range of UV radiation wavelengths that penetrate the atmosphere. Walker notes, “UVB rays are primarily responsible for skin cancer, while UVA rays contribute to wrinkles and skin aging.”

SPF, or “sun protection factor,” indicates how well a sunscreen protects against UVB rays. Kottschade clarifies, “It measures how effectively it safeguards the skin from harmful sun exposure.” However, Walker warns that “SPF only measures protection against UVB rays. A higher SPF indicates better protection against UVB, but to ensure comprehensive coverage, choose sunscreens that offer broad-spectrum protection against both UVA and UVB.”

“Aim for sunscreens with an SPF of 30 or higher, ensuring protection from both types of harmful rays,” Kottschade advises. Regardless of the SPF rating, Walker emphasizes the importance of minimizing exposure to direct sunlight and utilizing protective clothing and hats in conjunction with sunscreen.

Understanding Infrared Radiation and Heat Management

Walker explains, “Infrared radiation is primarily responsible for heating, alongside ambient temperature and physical activity.” The body employs sweating and the dilation of surface blood vessels to mitigate overheating. “Evaporation of sweat cools the body, while dilated blood vessels release excess heat when the surrounding temperature is below body temperature,” he adds.

Though covering up can reduce infrared absorption to a certain extent, it’s essential to note that sunscreens only block UV light, not infrared radiation. For more information about managing body temperature during exertion, I consulted the medical resources available on the World Rowing Federation (FISA) website: http://www.worldrowing.com/athletes/medical-and-antidoping/medical.

Staying Hydrated: The Key to Preventing Heat-Related Illness

According to FISA’s guidelines, maintaining adequate hydration is critical for heat tolerance and acclimatization to warm climates. “Dehydration hampers work performance and poses serious risks,” the guidelines emphasize. “Athletes should aim for a baseline intake of two liters of fluid daily, increasing that by an additional liter for every hour of rowing. For every 9°F rise in temperature above 77°F, one extra liter should be added to your hydration plan.”

“Heat-related illnesses often begin with dehydration, accompanied by a rise in core body temperature. Physical activity exacerbates heat load, further depleting energy reserves, particularly glucose. This scenario can lead to heat-induced illnesses, although it’s important to note that heat exhaustion and heat stroke can occur without prior dehydration,” the guidelines warn. Prolonged exposure to hot, sunny conditions, especially along with infrared radiation, contributes significantly to these risks.

Recognizing Symptoms of Heat Exhaustion and Heat Stroke

Failure to address dehydration can lead to heat exhaustion, characterized by symptoms such as elevated heart rate, dizziness, headaches, confusion, and nausea. The guidelines state, “Skin may still be cool and sweaty, but signs of vasoconstriction, such as pale skin, may also be present. In these cases, urine output tends to be minimal and concentrated, with cramps often accompanying dehydration.”

In cases of heat exhaustion, body temperature can escalate up to 104°F, and after intense exercise, athletes may collapse if not appropriately managed.

Heat Stroke: A Medical Emergency

Without immediate intervention, heat exhaustion can rapidly progress to heat stroke, which presents similarly but with dry skin, confusion, and potential collapse. This condition is life-threatening and requires urgent medical attention. “Any athlete exhibiting a temperature above 104°F that does not stabilize within 30 minutes of cooling and rehydration must be treated as a medical emergency,” the guidelines state.

To prevent these heat-related conditions, it’s vital to stay hydrated, seek shade, and utilize cooling methods such as fans, air conditioning, or water sprays.

Motivating Yourself to Prioritize Skin Protection

Finding personal motivation is essential for maintaining skin health, as Gevvie Stone emphasizes. “Whether you’re driven by the fear of skin cancer or the desire to prevent wrinkles, protecting your skin from damage is crucial,” she advises. “Utilize sunscreen on your face (preferably with zinc oxide and SPF 30 or higher) and wear a wide-brimmed hat. Protect your eyes with polarized sunglasses, as the polarization is worth the investment. For all exposed skin, apply broad-spectrum sunscreen (SPF 30 or higher) and wear sun-protective clothing, such as light long sleeves.”

She encourages individuals not to stop at prevention alone. “Schedule regular appointments with your primary physician if you notice any changes in moles or if they exhibit features such as asymmetry, irregular borders, color variations, or diameters greater than eight millimeters. It’s better to be proactive than reactive when it comes to your health.”

Lastly, while skin cancer is often perceived as an older adult’s issue, younger individuals should also be vigilant, as melanoma can have severe consequences if left untreated. “A dear friend of mine had melanoma removed at just 24 years old,” Stone shares. “This experience motivated me to enhance my own sun protection practices.”