After prolonged periods of lockdown during the Covid pandemic, restrictions have gradually eased across the world and summer has meant we can begin to lead more active lives once more. As we venture out into the sunshine, it’s important that we don’t let our enthusiasm run away with us and we forget the various health risks posed by prolonged exposure to the sun.

Foremost among these is skin damage that is strongly linked with both premature aging of the skin and also skin cancer. The cause of this skin damage is exposure to ultraviolet radiation (UV), which while it is invisible to the human eye, can nonetheless cause considerable harm as it’s absorbed into the DNA of our cells.

Often the damage caused by UV can be repaired by the cells themselves, but if this isn’t possible it can result in the kind of changes and mutations that can lead to cancer. This risk is particularly high in skin cells due to their exposure to the sun.

Getting a tan

When we get a tan it’s a result of our skin cells detecting this damage and sending an alert to pigment-producing cells to ramp up production and try and protect against any further harm. As a result, a suntan is both a sign that our skin has been damaged and also that our body is working to protect itself from further harm. It’s estimated that a tan provides a Sun Protection Factor (SPF) of around 4, which means we can spend around four times as long in the sun as we would otherwise be able to before we get burned.

This should not be taken to mean you have an infallible defense, of course, and prolonged exposure to UV can easily cause a sufficient level of DNA damage to completely overwhelm the defenses of our cells. When this occurs, our cells can choose to die in a process known as apoptosis, which results in cells being eliminated from the body before they might become cancerous, and therefore extremely harmful. This is a process that will be familiar to anyone who has suffered from sunburn as large numbers of dying cells cause the skin to redden as a result of inflammation.

If the damage caused by UV is sufficiently grave, however, then skin cancer can be the result. Incidences of skin cancer have grown considerably in recent years as the availability of overseas travel has soared alongside changing attitudes towards tanning. Indeed, a recent study in The Lancet suggests that skin cancer is eight times as prevalent today than it was in the 1980s.

Most weather forecasting services today provide some form of UV service, so it pays to monitor the ratings for your area, as the UV level can be high even when it appears cloudy outside. This can help to guide you on the best clothing and protection to apply, and indeed how long you should spend outside, especially during the hours when the sun is at its peak.

Light Sensitivity

Skin issues are not the only concern we might have as summer arrives and we venture outside more frequently. For instance, a well-known long-term impact of concussion is a particular sensitivity to light. Indeed, it’s estimated that this problem can persist for months or even years after the concussion occurred.

Light sensitivity, or photophobia, is experienced by as many as 43% of people suffering from concussion, with incidences particularly high among athletes in high-contact sports or those who have suffered from multiple head injuries. For instance, it’s estimated that up to 75% of active-duty soldiers who have suffered from blast-related concussions report sensitivity to light, with the majority rating their problem as severe.

The symptoms of concussion-based light sensitivity are varied and include headaches, vision fatigue, eye pain, and an inability to tolerate bright lights. Indeed, the International Brain Injury Association suggests that symptoms may even extend to fatigue, difficulty concentrating, and vertigo, with symptoms lasting as long as 6 months after the concussion itself.

Aversion to Sunlight

Bright sunshine is among the most common sources of light that triggers discomfort for photophobia sufferers, with sunlight exposing us to a large amount of blue light, which has been shown to be particularly painful for people with photophobia. Indeed, it’s even been shown to worsen any other concussion-related symptoms. With the numerous digital devices we rely on during our normal day also exposing us to a significant amount of blue light, it’s important that concussion sufferers are mindful of the additional impact sunlight can have.

Photophobia doesn’t currently have any medications to directly tackle the problem, but special photophobia glasses are recommended by the American Academy of Ophthalmology (AAO). Such glasses are tinted with FL-41, which helps to keep out much of the harmful blue light that so triggers symptoms among sufferers.

Research suggests that these glasses are capable of providing significant relief, with research showing that 85% of photophobic patients experienced some benefits from wearing them. If such glasses aren’t an option then alternative remedies might include wearing a hat outside, reducing screen time, and wearing polarized sunglasses when outdoors.

KEEPING OUR HEAD SAFE

As we take advantage of the sunshine to enjoy sports and other activities outside, we also have a heightened risk of concussion.  While we often associate sports-related concussions with high-impact activities such as football, research from the Henry Ford Health System reminds us that concussion is a risk in all sports, including basketball, hockey, and even swimming. What's more, the researchers argue that recovery from any sports-related concussions may be much longer than previously thought.

"The two sports, other than football, where concussions are common are soccer and hockey, although brain injuries can happen in any sport," the researchers explain.

With organized sports an option again after Covid, the researchers urge coaches and trainers to be on the lookout for signs of concussion, which include headaches, nausea, blurred vision, and sensitivity to light. While current MHSAA guidelines suggest sidelining athletes who present signs of concussion for at least 24 hours, the researchers suggest that a safer approach for athletes with only one concussion is to rest them for 30 days, with those suffering from multiple concussions requiring a longer recovery time.

"When you recognize that it can be up to 30 days to get a young student-athlete back, you're going to change your mindset on how you advance them, in terms of how you push them, in terms of how you test them," they explain.

While there is an understandable desire to enjoy the sunshine after so long spent stuck indoors during lockdown, it’s important that we take some simple precautions to ensure that we enjoy the sun safely, with this especially important if we’ve recently experienced a concussion.