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Never mind your aching feet. All too often, it's your skin that bears the brunt of your workout habits. "Without a doubt, athletic women face an increased risk of skin cancer if they are taking their routines outdoors," says Elizabeth K. Hale, MD, clinical associate professor of dermatology at NYU School of Medicine and a spokesperson for the Skin Cancer Foundation. "When women exercise, we wear shorts, tanks, sports bras; a lot of skin is exposed to the sun. Plus, we sweat. Wet skin not only intensifies UV penetration, it causes sunscreen to wear off more quickly, dramatically increasing our chance of burning."
Moreover, certain factors, like family history and skin color, can boost your chances of developing melanoma. We sent five enthusiastic exercisers on a mission to discover how their outdoor lifestyles and personal backgrounds affect their skin. After they received full-body skin scans at MoleSafe in New York City, a melanoma-detection clinic that uses a dermascope to magnify suspicious skin spots, their scans were analyzed by MoleSafe's dermatologist and melanoma specialist, Mark Gray, MD, and Dr. Hale. See what they learned -- and how their lessons can help you lower your risk of skin cancer."A tan makes me feel healthy."
Kerstin Larson, 31, fashion designer
Skin story: "When I have color, it reminds me I've been active outdoors, and I feel healthier. I play soccer twice a week without sunblock, so I'm no stranger to burns. Right now I'm more concerned about getting wrinkles than cancer. And I have melasma, a skin discoloration, on my face. The sun seems to make it worse."
Scan says: "The sun has aged Kerstin's face a good 10 years," Dr. Hale says. (Read: Dark spots are imminent.) She has a lesion on her nose that peels and bleeds, often a sign of basal cell carcinoma, a slow-growing skin cancer. "It's benign now, but that could change," Dr. Gray says. "She also has a mole on her face that may morph into a slow-to-develop melanoma called lentigo maligna in the future."
The next step: "Kerstin should see a derm twice a year and do monthly self-checks to look for pimples that won't fade, often an indicator of basal cell carcinoma. "Once you get it, the chance of developing melanoma swells," Dr. Hale says. On the field, a broad-spectrum sunscreen with SPF 30 is a must. Sports versions, like Coppertone Sport Continuous Spray SPF 50 ($9.99, drugstores), are the easiest to use on perspiration-soaked skin. Plus, it'll help with melasma. (Sun exposure worsens the condition.) "It's smart to wear a baseball hat when playing too," Dr. Hale says. "It will shield the spot on her nose better than any sunscreen."
Robi Dallow, 41, substitute teacher
Skin story: "Until I was 22, I'd regularly fry with baby oil and light reflectors in the backyard and tanning beds. Local salons would have 'Get your first tan free' deals, and I'd drive around, hitting all of them. I burned and blistered a lot! I've quit indoor tanning, but I rarely wear sunscreen when I run. It always drips in my eyes."
Scan says: "Robi has sun damage and numerous freckles on her chest and shoulders, thanks to her intense UV exposure," Dr. Gray says. "But she has only 25 moles, a low number when it comes to melanoma risk." (Got 100-plus? Your odds jump.) What is risky: Just one blistering sunburn as a child or young adult more than doubles her melanoma chances. And using tanning booths before 35 increases her probability by 75 percent.
The next step: Robi should try wearing UV-protective running gear that carries an ultraviolet protection factor seal, meaning that both UVA and UVB rays are blocked. She also needs to look for a light-textured sweat-proof broad-spectrum sunblock for her body and to reach for a sports stick of SPF 30 to protect her face without the eye-stinging drip. We like Mission Skincare Anti-Sting Sunscreen SPF 30+ Facestick ($8.99, missionskincare.com). "Even though Robi's skin is in the clear now, I recommend she see a dermatologist twice a year, based on her tanning-bed and sunburn history," Dr. Hale says."Melanoma runs in my family."
Liz Liss, 32, interior designer
Skin story: "My grandmother died of melanoma when I was 8. Nine years ago I had two moles taken off my stomach, and now I have a few new ones that worry me. I'm good about sun protection at the beach, but not when I walk outdoors. I can't find a sunblock that doesn't make me break out while exercising."
Scan says: "There is one mole on Liz's calf that looks darker than the others. Being dark isn't necessarily a problem, but because it's different than the rest, it's a good idea to monitor it," Dr. Gray says. (The back of the leg is a top spot for melanoma to develop in women.) Evidence of Liz's UV damage appears mostly on her shoulders and is probably due to walking outdoors in sports tops without protection.
The next step: An every-six-months visit to the derm is needed. "Liz's risk of melanoma is twice that of the average person because of her family history," says Dr. Gray, who suggests Liz share her grandmother's medical records with her doc. "Knowing her grandmother's pathology will help her doctor assess Liz's risk." And a noncomedogenic sunscreen, like Neutrogena Spectrum+ Sunblock Lotion SPF 100 for Face ($11.99, drugstores), will help prevent breakouts.
Jun Kim, 27, consultant
Skin story: "Last year I played softball with my company team about five hours a week. I wore moisturizer with SPF on my face, but I burned so badly that my skin still looks tan months later. This also happens when I run. No matter what I do to protect my skin, I burn. But I've never bothered to do a skin check."
Scan says: Despite her tendency to burn, Jun's skin is in good shape. (Her skin can better withstand UV damage because of its extra melanin.) "But since Jun has a burn history, she's upped her skin cancer risk," Dr. Hale notes. Her more immediate, and solely cosmetic, worry: the tan that won't go way. "It's actinic bronzing, a common problem for Asian women," Dr. Hale says. "Too much sun increases the size and number of melanin-producing cells in her skin."
The next step: Scans suggest that a darkened mole on Jun's face is harmless, but lasering it off -- Jun's first idea -- is risky. "You should never laser a mole, even if it looks benign," Dr. Hale says. "It will destroy any sign of melanoma, so you likely won't be able to detect the disease until too late," Dr. Gray explains. The better option: Have a skilled surgeon remove and biopsy all moles instead. For daily protection, Jun can stick with her SPF-infused moisturizer. On softball days a sports sunblock is best. If no moles change, she can visit the derm every two to three years, Dr. Gray says.
Ayren Jackson-Cannady, 29, FITNESS associate beauty editor
Scan says: "Ayren has a spot on her ear that shows she's had significant sun exposure," Dr. Hale says. Though not malignant, it's a reminder that the protective melanin in Ayren's darker skin doesn't fully shield her from damage. "She has a burn history, and she was a lifeguard," says Dr. Hale. "Both factors more than double Ayren's risk, regardless of her skin color."
The next step: Along with the usual SPF 30 mandate, "Ayren needs to put sunblock on her ears when exercising outdoors," Dr. Hale says. "Squamous cell carcinoma, another nonmelanoma cancer, is often detected on ears." For daily use, her SPF-laced moisturizer is fine. As long as Ayren continues to scrutinize mole changes -- and regularly check her nails, palms, and soles (cancer hot spots for African Americans because of lighter skin in those areas) -- she can visit her derm every two to three years.
Three easy solutions so you'll never forget the sun protection again."I forget to reapply during my workout."
Slather SPF on your skin and on this UVSunSense bracelet, part of the Sephora Sun Safety Kit ($25, sephora.com). When the wristband changes color, it's time to reapply."My lips burn easily."
Because glosses may speed UV penetration (blame the shine), opt for an SPF-packed balm, like Twist & Pout Lip Balm SPF-20 ($9.50, amazon.com). Hook one on your gym bag or purse for quick touch-ups."Sunblock makes my face feel sticky."
Thanks to ingredients such as zinc oxide and titanium dioxide, SkinCeuticals Sheer Physical UV Defense SPF 50 ($30, skinceuticals.com) feels ultralight and has a translucent finish. Bonus: It wicks away T-zone shine.
While 90 percent of women have some concern about getting skin cancer, only 39 percent have ever visited the doc for a skin check, according to an exclusive FITNESS/Skin Cancer Foundation survey.
Here's your chance to make good: Click below find out when the SCF's Road to Healthy Skin Tour rolls into your area. In its state-of-the-art RV, you can receive a full-body skin exam from a dermatologist (free!), load up on sun-protective goodies (free!), and learn lifesaving info (free!).
Originally published in FITNESS magazine, May 2010.