Skin cancer and cycling: how to protect yourself while riding

What is the most dangerous thing about cycling? Ask a thousand cyclists and you’ll hear similar answers: intolerant drivers, navigating traffic, potholes. Maybe even descending. Few cyclists, however, would point to the risk of skin cancer.

But they should. Skin cancer kills two people every hour in the United States, and the risk in other parts of the world is even higher. Spending hours outdoors, cyclists are especially at risk as they are constantly exposed to UV rays from the sun. That’s dangerous, as 90% of non-melanoma skin cancers and 86% of melanomas can be attributed to UV radiation. Those sought-after tan lines cyclists pride themselves on come with a big risk.

We recently spoke to Dr. Emma Ormerod, a consultant dermatologist, to learn more about the risks of skin cancer and, just as importantly, find out what cyclists can do to protect themselves.

What is skin cancer?

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Fair or freckled skin is more vulnerable to UV rays

To fully appreciate the risk to cyclists, it’s important to understand what skin cancer is. It’s a term many will be familiar with, but you may not realise that there are different types of skin cancer, as Dr. Ormerod explained.

“Skin cancer is the out-of-control growth or multiplication of abnormal cells in the skin,” she said.

“There are different types of skin cancer but the most common ones are melanoma skin cancer, basal cell carcinomas and squamous cell carcinomas.”

While there are several different types of skin cancer, there are some common causes for the disease, with UV exposure one of the most prominent.

“As with other sorts of cancer, it's a mix of environmental factors, which for skin cancer is mostly UV exposure, and genetic factors. There are also some inherited genetic factors which are important, as well as some inherited characteristics, such as very pale skin that freckles easily, or having a large number of abnormal or unusual moles. Anybody with a first-degree relative such as a parent or a sibling who's had skin cancer will be at an increased risk compared to other people in the population.”

Pale skin is up there as one of the key factors, so does that mean that those with darker skin are risk-free? As Dr. Ormerod pointed out, anyone can develop skin cancer, regardless of skin colour.

“Black skin has a natural SPF – or sun protection factor – of about 13.5 compared to about 3.4 in white skin. But people with brown and black skin can still develop skin cancer, and the same sort of protective advice will apply.”

How to prevent skin cancer

Alarm bells may be ringing in your head at this point. After all, as cyclists, we’re constantly exposed to UV rays when riding outdoors. However, the dangers of these rays can be mitigated by taking simple preventative measures, many of which lots of cyclists sometimes overlook.

“When you’re out and about, protect your skin with sunscreen, cover up with sleeves, a hat and sunglasses," Dr. Ormerod advised. "Try to seek out the shade if you possibly can, and avoid the very hottest parts of the day between 11am and 3pm when the UV rays are going to be at their highest.

“If you have a lot of moles, become familiar with your own skin so you know what moles you have. Then you will be able to recognise whether they're changing or you're developing any new moles or lesions on your skin. The best way to do that, especially if you have a lot of moles, is to take some photographs of your skin, because it's really difficult to keep track of them otherwise.”

How to apply sunscreen

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Sun cream is really important, even if it's cloudy

As pointed out by Dr. Ormerod, applying sunscreen is one of the most effective ways of protecting yourself from UV rays. That begs the question, how much sunscreen should you apply? Spoiler alert: it’s a lot more than you may think.

“As a general rule, people don't apply enough sunscreen,” Dr Ormerod said. “If you don’t, you won’t reach the amount of protection that's listed on the bottle, meaning you'll have lower SPF protection than you think you're getting.

“It's recommended that you use about two teaspoons of sunscreen to cover your face, neck and arms, if they're exposed. Or two tablespoons to cover your whole body excluding your swimsuit area.”

That’s a lot of sunscreen. And it’s not just an apply-it-once type of job, either. In fact, cyclists should be regularly reapplying to maintain the required protection from those pesky rays.

“The general recommendation is to reapply your sunscreen every two hours, but if you're sweating or you're in water, you need to apply it more often," Dr Ormerod said. "So, that’s obviously applicable to cyclists who might be outside for a long period of time.”

There are risks all year round

While many cyclists are blessed with glorious sunshine, many live in milder climates where sun-filled rides are a rarity. Yet, even for those who are more accustomed to rain than sun, sunscreen remains a necessity, regardless of the weather.

“It's something that you need to think about year round,” Dr. Ormerod explained. “There are different types of UV rays. The main ones that are relevant to us are UVA and UVB.

“About five per cent of the UV rays we're exposed to are UVB. They're responsible for burning the skin and also some sorts of skin cancer. They are seasonal, so they tend to be highest in spring and summertime and in the hottest parts of the day.

“UVA rays, which are responsible for the other 95 per cent of rays we're exposed to, cause ageing of the skin. So, wrinkles, pigmentation change, textural change in the skin, but also some skin cancers. They’re present in constant amounts year round and can penetrate cloud cover and glass windows, plus they’ll reflect off surfaces.”

There are other factors to consider too, including altitude and location, with those nearer to the equator and in areas where the ozone layer is thinner being exposed to more UV rays. And that’s not all: UV rays also reflect off surfaces, which is more significant than you may think.

“All UV rays will be reflected off surfaces,” Dr Ormerod explained. “Things like soil and grass reflect around 10 per cent of rays. while it’s up to 80 per cent for snow and ice. Clouds are also important. Some UV rays will be absorbed by clouds, but light clouds can actually increase your UV exposure by causing some scattering of the rays.”

So, don’t be fooled by a cloudy day and think the risk is gone.

How to identify skin cancer

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Photograph and monitor moles so you can spot changes or developments

Even with the correct protection, there are still risks, so it’s useful to know how to identify skin cancer. Like with any type of cancer, the earlier it’s discovered, the better. The ‘ABCDE’ rule used by Dr. Ormerod and other dermatologists provides a useful guide.

“A stands for asymmetry of the mole,” Dr Ormerod explained. “If you were to cut it in half, do the two sides look the same or vaguely similar? B is for border. Is the border irregular, notched or blurred? C is for colour. Are there two or more different colours in a single mole? The diameter of the lesion is also important, so is it greater than six millimetres in diameter? And, finally, E for evolution of the lesion. Is it changing over time and are there any new lesions which develop symptoms such as itching or bleeding which don't settle down?

“There are also other skin cancers, the basal cell and the squamous cell carcinomas, which present in slightly different ways such as a new lump or bump on the skin, something that's changing or growing which might be painful, or an open sore or non-healing area which just doesn't settle down over time.”

While these steps will help to identify any concerning symptoms, many people are often reluctant to take the next step of visiting a doctor. That could be a mistake, as you risk delaying important treatment.

“Most skin cancers are preventable or very easily treatable,” Dr. Ormerod explained. “So, getting these things checked out early is much better than sitting on it.”

No more tan lines?

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Turns out there's no such thing as a 'healthy glow'

We’ll end with the question many of you are probably thinking: what about my cyclist tan lines? We hate to be the bearer of bad news, but it’s not good on that front.

“There is no such thing as a healthy tan,” Dr. Ormerod emphasised. “Your pigment cells, the melanocytes, produce pigments when they've been exposed to excess sun to try and protect themselves. So, tan is a sign of skin damage and DNA damage.”

UV rays everywhere, no more tan lines… it’s all sounding a bit bleak. It’s important to reiterate that, if you follow the steps outlined in this article to properly protect yourself, it’s perfectly safe to ride in the sun. Doing so actually has benefits as UVB rays aid vitamin D production. It’s also great for our mental health. Who doesn’t love riding in the sun?

The reality is, though, lots of cyclists don’t do enough to protect themselves from skin cancer. Speaking to Dr. Ormerod was even a wake-up call for us at GCN.

Hopefully, however, with the help of this article, you’ve gained a better understanding of the risks of skin cancer, and are better prepared to protect yourself when out riding in the sun. It’s worth it.

Simon Richardson

GCN Presenter

Former pro road and mountain biker racer