Sunscreen protection with high spf of 50

My first time on here being new to blood cancer, I was diagnosed with E.T in December 23 and started on hydroxycarbamide 500mg and a 75mg daily aspirin. I’m still having regular blood tests and I’m now within a normal range as of today I’m at 319. I’m 68 I’m fine with what I’ve got due to a positive attitude of it is what it is and can’t be changed. My concern is more about getting skin cancer as I do like to sit and take in the sunshine being retired. I think I know the answer to my question but I’d like some advice on should I wear a moisturiser with a high spf of 30 which I seem to be able to buy, or wear my usual moisturiser and add on top of that a high sunscreen protection of spf50? Is it personal choice? And which is the main areas of the body more likely to get skin cancer, am I more likely to get skin cancer because of my condition? I don’t know the answer to these questions. Thanks in advance.

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I use a factor 50 face sunscreen after my moisturiser.
I tend to sit under a parasol now and cover up
I use sunblock on my arms
I find I’m cold most of the time as I’m on maintenance treatment and I’m rarely without thermal socks and a cardy even in summer apart from the very hot days
I was made aware that I’m higher risk for skin cancer and steroids thin your skin
Hat sunblock shade I was told

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Hi @Mrsmac welcome to our forum and a good question.
I have Chronic lymphocytic leukaemia (CLL) and I have been on active monitoring (watch and wait), so no treatment, for 20 yrs and have had skin cancer on the top of my head twice and odd bits and pieces on my face.
I use sun screen factor 50 and wear a jaunty hat when I go out and cover up my arms.
Better safe than sorry I say.

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I wear an SPF50 facial sunscreen everyday and I favour, Vichy, La Roche Posay or Beauty of Joseon. If I wear anything that exposes my skin then I wear SPF50, usually ambre solaire spray.
Like @Erica says, a hat is always good. I hope you find what works for you :revolving_hearts:

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Hello there @Mrsmac, welcome to the forum. So sorry to read of your Essential thrombocythemia (ET) diagnosis. I was diagnosed with a closely related Myeloproliferative neoplasms (MPN) last year too, Polycythaemia vera (PV), and uncannily I’m currently on the search for a new moisturiser with high SPF.

Sounds like your blood cell numbers are doing well and you’ve got an optimistic attitude about Essential thrombocythemia (ET). Great stuff! The forum is also here for you should you not be feeling great, and I speak from experience when I say it’s been an amazing support whilst I’ve got used to Polycythaemia vera (PV) and its treatments.

I’d say, as someone living in a sunny region and with global heating worsening overall, it’s only going to get sunnier so protecting our skin is the least we can do, no matter our age or lifestyle.

I walk a lot so something I’ve got into the habit of is avoiding the sun at the hottest part of the day as I can literally feel my skin sort of fizz with pinpricks from exposure, regardless of having applied sun lotion. I also take daily aspirin and hydroxyurea like you so I imagine the skin sensation is due to those plus UV light.

Like dear @Erica says, wearing a hat will help too. I always wear one outdoors. Some are made with sun protection like sun lotions. You can even get clothes with sun protection built in now!

I’ve found my skin is drier since starting hydroxyurea, despite my extra hydration, so moisturising helps. I use mineral-based sun lotions with SPF 30 or higher.

Hope this helps! Keep us posted about how you get on with your treatments.

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I forgot to add a good pair of sunglasses and a hat
My eyes are light sensitive due to treatment and they need protecting too

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Good point @2DB, thanks

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I don’t know enough to know about the evidence about links between our cancers and skin cancer but regardless I think we should all be careful in the sun. I have some scars that I have been told to cover at all times with factor 50 to avoid them discolouring brown against my pale skin and generally to follow these rules -

  • Limit or avoid direct exposure to the sun between 10:00 AM and 4:00 PM.
  • Wear sun-protective clothing, including a wide-brimmed hat that shades the face, neck, and ears. Clothes made from fabric labeled with UV protection factor (UPF) may provide better protection.
    *UV-protective sunglasses are also recommended.
  • Use a broad-spectrum sunscreen throughout the year that protects against both UVA and UVB radiation and is SPF 30 or more ideally 50. *Reapply sunscreen to your entire body every 2 hours or every hour after heavy sweating or being in the water.
  • Avoid recreational sunbathing.
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A couple of interesting reads

https://www.leukaemia.org.au/stories/increased-melanoma-risk-in-cll-patients-means-regular-skin-checks-critical/#:~:text=People%20with%20chronic%20lymphocytic%20leukaemia,%2C%20melanoma%2C%20researchers%20have%20found.

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Personally I don’t trust the efficacy of sunscreen levels in moisturisers (just based on my husband getting skin cancer despite using a moisturiser with sunscreen in it). I know since my lymphoma treatment I am also at higher risk of skin cancer in future so I use a factor 50 sunscreen (Altruist - you can get it on Amazon, developed by a dermatologist) for most of the year, factor 30 in the winter. And I always wear long sleeves and a hat in the sun.

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Hello @Mrsmac
Welcome and Thank you for posting on the Forum.
Asking about sun protection is such an important question and topic to raise, particularly as we’re beginning to finally have a few hours with some blue sky and sunshine!
Yes, we should all be protecting our skin from too much UV exposure, to lower our risks of skin cancer, however for people taking certain anti-cancer drugs there is also another risk.
Certain drugs are ‘photosensitive’ and can cause other skin issues, Hydroxycarbomide and Ruxolitinib are two of the Myeloproliferative neoplasms (MPN) drugs that are photosensitive. You would have been told to avoid the sun because of the Hydroxycarbomide being photosensitive, not because of the skin cancer risks.
“Due to an interaction between the drug and UV radiation, this can cause adverse dermatological manifestations”. The manifestations can range from itching and burning to skin blisters/eruptions, and in some cases needing high dose steroid treatments.
If you do choose to go out in the sunlight, it’s advisable to wear long sleeved clothing (UV clothing is even better) and a wide brim hat to reduce your photosensitivity risks, and also some sun cream for skin cancer risks.
We do have an information page on our website that may be helpful to read through: keeping sun safe.
Hopefully we can all enjoy the summer more safely.
Please do call our support line if you would like more support or information: 0808 2080 888 or discuss with your haematology team.
Take care, Heidi. :sunny:

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Wow thank you @Heidi_BloodCancerUK, another thing my former haematologist didn’t explain to me! Just a standard “be careful in the sun” with no mention of it being due to photosensitivity between hydroxyurea and UV light. Relieved to read that hydroxyurea is not carcinogenic after all, thank you for that. So the photosensitivity is why my skin can feel fizzy in bright sun!

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Last thing I want is to be is a killjoy, we all need a pamper be it climbing a mountain or jumping in freezing lakes but there’s caution :warning: needed!

I’m in the Clan Waldenstroms Macroglobulinemia and also an Excema sufferer. Having had PUVA years ago after Chemo/radiotherapy for Hodgkins, thats UVA managed through strict Phototherapy management as Chemo and Radiotherapy have a tendancy to screw up the Immune system as well as help specific illnesses. That includes skin disorders, after all our skin is our first line of immunity.

It was stopped as the risk of morbidity from Melanoma was greater than the distress of Excema. The vitamin D produced was a bonus as I’m also a S.A.D. sufferer.

40 years on I’m again immunosuppressed with a BC and open to a higher risk of infection from skin lesions and illnesses. Recently Atopic Excema flared to a dangerous level (mast cell eruption?). Haemotologist put me straight to Dermatology who put me on UVB narrow band. Worked wonders but again with the same advice and caveats given 10 decades before.
1 - Slip, Slap Slop,
2 - Ask yourself are the ‘rays’ for therapy or vanity?
3 - Monitor exposure and skin.

I’m more an optomist but it doesn’t stop a bit of caution. Please excuse the lecture but I can declare " I’ve been there, done it and I keep the T-shirt on".

Enjoy :wink: the sun, if we ever get any :sunglasses: but in moderation :rage:.

Regards to all,
Iain

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Ouch! Make that 4 decades. Silly me.

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I’ve had PUVA to but never UVB.I developed a rare T Cell Lymphoma call Mycosis Fungoides which was originally misdiagnosed as Eczema and later amended to a diagnosis of Psoriasis .When tumours came it leading to an amputation it was found to be actually T Cell Lymphoma .The PUVA never worked for me and only powerful Gamma Ray radiation will destroy the MF although it comes back.As I understand it UVA penetrates the skin the deepest and UVC the least, UVB being in the middle.Of the 3 UV types only UV A and B are used on people and UVC isn’t used as it causes bad surface burns.All 3 kinds of UV light carry the risk of skin cancer Melanoma being the worst.

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Hi@ Mrs Mac
I think you have opened a good debate about sunscreen. I have believed for a long time that a Vit D test should be included in our routine tests.
I asked my haematologist and he put the request down on my routine blood test form. It was great to know it was at the optimal level. I do take VitD supplements as diet only is very difficult to achieve a good level. I do use sunscreen a hat and sunglasses. But as the sun is the best way to increase Vit D levels I think the whole population should be tested regularly. And if necessary advised on supplements. Of course haematology or GPs should be spoken to before ANY supplements are taken. I have Chronic myelomonocytic leukaemia (CMML) and on watch and wait so no medication being taken yet. Anyway nice to speak to you on the forum
Best wishes
Unclejack.

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Hello @Duncan,

I am so sorry to tell you that taking Hydroxycarbomide can increase your risk of getting skin cancer. I worded my last post badly, and was meaning that the reason a Consultant tells their Myeloproliferative neoplasms (MPN) patients to cover up in the sun, wear SPF creams, etc is not just because of the skin cancer risks, but also due to photosensitivity. Sadly, there is the double-whammy of possible risk of skin cancer from the medication and then possible skin ‘manifestations’ from the treatment being photosensitive.
Some people may be unaware of the photosensitivity risks, and may think that if they lather themselves in sun-cream that is sufficient protection, however this does not protect your skin from potential blisters or burning caused by the photosensitivity.
I think the key message is to be careful, limit your risks where you can and get any skin changes checked out by your GP or Haematologist, particularly if you’re taking Hydroxycarbamide.
Apologies again for the confusion. Heidi.

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Oh no need for apologies @Heidi_BloodCancerUK, thank you so much for clarifying my misunderstanding! It’s good to know how careful of my skin I need to be in terms of both photosensitivity and skin cancer risk. Just off out to get my new moisturising sun lotion, funnily enough! I really appreciate you posting again to make sure I understood the risks, thank you!

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Thanks for the info, I’ve got myself a hat from wallaroo uk, they have plenty of nice hats to choose from which have uva/uvb sun block. I’ve got la Roche sun screen now and for my face murad! Expensive but nice on the face and has a really good lot of information about it too. Just small life changes to make.

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Thank for the advice I’m taking everyone’s advice here, got the wide brimmed hat, and la Roche for the body, and murad for the face. :wink:

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