Sunscreen Use on the Dorsal Hands at the Beach

Background. Since skin of the dorsal hands is a known site for the development of cutaneous squamous cell carcinoma, an epidemiologic investigation was needed to determine if beachgoers apply sunscreen to the dorsal aspect of their hands as frequently as they apply it to other skin sites. Aim. The aim of the current study was to compare the use of sunscreen on the dorsal hands to other areas of the body during subtropical late spring and summer sunlight exposure at the beach. Materials and Methods. A cross-sectional survey from a convenience sample of beachgoers was designed to evaluate respondent understanding and protective measures concerning skin cancer on the dorsal hands in an environment with high natural UVR exposure. Results. A total of 214 surveys were completed and analyzed. Less than half of subjects (105, 49%) applied sunscreen to their dorsal hands. Women applied sunscreen to the dorsal hands more than men (55% women versus 40% men, ). Higher Fitzpatrick Skin Type respondents were less likely to protect their dorsal hands from ultraviolet radiation ( ). Conclusions. More public education focused on dorsal hand protection from ultraviolet radiation damage is necessary to reduce the risk for squamous cell carcinomas of the hands. 1. Introduction Sunlight exposure, particularly ultraviolet radiation (UVR), is recognized as a risk factor for skin cancer. Photoprotection may reduce the risk of developing skin cancer. However, what efforts are made to protect the dorsal aspect of hands from UVR is unknown. There are over a million cases of skin cancer diagnosed each year in the United States (US), and this number is expected to double in the next 30 years [1–3]. About 2000 deaths occur each year from nonmelanotic skin cancers in the US. The cost of care for nonmelanoma skin cancers is the fifth highest for all cancers in the US Medicare population [4]. Many factors contribute to the risk for developing skin cancer including UV exposure, low Fitzpatrick Skin Types, male gender, and advanced age. However, unprotected UVR exposure is the single most important environmental risk factor for developing most nonmelanocytic skin cancers. Several studies have evaluated photoprotective behaviors on anatomic regions that are frequently partially or completely unprotected from UVR damage, such as the scalp, lips, and eyelids [5–7]. The dorsal hands, along with the face, forearms, neck, and legs receive the most sunlight exposure, but unlike the forearms and legs, the hands are often unprotected by clothing. In lower latitudes during the midday hours, the