My Summer Joys—and Some Serious Precautions
News Flash: Infectious Ticks Are Bad News!
I love summer. While it’s not here yet on Long Island, when it does get hot in late June, and then even hotter in July and August, I spend glorious days of summer outdoors, barefoot, in shorts, and on (or in) the water. Since childhood I have associated this weather with some of the happiest times of my life. Some of it I’m sure was the carefree, no-school summer vacations at a little house near a lake in northwest New Jersey. To this day, being outdoors on a warm day with as little clothing on as possible makes me happy.
But this happiness comes at a price if I’m not careful, with two different threats where I spend summer: ticksand sunburn. Ticks carry Lyme disease and other pathogens, and sunburn can lead to skin cancer.
A Really Bad Summer, Thanks to a Tiny Tick
Two summers ago, I was bitten by a tick that I hadn’t noticed and simultaneously developed Lyme disease and babesiosis, another tick-borne pathogen. It was one of the worst experiences of my life, landing me in the emergency room for 24 hours on Labor Day weekend. By that time my immune system had taken such a hit that I also had mononucleosis. I was put on 3 antibiotics, which killed off the bacteria that caused the diseases over a few weeks, but my immune system took another 6 months to fully recover. And I was one of the lucky ones. I have heard horror stories about “long Lyme” and permanently suppressed immune systems, as well as other symptoms like permanent hearing loss. ’Nuff said. Ticks are bad news.
Being barefoot in grass and sand is an essential part of my summer. Long pants and shoes and socks are not an option. So, I have to be careful. Cedar oil is a good natural repellent that doesn’t seem to irritate my skin. But most important of all is a daily (or more often) tick check, in front of a full-length mirror with a bright light. If I see something that looks suspicious, a magnifying glass helps. According to my doctor, if you get the tick off within 24 hours, it hasn’t released any pathogens it might be carrying. (Upward of half of the ticks in this area carry Lyme disease. Lyme, Connecticut, where it was first diagnosed, is just across Long Island Sound.) The last-stop precaution I keep around is a preventive dose of doxycycline. If I’ve missed a tick and find one within a day or two, two pills, one at night and one the next morning, will kill the pathogen.
Tip: If you see a red ring around a tick bite or you are feeling sluggish and have a low-grade fever, these may be signs of Lyme disease. You will need to see a doctor immediately and may need to start a long-term dose of doxycycline as soon as possible.
“Fun In the Sun” Means Thinking about Skin Care
Sun is the other factor I need to be careful of. I was a redhead as a child and burned often. This was long before the age of sunscreen. Then, for several years in my 20s, I worked outdoors building houses, shirtless all summer, again pre-sunscreen. My skin burned and then got very tan, and I have lots of freckles (which dermatologists call “skin damage”) on my back, shoulder and arms. I now get checked by a dermatologist every 6 months for anything amiss on my skin and have had a couple of small, early squamous cancer lesions frozen off. Still, I love the feeling of the sun on my skin, I know there are benefits to it like vitamin D, and I still like to get tan, not burned. I also don’t like the feeling of sunscreen on my skin unless using it is absolutely necessary during an outdoor activity. So, how do I manage it?
We’ve all heard that the midday sun is the most damaging. Why? In my reading, I’ve learned that it’s not because the sun is any stronger or weaker at that time but it’s due to the amount of atmosphere, which includes ozone, that filters the sun’s rays during that time. The part of the sun’s rays that tan and burn are the ultra-violet spectrum (UV). These are further broken down into UVA, UVB, and UVC. Most of what makes it to the earth is UVA, which doesn’t burn your skin, although this type of UV radiation can cause premature aging and dryness. Our atmosphere filters out all the UVC and most of the UVB. UVC radiation would fry us if our atmosphere didn’t filter it out, and UVB is the part of the spectrum that burns us. Only 5% of UVB radiation makes it through the atmosphere, even at midday, although this has increased slightly with the depletion of ozone.
During the early-morning, late-afternoon, and evening hours, much less UVB gets through because the angle at which the sun’s rays hit the earth travel through much more atmosphere. This is a long way of saying that those periods are “safer” to be outside, from a sunburn and skin cancer standpoint. I try to restrict my outdoor activities to those times, whether I am sailing, paddleboarding, swimming, walking, running, riding my bike, or playing outdoor games (usually slower and more social games like horseshoes, boules, or croquet.) During the midday hours on a sunny day, especially from 11:00 a.m. to 3:00 p.m. (midday here is around 1:00 p.m.), I am either inside, outside covered up with a hat and clothing, or under an umbrella on the beach. If I need to be out in the sun, I will wear sunscreen.
Most doctors would prescribe either covering up or wearing high-factor sunscreen all the time. I know I won’t be able to enjoy my summers if I did that, so my own prescription is what works for me. When I told my dermatologist this, she was surprisingly forgiving. She said that given the amount of exposure I’ve had over my life my skin was in relatively good shape. And then she said something even more eye opening. She said that whatever damage our skin has suffered and that might cause any form of skin cancer happened many years ago, when we were much younger. What we do now is less important than what we did then. To me, that is a cautionary tale for my daughters and their sun habits, now that we are in the age of sunscreen, less ozone, and more knowledge about the causes of skin cancer—and how to prevent it.
