Mental impact - now scared of the sun

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Hi All,

Just wondered if anyone has any tips for "getting on with life" again after treatment for bcc and AK.

I had treatment for two BCCs back in 2015 using Aldara, which was a traumatic three months with every side effect on the list, including depressed mood and teariness.  That was my first encounter with skin cancer and it took a good couple of years before I was relatively happy being out in the sun again, although I always tried to avoid it when possible and wore SPF 40/50 cream when exposed.

My skin has continued to deteriorate since then and I used Diclofenac for around three months on several patches of possible AK late 2020/early 2021, and was then given Efudix by my dermatologist to treat a couple of larger areas of definite AK.  That produced a similar surface reaction to the Aldara and does seem to have settled those areas again for a bit, but thankfully without the systemic flu-like response. 

Until this week, I've stayed out of the sun completely this year, but used to be a really outdoorsy person, loving walking, running, cycling, kayaking etc.  Not only has this dramatically affected my physical fitness, which I'm going to start to address by joining a gym, but it's also starting to impact my mental health, which I'm more concerned about.  A few days ago I spent 30 minutes - yes, just 30 minutes - doing some gardening in the sunshine after 3 pm, and in that time three red patches appeared on my forearm and have not disappeared since.  I've not walked, run or cycled at all for many months now, and no longer accept invitations to BBQs, friends' gardens etc. as they're outside.  The sun has become my enemy.

I'll keep an eye on the physical side of things, of course, but can anyone help with the mental side?  These new red patches have again reinforced my feeling of being scared to go out at all now, and my attitude's become one of "ooh look, it's a lovely day - better hide indoors on the sofa, then".  When I spoke with my consultant back in July, he said he'd refer me for psychology support, but I know that will take a while.

Thanks in advance for sharing any suggestions or personal experiences!

  • Hi 

    I'm sorry to read how worried you are about going out in the sun and I can totally understand how you might be feeling at the moment.

    I was diagnosed with malignant melanoma in November 2016 so have had 5 summers since then when I've had to adapt my way of life to stay safe in the sun. I've also had an actinic keratosis and a BCC removed since then.

    As you know it's important to protect your skin from the affects of the sun but this doesn't mean that you have to stop doing things you used to enjoy doing, unless that was sunbathing, but you need to change some things to protect yourself.

    When I was diagnosed with melanoma I was given a leaflet with the following advice and thought you might find it helpful:

    1. Stay out of the sun during the strongest time of the day (11am to 3pm) between April and October inclusive in the UK and in all months of the year in any other part of the world
    2. When going outside wear long sleeved tops and trousers/skirts made from natural fibres like cotton
    3. Wear a broad brimmed hat (brim should be at least 3 inches) and sun glasses
    4. Sit in the shade and never sunbathe (or sun bake as the Australians call it!)
    5. Any part of your body that is not covered, ie. face, neck, back of hands should have a sun protection cream of SPF 50 that is effective against both UVA and UVB rays
    6. Re-apply the sunscreen every couple of hours or immediately after swimming
    7. Never use sunbeds
    8. Don't use sunscreen instead of covering up

    The first summer after I was diagnosed was particularly hard as I used to enjoy sitting in the sun. However, I quickly got used to the new regime and have a selection of hats to choose from when I go out. I also decided that I now needed a whole new wardrobe so went on a shopping spree. So, every cloud has a silver lining!

    I still go walking and obviously it isn't always possible to avoid the 11am to 3pm window so I make sure I'm covered up and liberally apply sunscreen every couple of hours to my face, neck and back of hands which aren't protected. 

    I still go to friend's BBQs, etc but make sure that I always sit in the shade and as they all know I had melanoma they don't think it's strange that I don't sit in the sun.

    So cover up, stay in the shade when you can and apply sunscreen to any parts of your body that are exposed and you should still be able to do all the activities you used to enjoy!

    x

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  • Hi ,

    Like , I am very sorry to hear that you have such a fear of the sun following your BCC and AK experiences. Unless your dermatologist has told you to never be out in the sun, I feel that you are probably taking unnecessary precautions. Spending time outside, doing sport and enjoying time with friends are all essential to your general health. Do not abandon them lightly!

    I had melanoma in 2017 and also several BCCs that were diagnosed around the same time. My initial fear was that I would have to give up my outdoor activities. The only activities I was told to never do were sunbathing and sunbeds.

    To put this into context I live in the south of France. My hobbies include hiking at high altitudes, snow shoeing, coastal walking and swimming. Some of these involve all day excursions where I am outside in the middle of the day with a high UV intensity. I wear cotton with a tight weave, shirts with long sleeves that are buttoned up with the collar raised and leggings, as well as a hat and cycling gloves. I apply factor 50 suncream on my face and neck before setting out and every 90 minutes or so. It's not glamourous at all but it works for me. I get pretty hot and sweaty at times but it is worth it to be able to keep up my activities. As soon as I am in the shade or under trees I open a few buttons to cool down.

    At the beach, I have a UV T-shirt for swimming and I get dressed straight after my swim.

    Gardening I do in the morning and late afternoons and always well covered up too. The rash you got after gardening could well be from contact with a plant that irritated you. I have very sensitive skin and easily get rashes. I always wear gloves and long sleeves to protect my hands and arms.

    I don't wear UV clothing otherwise as I hate the feel of the fabric and cannot tolerate synthetic fabrics against my skin. Just tight weaves and very covering clothes.

    You might like to keep an eye on the Melanoma forum as you figure out how to get back to your activities and find the best way to protect yourself in the sun. There are regular exchanges on sun protection and lots of ideas

    Take small steps to build up your comfort in the sun. Going into autumn is a good time to start building up again. It's definitely less scary than high summer. By the time spring comes you will feel less intimidated and ready live with the sun again - on your terms!

    I hope this helps to reassure you that you while you need to protect yourself from the sun (true for everyone!), you do not need to avoid it.

    Take care

    Miranda 

  • FormerMember
    FormerMember

    Hi ,

    I'm pretty much in the same position, spent my life in and chasing the sun and always loved being outdoors. As well as the BCC I have been diagnosed with I have red shiny patches, small red spots like solid blood blisters and various dry patches, discolorations, lumps and bumps. Never really given them much thought until this unhealing skin symptom cropped up and forced me to take action - albeit after waiting for Covid 19 crisis to wane a bit.
    At present, I have simply covered up with the lightest possible clothes and hat and started routinely applying sun cream to any exposed areas. I'm hoping to go on holiday at the end of the month, visiting kids and grandchildren in the process, so will start to find out what the true impact of this new lifestyle is.
    That will be my approach, though. to do what needs to be done first and foremost, then to ease of very slowly and carefully if I find it is too hard a task to cope with on a day to day basis. The difficulty for me is what to tell people. Obviously, you need to be as open as possible to get cooperation and to address the big issues but, as anyone who has had any type of Big C knows, it is still a delicate issue and very dependent on the people and details...
    Anyhow, very best of luck and good wishes.