Frank is the consultant dermatologist at Aberdeen Royal infirmary and this year completed his first iron distance race in Roth, Germany. For triathletes the sun tan is not just about the all important look but is part of being acclimatised to racing in hot climates like Hawaii. Frank understand better than anyone the problems this causes and has some interesting insights and useful advice for us all.
Frank, tell us a little about yourself and what motivated you to do an ironman?
I have recently moved from Dundee to Aberdeen where I found perfect training conditions for triathlon. Deeside has an almost unlimited supply of scenic and quiet cycling routes and Knockburn loch is perfect for open water swimming. For the past 2 years I have worked at Aberdeen Royal Infirmary as a Dermatology consultant with special interests in skin cancer and phototherapy. I have been participating in Triathlons since the late eighties, but only got seriously into it for the past four years. Triathlon is such a great sport, working on different muscle groups, training of your cardiovascular system and after finishing an event you get a great sense of achievement.
Many triathletes aspire to a sun tan like world champions Chrissie Wellington or Chris McCormack but is this healthy?
Of course it is a worrying site seeing perma-tanned Chrissie Wellington with signs of premature skin ageing. You can fast forward and have a look at Paula Newby Fraser, who looks extremely photodamaged and I am pretty sure must have had some form of skin cancer or pre-cancerous skin conditions despite her relatively young age.
Ironman training and racing often means we spend hours in the sun at the worst times of day, what problems does this cause?
Getting burned during a race will have an effect on your performance. The skin loses its function in thermoregulation and will also have an increased risk of fluid loss, which means you will overheat and get more dehydrated.
In the long term you will also increase your risk of skin cancer.
Who is most at risk from skin damage and what warning signs we should be looking out for?
People who are fair skinned are most at risk. For sunburn there are no warning signs, you are not able to feel or sense the strength Ultraviolet (UV) light. Take an overcast day for example, the clouds will block the heat rays, but fail to block the ultraviolet rays, which is a particular dangerous situation.You also have to be aware that the redness of sunburn only becomes apparent with a 4 to 8 hour delay after exposure to ultraviolet light, so when you can see redness on your skin then it is far too late.
What should we all be doing to combat the problems you mentioned?
Use sunscreen and cover up if possible. Have sunscreen with you on race day, keep it in transition or in your bentobox on the bike. In Roth this year, I wore a cycling top covering my shoulders, a bandana under my cycling helmet and uncovered areas like face arms and lower legs covered with sunscreen. If you use bandanas or caps you will not have to apply sunscreen above your eyes, which prevents sunscreen dribbling in your eyes especially when you sweat. I also re-applied sunscreen during the marathon.
Torbjørn Sindballe is famous for pioneering arm coolers and long sleeved tops. What do you think of this and are all garments equal when it come to UV protection?
He definitely had the right idea. You have to be a bit careful with garments and UV protection, it depends how tightly woven they are, so if they are very see through you might still get burned. I also spotted Bella Bayliss wearing a long sleeve top, considering she is from Scotland and fair skinned that makes sense.
There has been a lot in the media about sunbeds recently, are they a good way to acclimatise to the sun, or should we stay away from them?
Commercial sunbeds in tanning parlours emit mainly UVA, which will give you a tan, if you have the type of skin that tans. A tan does not give you very much UV protection, only a Sun Protection Factor (SPF) of 2 to 4.
There a few fair skinned pro-athletes that would be in contention for podium spots but struggle in the sun of Hawaii . For these select few is there any more extreme options?
The skin adapts to UV exposure in 2 ways, one is the tanning response the second is by skin thickening, skin thickening is mainly induced by UVB rays. Thickening of the skin gives you a much higher SPF and would be particularly helpful in fair skinned athletes. We use UVB desensitisation for people with photosensitive skin conditions to toughen their skin up in spring. This type of light treatment is only available medically and is closely monitored. It might be an option for a pro before going out to Hawaii.
So Frank what is the take home message and what should people do if they are worried?
Don’t get burned, it will impair you performance on the day and increase your risk of skin cancer in the future. You have to experiment with different garments and sunscreens to see what works for you best. If you are worried about moles etc, you can go to your GP and get them checked out. There is also excellent information available on skin cancer, sunbeds and sensible sun behaviour on the cancer research uk website.
http://www.sunsmart.org.uk/skin-cancer-facts/index.htm
http://www.sunsmart.org.uk/skin-cancer-facts/howdoweknow/sunprotection/index.htm
Finally, what are your racing plans for the near future?
Off to New Zealand in January, to do the Lake Wanaka triathlon, another ironman distance and part of the Challenge family.
very good article, thank you
sinballe used long sleves to perform better, not as protection from sun, not for his health, but i know dejan patrcevic, croatian ironman pro, is one of few i know who are obsessed with sun protection as he ran in 35+ C with long sleves and neck covers. one reason dejan does not like hot places to train during winter, but prefers to stay in continental europe.
but this article is great, answers all my questions
A very comprehensive article. This certainly increases my awareness before I tackle any bigger races in warm climates!!Many thanks
I was asked to supply a little info on my strategy which i am happy to do. It is true that my major concern was performance first, but part of that was also to prevent the big sunburns you usually get when competing, as they will impair thermoregulation as mentioned in the article above. During the development with craft we also tested a mesh fabric but the spf in this was only around 25 compared to the 50 in the craft procool material.
I also know that craft is working on new treatments and technologies to further improve the sunprotaction in their materials as they are commited to provide clothing that can be used as sunprotection and increase performance in trainign and racing. It will be much easier to slip on a shirt or tights than apply sunscreen all over all the time.
I have always used sunscreen in training but have been hesitant to use large amounts of suncreen during races i have the feeling that it reduce the ability to sweat proberly, however i do not know whether this makes sense so it would be nice to know if dr. frank muller had an answer to this?
also it is interesting that athletes such as normann stadler and macca who are muscularly build and heavier than crowie, raeleart or lieto have done very well in Kona. Maybe their darker skin plays a role in this??
Dear Torbjorn,
thank you very much for your comments. I entirely agree that covering up is the better option. Hopefully, if technology advances we will have a garment that is light enough to allow adequate thermoregulation, though thick enough to filter out UV.
With regards to sunscreen and reducing the ability to sweat:
Greasy emollient could almost certainly do that, I wouldn’t expect a water based sunscreen to do that, even some of the reflectant sunscreens use nanotechnology, molecules far too small to clog up pores.
It might be a more subjective thing, so trying a few different preparations to find one that feels right for you might be the way forwards.
Kind regards.
Frank