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The great indoors

Fearful of skin cancer and the sun's damaging rays, some fitness fanatics are heading inside

By Beth Teitell
Globe Correspondent / June 18, 2009

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Diane Dalpe, an aspiring health nut from Arlington, was confused. “All the advice says, walk, walk, walk,’’ she said, “but then the doctors tell you to stay out of the sun.’’

Dalpe, 56, could head outside in a wide-brimmed hat, pants, long sleeves - and apply the recommended shot glass of sunscreen - but, she admitted, “it gets to be a little ridiculous.’’

What’s a person to do? Exercise in the great indoors, that’s what. True, she misses out on the scent of the flowers and freshly cut grass, the sounds of the birds, the feel of the fresh air. But that’s what those nature programs on TV are for. “It’s an Earth experience,’’ Dalpe says of the gardening and outdoors shows she watches from the comfort of her home treadmill.

There are no statistics on the number of people who’ve decide to exercise indoors exclusively to avoid the sun’s aging and cancer-causing rays. But local dermatologists report growing concern about outdoor exercise among their sports- and fitness-minded patients.

“It’s a real issue,’’ said Dr. Jeffery Dover, a director of SkinCare Physicians in Chestnut Hill. “I talk about [sun damage] all the time with my patients who run. Some of them are very smart about it,’’ following sunscreen guidelines and other advice, “and some are not, and they don’t look so good.’’

Like other dermatologists, Dover advises working out early in the morning or very late in the day to avoid the harshest rays, consistent and ample sunscreen use, and covering up. Great advice - that’s often promptly ignored by patients who don’t want to reapply sunscreen mid-run, or can’t fit in an entire golf game before noon.

And the sad truth is that even those who wear a baseball cap while they’re working out in the sun aren’t really doing enough. In general, caps protect the forehead, and if the brim is on the long side and pulled down low, the nose. But the cheeks get little if any shade. For full protection, Dr. Dover said you need a hat with a brim all the way around. “You virtually never see anyone running with a hat like that. It would bounce.’’

And cyclists face an additional challenge: the incompatibility of bike helmets and any kind of sun-blocking hats.

“Unless they made a helmet with a flying-saucer type brim all around it, I’m not riding outside,’’ said Janet Plotkin, 63, of Cambridge, a dedicated stationary bike rider. The warmth of the sun on her skin, she said, makes her think of cancer and wrinkles, not summer. “I refuse to exercise outdoors.’’

To be fair, the sun does provide people some benefits, such as aiding in the synthesis of Vitamin D. Increasingly, researchers are recognizing the nutrient’s value, which may extend beyond helping to build strong bones to reducing the risk of certain cancers, heart disease, and arthritis.

Unfortunately, dermatologists don’t have a simple chart that translates hours spent in the sun to years added to one’s appearance or increased skin cancer risk. But one thing is clear: The more time spent in the sun, the more damage skin endures.

“All sun damage is damaging,’’ said Dr. Barbara Gilchrest, professor of dermatology at Boston University School of Medicine. “And it’s cumulative.’’

The incidence of all skin cancers continues to increase in the United States and is widely attributed to sun exposure, according to Gilchrest. Melanoma, the most dangerous type of skin cancer, has increased more than 40-fold since statistics were first kept in the 1930s, she continued.

According to the American Academy of Dermatology, “excessive sun exposure, especially severe blistering sunburns early in life, can promote melanoma development. The risk for developing melanoma may also be inherited.’’

Donna Nardolillo, 48, a part-time accountant from Cranston, R.I., says she is acutely aware that the clock is ticking whenever she’s in the sun. She’s started rationing her time outdoors, and no longer blows her whole sun budget running or biking. She prefers to spend it socializing at the beach, or watching one of her children play sports. She always wears sunblock.

“Once you start thinking about all the damage you’re doing you can’t shut it off,’’ she said as she browsed at Saks Fifth Avenue in Back Bay. Nardolillo works out at her local Gold’s Gym, where, she adds, faux tans are very much in evidence.

“You’ll notice everyone at the gym has a tan - they spray,’’ she said. “It shows off your muscles.’’ The anti-sun message has also gotten through to Dean Linendoll, 40, district manager for the BCBG clothing chain. “Running outside defeats the purpose,’’ he said. “I feel like I’m taking too many chances [with damaging rays]. I want to age gracefully.’’

Asked what level sun protection he wears, Linendoll turned shy. “It’s embarrassing - 30,’’ he said, referring to the SPF, or sun protection factor, in his sunblock. The higher the number, the more protection from burning rays it offers. These days, a 30 SPF is not that high. Neutrogena recently broke the three-digit barrier with its 100+ SPF sunblock, and other brands are creeping in that direction.

Still, until a manufacturer comes out with a sunscreen that functions as an actual umbrella, dermatologists will continue advising patients to stay out of the midday sun and cover up.

“What I see a lot in my office are people who exercise in tank tops,’’ said Dr. Madeline Krauss, a Wellesley dermatologist. “That’s a nightmare. The shoulders and the chest are very common areas not just for sun damage, but a lot of skin cancers and a lot of precancerous lesions.’’

Some of her patients have started exercising indoors, she said, but others prefer to deal with the sun issue in another way: They want the damage removed with lasers or other cosmetic procedures. To such patients, Krauss offers words of caution.

“Unless they can turn it around and protect themselves better than in the past, it doesn’t make sense to do [cosmetic procedures],’’ Krauss said. “With enough repeat sun damage, they’ll be back to where they were before.’’

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