Summer has officially arrived on Aotearoa’s shores. With the sun blazing and holidays just around the corner, many whānau will be planning outdoor activities.

Of course, spending time outdoors requires sun protection but do Māori and Pacific Islanders really need to use sunblock?

Many have heard phrases like ‘I’m brown enough’ or ‘I don’t burn,’ but do these opinions protect our whānau from skin cancers caused by the sun?

What do the experts say?

Dermatologist Dr Monique MacKenzie (Ngāti Tuwharetoa) and skin cancer prevention expert Dr Bronwen McNoe both believe everyone should be sun protected.

MacKenzie said there was a lot of misperception when it came to Māori and Pacifika people in the sun.

“If you tan, then people falsely associate that with a natural type of sun protection, but that’s just not really the case.”

She said people with more melanin in the skin were more protected but weren’t immune to skin cancer.

“That false misconception that you’re immune from developing a skin cancer actually results in more progressed cancers, so more severe outcomes and worse prognosis,” MacKenzie said.

She referenced the late Jamaican musician Bob Marley, who died of melanoma at the age of 36.

McNoe said skin cancer formed when skin cells were damaged from the sun’s UV rays.

“Your skin cells have DNA, so it’s basically a set of instructions that tells your cells how to grow and work properly.

“When UV rays damage the DNA in your skin cells, the cells may not follow the instructions anymore properly.

“Normally what skin cells will do is they grow, they’ll do their job, and then they’ll die when they’re no longer needed but, if the DNA gets damaged, the cells can start to grow out of control and they won’t stop as they should and that can lead to the development of a lump or tumour forming on your skin,” she said.

‘Cancer doesn’t discriminate'

Briar Avatea (Ngāti Tuhoe) is a melanoma survivor.

She also believes Māori and Pacific people should be sun-protected.

“You hear so many people says ‘I’m brown, I don’t burn’ and it’s like well it doesn’t actually matter if you burn or not, or what colour your skin is - cancer doesn’t discriminate.

“We have to be smarter.”

When Avatea was pregnant with her youngest child, she noticed a spot on her arm that never went away. After the birth of her son she finally got it checked by a doctor who cut it out to send it to a lab. Four weeks later she received a call that changed her life.

“I was on my way to playcentre with my kids and [the doctor] just said ‘I’m really sorry, you’ve got the most aggressive form of skin cancer, you’ve got melanoma.

“Being post-partum is already hard enough a lot of the time and then finding out I had cancer was, well, life-changing.”

With two infants, Avatea said she started to spiral going against advice and Googling, which did her a disservice as it provided an article about death from the cancer.

Luckily she had her husband by her side supporting her along her journey, staying up at night while she breastfed their baby and talking to her about what might happen.

“We sort of just went into a planning mode because we didn’t know how bad it was going to be.

“I think that was the hardest part, the unknown and not knowing if I was going to be there for my children, or if my husband would have to raise the children without me.”

During Avatea’s journey, her husband was by her side but many of her whānau and friends didn’t want to or know how to talk about it. She also found comfort in a Facebook group page for melanoma support.

Before the diagnosis, Avatea wasn’t the sun’s biggest fan before the diagnosis but those times she did venture out she admitted she only sometimes put on sunscreen.

" I wouldn’t say I was out there burning, but I wasn’t exactly covered either."

The advice she wants to give to the Māori and Polynesian community is to get their skin checked either by themselves, a partner (For the hard-to-see places), or a GP regularly.

What should our whānau do?

Sunblock isn’t the only way to stay sun-smart this summer. McNoe advises wearing sunglasses, clothing with collars, long sleeves, and long pants to protect skin. Whenever possible, people should seek shade under trees or other shaded areas.

She also recommended wearing a broad-brimmed or bucket hat. Caps were “okay’ but offered little protection.

“If you are going to wear a cap, then you really, really have to wear sunscreen with it because you won’t get protection for your ears, neck, parts of your face, usually your nose."

When using sunscreen, it’s recommended to choose a cream with SPF 50+, nothing less, and ensure it provides broad-spectrum protection.

Many people dislike sunscreen because it leaves a white cast on the skin but McKenzie said formulas hda improved significantly. She personally uses sunblock with “ultra-light fluids”.

“There’s several reasons why that’s good. One is it just absorbs really quickly because a lot of people hate that sticky feeling of having sunscreen on, it doesn’t leave a white cast and, for our whānau members who want to put makeup on over top of that, it’s not going to peel,” the dermatologist said.

But she did recommend shopping around depending on the activity people were doing, such as for those who swim to get waterproof creams.

One perk of wearing the sun protective was keeping a youthful look, McKenzie said.

"[The] sun accounts for 85% of skin ageing and wrinkles, so that’s a good reason to put some sunscreen on and use some protection."

Skin cancer isn’t always a dark mole

Melanoma is one health statistic where Māori and Pasifika people are not the ethnic groups at risk, according to Te Whatu Ora’s Cancer Data Web Tool.

Many people might be aware that a dark, unusual mole on the body should be checked but McNoe warned that not all skin cancers were pigmented.

“I recently had a skin cancer removed that looked more like a pimple on the skin which just didn’t heal. And that turned out to be a non-melanoma skin cancer.

“So just don’t think they’re always dark, they’re not,” she said.

She also cautioned melanoma didn’t always grow in sun-exposed spots.

McNoe called for better prevention in Aotearoa, saying it would save a lot more money in the long run and save lives.

“New Zealand Aotearoa spends 1600 times on treatment what we do on prevention and, if we work on improving prevention, we can reduce that cost considerably for our children and grandchildren in the future.”

That sentiment was shared by Avatea who believed there wasn’t enough awareness in the communities.

“Since I’ve had melanoma, I see it but, before then, I didn’t see it. I don’t remember other than slip, slop, slap and wrap growing up. I don’t remember seeing any other sun awareness or skin cancer awareness.

“People know about sunscreen but they don’t know how deadly it can be having skin cancer or, even if you don’t die, how impactful it can be on your life or your whānau.

“So I think if we can get it out there in the schools, kura, kōhanga, start it from young that sunscreen is just a norm we put on every day when we go outside. If we start it as young as possible we can prevent this.”

MacKenzie added that it was now a requirement in New Zealand dermatology training to understand the treatments and care for people with darker skin tones, as well as how these individuals are affected by different environments, including sun exposure. This was not a requirement previously.