When it comes to skin cancer prevention, consistency is key. And if you have an outdoor hobby, like golf, not using your sunscreen every time you hit the course is a real handicap. Here, our experts drive home advice from their golfing patients that is sure to inspire others.
By Emilie Jacobsen, MD, and C. William Hanke, MD, MPH
Even among regular sunscreen users, the way we use sunscreen products is highly variable, depending on the number of clouds in the sky, the time we expect to spend outdoors, the places we plan to go and the activities we plan to do there. When most people think of sunscreen, it conjures pictures of colorful striped towels and umbrellas littering a sun-drenched beach, buckets of sand for castles, lifeguard towers and volleyball players lunging through the sand. And for many of them, the thought of sun protection (which includes more than just sunscreen, of course) doesn’t evoke a picture of tees, clubs and fairways — but it should.
For some diehard enthusiasts, their passion for golf takes them from coast to coast (or abroad), rain or shine, any time of year. With that comes plenty of exposure to the dangerous ultraviolet (UV) rays from the sun that damage DNA in your skin cells and can lead to skin cancer.
We wanted to know more about what makes the game so addictive, and how it has changed some golfers’ perspectives on their skin health, for better or worse. Read on to hear from four avid players, ranging from casual weekend warrior to professional championship winner, about their favorite courses, best scores and golf tips, and how they think about sun protection. It may change the way you think about it, too!
Golfer: Patrick O’Connor
Favorite course: Cassique Golf Club, Kiawah Island, South Carolina.
Best 18-hole score: 66 (4 under par, he notes) at Highland Golf and Country Club, Indianapolis.
Favorite thing about golf: “It’s versatile. Golf allows people of various skill levels to play with each other due to its handicap system. Also, people can play for social interaction, for work, for competition — and go on golf trips to beautiful locations. It’s played outdoors, and you can go out and play by yourself.”
Most useful golf tip: “Learn to play golf from the green back to the tee. Learn how to putt first, then how to chip, then how to pitch, then your irons, finally the driver, 3-wood and longer clubs.”
Sun protection style: Because of his light skin tone, red hair and history of sunburns, Pat has always known he is at risk for skin cancer. In fact, he’s already had a few: “too numerous to count. I have had all three main types of skin cancer, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. I was first diagnosed with melanoma on my upper arm in 1986.”
This hasn’t kept him from his hobby, but it did change his habits on the course. He explains: “I try to always wear a circular, wide-brimmed hat, a long-sleeved shirt and long pants with sunscreen on my face and neck. I wear sun-protective clothing and sunglasses when playing.” He notes that there are several golf companies that make clothing with a UPF rating (it stands for ultraviolet protection factor) that is comfortable even in hot weather. He tries to make sunscreen part of his routine for all outdoor activities, but if there’s one thing he’s working on besides his game, it’s reapplication, “I probably only reapply sunscreen while playing on the course about 20 percent of the time. I need to get better.”
Golfer: John Turner
Favorite course: World Tour Golf Links in Myrtle Beach, South Carolina (where the holes are replicas of 18 renowned holes from famous courses around the world).
Best 18-hole score: 74 at The Legends Golf Club in Franklin, Indiana, with an eagle on the hardest hole on the course that day!
Favorite thing about golf: For John, the fun of the game has always been mostly about who he gets to spend time with on the course. John’s been golfing for 47 years, starting when his uncle took him for the first time at age 13. “It’s being able to hang out with some of my buddies, and at my age now, I love playing with my son.”
Greatest golf achievement: His first hole in one at The Quarry Golf Club in Canton, Ohio.
Most useful golf tip: “Try not to hit the ball as hard as you can; that usually doesn’t work well,” he advises. He also suggests taking lessons: “Before, even when I was golfing consistently, I would keep scoring in the same 88 to 90 range. I took lessons, and then I started shooting in the 100s. But each time I would do that, I would hit that one shot that was just … a pure golf shot, and that’s what keeps you going. Take a few more lessons and pretty soon, most of the ugly shots are gone.”
Sun protection style: John started wearing sunscreen on the course after his first Mohs surgery on his face. Before that, he says, “It wasn’t a thought. When we were growing up, people would lay on aluminum foil, they would use the oils. You didn’t realize what the cost was going to be later on.” He admits that he’s still not perfect when it comes to sun protection, “I don’t use it as often as I should, and I don’t reapply as often as I should.”
Another hindrance, he says, is that he hasn’t found a perfect sunscreen that won’t make his hands greasy when gripping his clubs. Luckily, more companies offer breathable golf gloves these days that are UPF-rated and also help with grip. And while he prefers shorts and short-sleeved golf shirts, he does try to wear a ball cap most of the time (it’s better than no hat at all, but sunscreen is a must on ears, neck and face). He also keeps up regularly with his dermatologist and hopes that in the future he can incorporate more regular sunscreen use into his golf routine.
Golfer: Nancy Fitzgerald
Favorite course: Crooked Stick in Carmel, Indiana. She was a close friend of Pete and Alice Dye, who designed this course, as well as many of her other favorite courses.
Best 18-hole score: 66 at Crooked Stick Golf Club, during a tournament (a course record)!
Favorite thing about golf: Nancy started playing golf before she was 7 years old, and she’s gone on to have a prolific golf career. “My father was a Hall of Famer in Michigan,” she says. “I didn’t fall in love with the game; I just loved being with my dad. He was very cool. Luckily, I inherited his ability.” At one point, she considered turning professional and even went on tour for a short time before she realized professional play wasn’t what she expected: “I didn’t learn it that way. I learned it to have fun, enjoy the game and enjoy people. On the tour, at that level, that just wasn’t the primary focus.”
She’s continued to play in amateur tournaments around the world, making friends who share her love for the game. She also loves the challenge: “I think it’s the hardest sport. Every shot you make is different from the one before. The challenge is to be able to control your shots no matter what condition you’re playing in and where your ball happens to land.”
Greatest golf achievement: Winning the 1997 U.S. Golf Association Seniors Women’s Amateur Championship. She was also inducted into the Indiana Golf Hall of Fame in 1990.
Most useful golf tip: “Lower your expectations. If you can hit one or two really good shots, be happy with that! I’m teaching my 10 grandkids, and I tell them that it’s not how far you hit it — it’s trying to keep it in play.”
Sun protection style: Nancy grew up on a lake in Michigan, in the era of baby oil and reflectors, and waterskiing all summer long. For years now, though, Nancy always wears sunscreen on the course, despite a humorous outlook on the sun mistakes of her past. “It’s kind of like shutting the barn door after the horses are out,” she says with a wry chuckle. “The damage has been done!”
She considers herself lucky for having evaded skin cancer so far, especially since she has a family history with her English/Irish heritage. So, she checks in with her dermatologist once a year and makes sure to always apply sunscreen to her face before a game, reapplying after nine holes.
Golfer: Michael Stull
Favorite course: Bear Slide Golf Club in Cicero, Indiana.
Best 18-hole score: 72 at the Golf Club of Indiana in Zionsville.
Favorite thing about golf: Michael began playing golf in 1982, explaining, “I started later in life.” He first gave it a try on a course in Florida on a trip to see his parents, but now the game is in his blood. These days, he practices his shots at least an hour a day and plays about twice per week. He enjoys finding courses where he gets to work on a variety of shots, and where he can use every golf club in his bag. The outdoors is a big part of the appeal for him: “I enjoy being outside in the fresh air, with the sunshine, the smell of the grass.” He also likes to challenge himself: “Even if I play with somebody, I’m always competing against myself.”
Most useful golf tip: “Relax. Relax your muscles. When you grip a golf club too tight, your forearms get tight. Hold the golf club like you would hold a baby bird. If your hands are tight, then your shoulders become tight. You have to turn your whole body, and you have to be pretty relaxed to do that well.”
Sun protection style: Nowadays, Michael makes sure that he wears sunscreen on the course “all the time,” paying particular attention to his face, where he has had a few skin cancers. However, this wasn’t always the case when he was growing up on the Jersey Shore. When he graduated from high school in 1968, protective sunscreen wasn’t widely available, and he knows that his early sunburns and tans likely caused some damage to his skin. “We had stuff called tanning lotion and suntan oil. And I loved being out there on the beach at 9 o’clock in the morning until usually 5 o’clock at night.” Then, as a track athlete in college at the University of Kansas, he admits, “I never put sunscreen on. We practiced for two hours outside, but I just never thought to use sunscreen.”
That changed, however, when he got his first skin cancer diagnosis (he notes that he has had seven, both BCC and SCC) and started seeing a dermatologist regularly. Now, his favorite sunscreen has an SPF (sun protection factor) of 100, he wears a hat all the time on the course (he hasn’t adopted a wide-brimmed style but always applies sunscreen to his ears) and his golf habit feeds his sunscreen habit: “I practice golf every day, and every time, I’m wearing sunscreen.”
Emilie Jacobsen, MD, is a dermatologist who is completing a fellowship in Mohs surgery under the mentorship of C. William Hanke, MD, at the Laser and Skin Surgery Center of Indiana and Ascension St. Vincent Hospital, Indianapolis.
C. William Hanke, MD, MPH, is a Mohs surgeon at the Laser and Skin Surgery Center of Indiana. A senior vice president of The Skin Cancer Foundation and a member of its Amonette Circle, he has also served as president of 13 professional societies.