July 2, 1999 - Question: What is the most important thing in your golf bag? Is it the $400 driver you got last Christmas, a scoring pencil with an eraser, or a bottle of sunscreen? For golfers, who are at greater risk of developing skin cancer because of their prolonged exposure to sun, the answer should be obvious.

Consider that a round of golf can take four to six hours to play and preferred weekend tee times are generally in the mid-morning. A golfer who tees off at 10 a.m. will be playing during the hours of the day when the sun is at its hottest.

"The unique problem golfers face is they are out in the sun for 4 1/2 hours at a time," says Patricia K. Farris, MD, a dermatologist and clinical assistant professor at Tulane University in New Orleans. "They are exposed to a lot of sun."

To reduce the risk of skin cancer, the American Cancer Society (ACS) recommends limiting or avoiding exposure to the sun between 10 a.m. and 4 p.m., when the sun's ultraviolet rays are strongest. Use sunscreen with at least SPF 15 and cover as much skin as possible by wearing a long-sleeved shirt, long pants, and a hat with a wide brim. It's also a good idea to wear sunglasses.

However, a few of those guidelines may prove difficult for some golfers. Tee times between 10 a.m. and 4 p.m. are prime for playing golf. As for long-sleeved shirts and long pants, wearing them in the dead of summer can turn a pleasant stroll from tee to green into a boot camp exercise. If hot weather prevents golfers from wearing long-sleeved shirts or long pants, then sunscreen should be applied to exposed skin.

Dr. Farris, a golf enthusiast with a 35 handicap, said this doesn't mean people should give up the game. Practical solutions include trying to play early in the morning, late in the afternoon, or in the evenings. "I'm out there twice a week and I'm not in long pants," said Dr. Farris. "I do recommend wearing a long-sleeved shirt and a hat with at least a four-inch visor."

However, golfers should not compromise when it comes to sunscreen. While guidelines call for at least SPF 15, Dr. Farris recommends golfers also use a broad spectrum sunscreen that blocks both ultraviolet A (UVA) and ultraviolet B (UVB) rays. In addition a golfer should apply sunscreen before a round and reapply it every two hours, she said. "You sweat and it comes off. A good thing to remember is to reapply sunscreen at the turn. One thing clubs can do for their members is have sunscreen available between the ninth green and tenth tee."

"The basic principle is to protect the skin," said Martin Weinstock, MD, PhD, professor of dermatology at Brown University and chairman of the ACS's Skin Cancer Advisory Board.

Dr. Weinstock added the benefits of physical activity from golf outweigh the need to avoid the sun. "Golfers are clothed and generally protected," he said. "They have a leg up on sunbathers, for example. They just need to protect their hands, arms, legs, top of the head, face, and ears. For legs, long pants are a reasonable measure. A wide-brimmed hat to protect the head and ears is preferable to a baseball cap."

• Skin Cancer Resource Center
• Protect Your Skin from the Sun