The Medical Minute: Be sun smart -- protect and examine your skin

By Elizabeth Magill Billingsley

As summer approaches, we all look forward to spending more time outside. Although the media continues to inform us about the rising incidence and danger of skin cancer, the lure of beach vacations, poolside activities and outdoor play is hard to resist. With awareness of sun protection and a sensible approach to sun exposure, it is certainly possible to have an enjoyable outdoor summer season without compromising your health.

Skin cancer is the most common cancer occurring in the United States. At current rates, 1 in 5 Americans will develop skin cancer in his or her lifetime. Fortunately, the majority of these cancers are basal cell carcinoma. These skin cancers are slowly growing lesions that may crust or bleed and do not heal on their own. Basal cell cancers most commonly occur on the head and neck but also can grow on the arms, legs, and trunk, especially in people with significant sun exposure. The good news is that basal cell cancer is extremely unlikely to spread to other parts of the body and can be treated fairly easily if detected early. The next most common type of skin cancer is squamous cell carcinoma. These cancers may look similar to basal cell carcinomas but often are more crusted and scaly. Squamous cell carcinomas can usually be treated very successfully with simple approaches; however, if neglected, these cancers have the possibility of spreading to other parts of the body.

Malignant melanoma is the most deadly of the commonly seen skin cancers. Its incidence is rising faster than that of any other cancer in the US. The incidence is especially increasing in young adults, and more than 8,000 Americans will die of melanoma this year. Melanoma often appears as a brown lesion that looks like a mole. They usually have color variation with shades of brown or black, and occasionally red or white irregular borders; they are asymmetrical; and they change over time. Fortunately, melanoma can be treated successfully if detected early. However, if melanoma is not detected very early, it can spread to other parts of the body and is extremely difficult to treat at that point.

Risk factors for skin cancer include fair complexion, light eyes, family history of skin cancer, inability to tan easily, red hair and history of significant sun exposure. As mentioned above, early detection of skin cancer is critical to a successful outcome. Self exams of the skin can easily be performed in front of a mirror. Special attention should be paid to appearance of a new lesion, a non-healing lesion or a change in a previously stable lesion. Yearly skin checks are important, especially for individuals with a personal or family history of melanoma.

What can be done to prevent skin cancer? The most common cause of all skin cancers is ultraviolet radiation -- from the sun or from artificial sources, such as tanning beds.

Simple ways to limit sun damage and minimize the risk of skin cancer are:

  1. Sunscreen -- Use SPF 15 or greater; apply every two hours and after swimming or sweating. Apply liberally – it takes one ounce (a shot glass) to cover the sun-exposed parts of the body. Use a sunscreen that blocks UVA and UVB rays, and apply even on cloudy days.
     
  2. Moisturizing lotion with sunblock should be applied daily to the face and neck. These products are lightweight and can be applied each morning after washing the face or shaving. This easy practice can minimize the daily incidental exposure and cumulative damage.
     
  3. Wear a hat -- A broad-brimmed hat rather than a baseball cap provides excellent protection for the ears, neck and cheeks.
     
  4. Cover up and wear sun protective clothing. Keep a shirt on when at the beach or working in the yard. Many companies manufacture clothing that has SPF incorporated or is designed to cover up while keeping you cool.
     
  5. Limit time in the sun between 10 a.m. and 4 p.m. when the rays are the strongest.
     
  6. Be aware of reflected sun from water and snow. Wear sunblock when skiing.
     
  7. Seek the shade. Umbrellas at the beach are a great way to stay cool and protect your skin.
     
  8. Avoid tanning beds -- The ultraviolet radiation from tanning beds is associated with skin cancer, including melanoma. The rays also penetrate deeper in the skin and are associated with photo aging changes such as wrinkles and pigment irregularities.
     
  9. Seek your vitamin D from your diet, not the sun. Although sun exposure can help with vitamin D levels in the skin, it does not justify purposeful tanning. Studies have shown that a healthy diet provides adequate intake of vitamin D. If levels are a concern, eating fortified foods or taking a supplement is adequate. Additionally, it takes very little sun exposure to produce vitamin D to healthy levels.

Enjoy the summer. Do the outdoor activities you love, but be sun smart about it. Protect your skin, avoid purposeful tanning, and examine your skin. Remember, skin cancer is curable if detected early, but prevention is even more important.

For more information on ways to prevent skin cancer, visit the following Web sites:


Elizabeth Magill Billingsley is an associate professor of dermatology at Penn State Milton S. Hershey Medical Center.

 

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Last Updated March 19, 2009