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 Summer is in full swing and we are enjoying the sunshine, blue skies and long lazy days at the beach. Unfortunately, many people are unaware of the significant skin damage that occurs during this wonderful time of year. This damage, when it occurs time after time, year after year can ultimately lead to skin cancer. The rates of skin cancers are rising dramatically. In the United States alone there are over 1 million new cases per year. One in five Americans will develop at least one skin cancer during their lifetime. Ultraviolet radiation, whether from the sun or artificial sources, is the cause of the vast majority of skin cancers. The most common type of skin cancer is basal cell carcinoma. Actually, basal cell carcinoma is the most common type of cancer worldwide, skin or otherwise. It most often occurs on areas of the skin excessively exposed to the sun, such as the face, ears, scalp, neck, back and shoulders. More rarely, it can occur in areas usually protected from the sun. In the past, this tumor was often found in older people, men in particular. More recently, increased cases of basal cell carcinomas have been found in women in their twenties and thirties. Warning signs of basal cell include: a persistent, non-healing sore; a red patch that may itch; a shiny bump with an indentation in the center or a scar-like area which may be white, yellow, or waxy. Fortunately, this type of skin cancer does not metastasize or travel through the blood stream but it does infiltrate the surrounding area which causes significant tissue destruction. Squamous cell carcinoma is the second most common type of skin cancer, with more than 250,000 new diagnoses per year. Increased numbers of this skin cancer are found in patients with organ transplants, chronic skin ulcers, prior x-ray treatments or radiation, arsenic ingestion, smoking and toxic exposure to oils and tars. This skin cancer can occur on any area of the skin as well as in the mouth or genital region, but most commonly appears on areas that are excessively exposed to the sun. As with basal cell, squamous cell carcinoma is often locally destructive, but aggressive tumors (on the lips or ears) can spread to the lymph nodes or other organs resulting in 2500 deaths per year. Non-healing sores, crusted, wart-like lesions or a persistent red patch should be evaluated by your dermatologist. Finally, melanoma is the most serious form of skin cancer. Although it is not the most common type, it does result in the most deaths. Approximately 62,000 cases of invasive melanoma are diagnosed per year and of those, over 8,000 deaths will occur. Fair skin and history of blistering sunburns increase the risk for melanoma. Additionally, 10% of patients with melanoma have a family member with a history of melanoma. The ABCDEs of melanoma are warning signs that should prompt you to see a dermatologist. Asymmetry means a mole does not look the same when you cut the mole in half. Border irregularity refers to scalloped or indented edges. Having a variety of Colors within one mole is also a warning signal. Varying shades of tan, brown or black as well as red, blue and white should not be ignored. D stands for diameter, melanomas are usually larger than 6 mm, or the size of a pencil eraser. Finally, E is for evolution, or a changing mole. I also consider the ugly duckling sign, a mole that is different from other moles on your body. Prevention and early detection is the key with all forms of skin cancer, but is essential with melanoma which is 100% curable if caught in its early stages. Given that ultraviolet radiation is the primary cause of most skin cancers, protection from excessive UV exposure is essential to decrease the risk of developing skin cancer. This is especially important for children as most sun exposure is obtained prior to the age of 18. Using sunscreen with good UVA and UVB coverage prior to sun exposure is essential for anyone 6 months or older. Children under the age 6 months should be kept out of the sun. Reapplication of sunscreen should be done every 1.5 to 2 hours as well as after swimming or sweating. Sun protective clothing is also available, with SPF built right into the fabric. I also recommend hats and sunglasses. Self skin examinations should be performed on a monthly basis, examining every area of skin from head to toe. This is especially important for patients who have already been diagnosed with a skin cancer because recurrence is most common within the first 2 to 5 years of the initial diagnosis. Avoiding the sun or seeking shade between the hours of 10 am and 4 pm can also help to prevent excessive UV exposure. Also, avoiding artificial UV exposure such as tanning booths is recommended. Finally, a professional skin exam should be performed on an annual basis by your dermatologist to ensure lesions are detected early. So continue to enjoy those days at the beach but don’t forget your sunscreen and wide-brimmed hat!
Dr. Dara Spearman practices medical and cosmetic dermatology with Dermatology Associates of West Michigan, in Grand Rapids, MI. Dr. Spearman received her BS and BA degrees at Hope College where she graduated summa cum laude and was elected to the Phi Beta Kappa honor society. She completed medical school and dermatology residency at the University of Michigan where she was elected to the Alpha Omega Alpha honor society. Dr. Spearman has a special interest in skin of color and has lectures frequently on the topic. Send your questions to Dara@smartnow.com |
