May is Skin Cancer Awareness Month. Skin cancer is the most common form of cancer in the United States. It is estimated that one in five Americans will develop skin cancer in their lifetime, according to the American Academy of Dermatology. The Environmental Protection Agency estimates that 90% of non-melanoma skin cancers and 65% of melanoma skin cancers are associated with exposure to ultraviolet (UV) radiation, whether from the sun itself or artificial sources.
Understanding Skin Cancer
Skin cancer comes in three forms: basal cell carcinoma, squamous cell carcinoma and melanoma.
Basal cell carcinoma
Basal cell carcinoma (BCC) is the most common skin cancer type with millions of diagnoses every year. BCC normally forms on skin that gets the most sun, such as the head, face, neck and hands. It can resemble psoriasis or eczema. See a doctor if you have a persistent non-healing sore, a reddish or irritated patch, a shiny bump, growth with an elevated border or a scar-like area with undefined borders. BCC is easily treated when caught early.
Squamous cell carcinoma
The next common type of skin cancer is squamous cell carcinoma (SCC). There are approximately 700,000 new cases in the United States annually. SCC develops from years of UV exposure typically on the scalp, neck, hands, limbs and areas of the face like the ear and lower lip.
Signs of SCC include a scaly red patch, an elevated growth with a central depression, a persistent open sore or a wart-like growth that crusts. This form of skin cancer can spread in the body. So, early diagnosis and treatment is imperative for a complete recovery. Mohs surgery is a procedure that treats BCC and SCC where layers of skin are removed until only cancer-free tissue remains. “I’ve had four spots on my face from years in the sun and had to have Mohs,” Phyllis Hertzberg, an 80-year-old Florida resident, said. “I noticed the first spot on my nose and went right to the doctor.” She now goes to the doctor every three months for a checkup and routinely checks her own skin. “You know your body best, so always check and go to the doctor right away,” she said.
Melanoma
Melanoma is the most dangerous and deadly kind of skin cancer. Melanomas look like moles and can sometimes develop within an existing mole. So, it is important to know and keep a close eye on your body. Examine yourself once a month and look for changes to existing moles or new moles that may correspond to one or more characteristics on the ABCDE scale.
Suspicious moles may be asymmetric (A), have uneven borders (B), be various shades of color (C), have a diameter (D) larger than a pencil eraser or evolve (E) over time. Any suspicious mole should be brought to the attention of a dermatologist immediately. Melanoma can spread quickly to other parts of the body where it becomes more difficult to treat.
Protecting Yourself From UV Radiation
UV radiation comes from the electromagnetic spectrum from the sun. UVA and UVB are two types that affect the skin. UVA rays cause your skin to tan, while UVB rays are the sunburn culprit. Both forms cause damage to your skin, requiring the use of sunscreen with a proper Skin Protection Factor (SPF). Sunscreen protects your skin by absorbing and reflecting light, and SPF measures the effectiveness the product has against skin reddening and sunburn.
The Skin Cancer Foundation recommends using at least SPF 15 for normal activity and at least SPF 30 for extended outdoor exposure. Use a sunscreen that is labeled broad spectrum to protect against both UVA and UVB rays. Sunscreen works best when applied at least 30 minutes prior to sun exposure (so it can absorb into the skin). It should be reapplied every two hours. Apply liberally to the thin skin on your face and include your ears, tops of your feet and other often overlooked areas. Do not assume using a higher SPF gives you leeway. Double the SPF level is really not double the protection. Products with SPF 15 block out 93 percent of UVB rays while SPF 30 only blocks out 97 percent. No matter the SPF, tanning is not a safe activity.
Skin types
While the same sun shines down on all of us, not all skin is created equal. The Fitzpatrick Skin Type is a classification system developed to estimate genetic disposition and the skin’s reaction to UV radiation.
The scale categorizes six different skin types depending on skin color (fair being type I and very dark being type VI) and whether or not the skin burns easily. Skin types I–II, with ivory-white to white skin that rarely tans and almost always burns, are at the highest risk for skin cancers. Type III, white skin that experiences moderate tanning and sometimes burns, is also susceptible to skin cancers. That is not to say that skin types IV–VI are not at risk. All types are vulnerable. While dark skin produces more melanin, which provides some protection, it does not create an immunity. It is important that everyone protect their skin regardless of color and race.
Along with skin protection, getting screened by a dermatologist is vital. Dr. Sailesh Konda, co-director of Mohs surgery and surgical dermatology and assistant clinical professor of dermatology at University of Florida Health Dermatology, advises that everyone see a board-certified dermatologist once a year for a skin examination. “Self-examination of your skin from head-to-toe can also be performed every month at home,” he said. Konda recommends taking sun protection a step further than sunscreen by incorporating protective clothing, including a brimmed hat and UV-blocking sunglasses. As if skin cancer is not reason enough to find some shade, UV rays can also damage collagen fibers and contribute to premature aging such as wrinkles and leathery skin. Solar lentigines, skin discoloration better known as age or liver spots, is also caused from prolonged exposure. Do your skin a favor, grab some SPF and protect yourself from the Florida sun!
But What About My Tan?
There is no such thing as healthy tanning. The American Academy of Dermatology warns that base tans are not beneficial. A base tan is just a tan, and tanning is actually a mutation caused by skin cells attempting to ward off damage from UV radiation. Continuous mutation of the skin’s cells can lead to skin cancer. It is not just the sun; any kind of tanning involving UV rays is damaging.
Indoor tanning is quite dangerous and can increase the risk of developing melanoma by 75 percent. The National Conference of State Legislature reported that 16 states have banned the use of tanning beds for children under the age of 18 and at least 42 states have imposed regulations. Brazil and Australia have banned indoor tanning altogether. While that sun-kissed glow looks nice, it carries dangerous consequences. There is no benefit to tanning, only a long list of negative effects, with a prominent one being skin cancer.
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