With summer’s outdoor activities just around the corner, now is a good time to take a few minutes to think about your skin’s health and how to protect it. Al Knable, MD, a board certified dermatologist, and Lucio Di Nunno, MD, a board certified medical oncologist, share their knowledge and offer tips on how to protect yourself from skin cancer.
As Dr. Di Nunno explained, “There are 3.5 million diagnoses of skin cancer every year in the United States. The majority are basal cell carcinomas. They are extremely unlikely to spread, and when removed promptly, are basically cured. Somewhat less frequent are squamous cell carcinomas. They may spread, particularly when they occur on the lip or ear or in immune-suppressed patients. But when they’re treated early, they are usually curable. The most dangerous type is melanoma. It is less frequent, but is the most likely to spread. It causes 75 percent of all deaths from skin cancer.”
“People need to know the magnitude of the problem to understand why it’s so important to be aware of their skin’s health and take precautions against skin cancer. And they should realize that their skin’s natural color, even if it’s very pale, is what’s healthy and beautiful.”
Lucio Di Nunno, MD
Board Certified Medical Oncologist
Floyd Memorial Cancer Center of Indiana
“It’s important to remember that nobody is exempt from the possibility of skin cancer. From the fairest of the fair to the darkest-skinned African-Americans, everybody needs to take inventory, periodically doing a self-assessment for new moles or changes in their skin.”
Al Knable, MD
Board Certified Dermatologist
Associates in Dermatology
How to Recognize Skin Cancer
Basal cell carcinomas are often flesh-colored. They may appear as a waxy bump, or a flat, scar-like lesion. They are usually symmetrical, often have elevated borders and sometimes have ulceration in the middle.
Squamous cell cancer may appear as a firm, red nodule, or as a patch that is red, crusted and scaly.
Melanoma presents itself as a mole, a lesion or a large brownish spot with darker speckles. As Dr. Knable explained, “There is a pneumonic to help people remember what signs to watch for in a mole. It is A, B, C, D and now, E.” (See “Warning Signs of Melanoma” below.)
WARNING SIGNS OF MELANOMA
If you have a mole that changes in color, size or feel, one that bleeds or has any of the following signs, you should see your doctor.
When the two sides do not match.
“Watch for jagged edges or finger-like projections,” said Dr. Knable.
Melanoma may be speckled with brown and black, or have portions that appear red, white, blue or blue-black.
As Dr. Di Nunno explained, “Any mole with a diameter of ¼-inch or more should be evaluated.”
Check out any mole if the elevation is uneven, or if it is evolving in size, shape
When to See a Doctor
According to Dr. Knable, “If you have a spot that hurts or itches for more than a couple of weeks, it needs to be checked. Any new mole you develop over the age of 40 is a red flag and should be looked at as soon as possible. And a sore that doesn’t heal within a month should be assessed as well.” He added, “Nothing needs to be alarming or scary. It should just be checked out by someone who knows what they’re looking at.”
- Excessive sun exposure – “Sun exposure is absolutely the main cause of skin cancer,” said Dr. Di Nunno. “Ninety percent of it occurs on uncovered parts of the body, such as the face, ears, neck and the back of the hands. As Dr. Knable said, “I equate sun exposure with tobacco use. Both are known carcinogens. That’s why I don’t think there is any completely safe exposure. But I’ve never recommended that anybody skip a golf outing or a boat ride. You should definitely do what you enjoy outdoors. Just protect yourself.”
- Use of sunlamps and tanning booths – the risk of skin cancer is greatly increased among people who use them, particularly before the age of 30.
- A history of severe, blistering sunburns
- Smoking – it increases the risk of skin cancer twofold.
- HPV – “Certain types of HPV, the human papilloma virus, increase the risk of squamous cell cancer,” said Dr. Di Nunno.
- Heat, chronic ulcers and contact with petroleum products – “Anything that causes chronic inflammation of the skin is a risk factor,” explained Dr. Di Nunno.
- A personal or family history of skin cancer
- Skin that burns easily – The risk is higher among people with pale skin; blue, gray or green eyes; red or blond hair; or many freckles.
- Certain medical conditions or medicines, including those that suppress the body’s immune system
- Exposure to arsenic
How to Protect Yourself
- Avoid being in the sun during the middle of the day; between 10 am and 3 pm.
- Wear sunscreen all year-round – “For routine purposes,” said Dr. Knable, “a person with a fair complexion who will be in the sun more than an hour a day should wear sunscreen with an SPF of 50. If you’re just out running errands in the summer, you should wear a sunscreen with an SPF of 30, particularly on the backs of the hands, the arms, nose, ears and forearms. In the winter, an SPF of 15 is appropriate.”
- Wear protective clothing.
- Avoid tanning beds.
- Be aware of medications that might make your skin more sensitive to the sun, such as certain antibiotics, anti-inflammatory drugs, and some medications for cholesterol, high blood pressure, diabetes and anti-cancer chemotherapy.
- Check your skin regularly and tell your doctor about any changes you notice.
The Facts About Sunscreen
With hundreds of products on the market, choosing the right sunscreen can be a challenge. Here are a few tips to keep in mind.
SPF, or Sun Protection Factor, is the comparison between the time it will take for your skin to begin to burn with and without protection. For example, if your skin normally starts to redden 10 minutes after you’ve been in the sun, a product with an SPF of 15 should allow you to stay out 15 times longer, or 150 minutes, before your skin starts to burn. However, you need to use enough sunscreen, apply it evenly, put it on 15 minutes before your exposure to the sun, and reapply it often. Few people use sunscreen in a way that will give them maximum protection.
Numbers Do Matter
“Several years ago, there were a lot of articles claiming that a sunscreen with an SPF of 15 was about the same as one with an SPF of 30 or higher,” said Dr. Knable. “Maybe that was true then, but not now. With modern sunscreen, there is a big difference. There are calculable differences, even between SPFs of 50 and 100.”
UVA and UVB Protection
Choose a sunscreen that protects you from both types of the sun’s rays. According to Dr. Di Nunno, “Protection from both UVA and UVB rays is important. But be sure to look for UVA protection. Those are the rays that are most associated with melanoma. Light-scattering sunscreens, such as zinc oxide and titanium dioxide, seem to offer better UVA protection.”
- Use enough sunscreen
- Apply it evenly
- Put it on 15 minutes before your exposure to the sun
- Reapply it often
Free Skin Cancer Screenings
Screenings performed by board certified local dermatologists.
Thursday, May 19, 3 – 5 pm
Floyd Memorial Cancer Center of Indiana
2210 Green Valley Road , New Albany, IN
Wednesday, June 29, 1 – 4 pm
Floyd Memorial Medical Group – Salem
1100 Jim Day Road, Suite 107A , Salem, IN