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UV Safety

There are two main types of ultraviolet, or UV, radiation that come from the sun, named UVA and UVB radiation. Both UVA and UVB rays… Read more

There are two main types of ultraviolet, or UV, radiation that come from the sun, named UVA and UVB radiation. Both UVA and UVB rays are dangerous for the skin; they cause premature wrinkles and can increase your chance of developing skin cancer.

So, is there a safe way to tan? No, there is no safe way to tan. A tan is the skin’s response to injury caused by UV exposure. To protect your skin from UV damage, your body makes melanin, the pigment that gives color to your skin and eyes.

When your skin gets damaged by the sun’s rays, it makes more melanin to try and protect your skin from further damage. This causes the skin to change color — to darken in the case of a tan or to burn. Every time you tan, you damage your skin and this damage accumulates over time. This accumulated damage, in addition to accelerating the aging process, also increases your risk of developing skin cancer.

It is important to protect yourself from the sun because skin cancer is currently the most common cancer in the United States, and it is estimated that one in five Americans will develop skin cancer in their lifetime.

To protect yourself from UV radiation and help prevent skin cancer, we recommend take the following precautions:

•   Seek shade when possible, remembering that the sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow is shorter than you are, seek shade.
•   Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses. A wide-brimmed hat is a good way to create shade on your face and neck. Wearing sunglasses can help to avoid skin cancers that occur in the eye.
•   Generously apply sunscreen and reapply every two hours.

There are two main types of sunscreen, physical blocking sunscreen and chemical sunscreen. Physical and chemical sunscreens work a little differently, but they are both effective when used correctly. Physical blocking sunscreen works like a shield, deflecting the sun’s rays. It contains the active ingredients zinc oxide or titanium dioxide and is specifically recommended for those with sensitive skin. Chemical sunscreen works like a sponge, absorbing the sun. Chemical sunscreens contain the ingredients oxybenzone, avobenzone, actisalate, octocrylene, homosalate and octinoxate. The benefit of chemical sunscreen is that it is generally easier to rub into the skin and does not leave a white residue. When using chemical sunscreen, opt for an SPF of 30 or higher; make sure the words “broad spectrum” are on the packaging and be sure to apply 15 minutes prior to exposure to the sun.

Skin cancer types

There are many types of skin cancer, however the main ones to understand are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma

BCC facts

BCC is the most common form of skin cancer and the most common cancer among all cancers.

– BCCs occur most often as a result of ultraviolet damage to the outermost layer of skin over an extended period of time. In other words, the longer the history of sun damage the higher the risk of developing BCC (and other skin cancers). Some rare genetic syndromes, however, are also associated with the development of frequent BCCs (such as Basal Cell Nevus Syndrome).

– A common patient concern among those with a history of BCC is a growth on the skin that sometimes has a fine scab or scale and bleeds then appears to heal but often never completely heals. BCCs are often mistaken for bug bites, skin infections, pimples or other similar growths. However, one of the most common patient-reported occurrences is that the growth never completely heals.

– BCCs commonly arise in sun-exposed areas of the body. In patients with darker skin, about half of BCCs are pigmented (meaning brown or dark in color).

– The good news is that most cases of BCC are curable and cause minimal damage when caught and treated early. The bad news is that BCCs typically grow slowly and very quietly, and, therefore, many patients do not begin to have symptoms until they are advanced, which is when many patients go to the dermatologist for an evaluation.

– While BCCs rarely spread beyond the original tumor site, if allowed to grow, these lesions can be disfiguring and dangerous. Untreated BCCs can become locally invasive, grow wide and deep into the skin and destroy skin, tissue and bone. The longer you wait to have a BCC treated, the more likely it is to recur, sometimes repeatedly.

SCC facts

Squamous cell carcinoma is the second most common skin cancer.

Squamous cell carcinomas usually appear as crusted or scaly patches on the skin with a red, inflamed base; a growing tumor; or a non-healing ulcer. They are generally found on sun-exposed areas like the face, neck, arms, scalp, backs of the hands and ears. However, squamous cell carcinoma can also occur on non-sun exposed areas such as inside the mouth or on the genitalia.

If left untreated, squamous cell carcinoma can destroy much of the tissue surrounding the tumor. Aggressive types of squamous cell carcinomas, especially those on the lips and ears, can spread to the lymph nodes and the rest of the body. The good news is that squamous cell carcinoma is easily treated if caught early.

Importance of skin exams

Regular skin examinations by a dermatologist are very important in the diagnosis of skin cancer since diagnosing them early requires a trained eye to identify the signs for an accurate diagnosis.

– If your dermatologist identifies a suspicious growth on your skin, he or she may take a small sample of skin called a skin biopsy to confirm the diagnosis.

– The longer the skin cancer has been on your skin the more aggressive it becomes over time, leading to increasing risk of further spread.

Once a patient has been diagnosed with SCC or BCC, the treatment options include:

– Curettage and electrodesiccation (electrosurgery)

– Mohs surgery

– Excisional surgery

– Radiation therapy

– Photodynamic therapy

– Cryosurgery

– Topical chemotherapy for superficial BCC

– Systemic cancer medications for advanced BCC and SCC

Mohs surgery is considered the gold standard treatment for BCCs and SCCs of the head and other sensitive areas because it allows for the highest cure rate (up to 99 %) while leaving the smallest wound possible when compared to other treatment options. It is also safely performed with local anesthesia and tolerated very well.

Melanoma facts

Melanoma, the most serious form of skin cancer, is characterized by the uncontrolled growth of pigment-producing cells. The vast majority of skin cancer deaths are from melanoma. One American dies of melanoma every hour.

Melanomas might appear on the skin suddenly without warning, but they can also develop on an existing mole. They most frequently appear on the upper back, torso, lower legs, head and neck.

More than 1 million Americans are living with melanoma, and melanoma is not just being diagnosed in older individuals any longer. In fact, it is the second most common cancer in females 15-29 years old.

If detected and treated before it reaches the lymph nodes, melanoma has a 99% five-year survival rate.

Who gets melanoma?

Melanoma can strike anyone, but the risk factors include:

• Skin that burns easily, blond or red hair, immune system suppression
• Exposure to Natural and Artificial Ultraviolet Light
  • Even one blistering sunburn during childhood/adolescence can nearly double a person’s chance of developing melanoma
    • Having more than five blistering sunburns between 15 and 20 increases melanoma risk by 80% and nonmelanoma risk by 68%
  • Tanning beds increase risk of melanoma
    • May cause over 400,000 cases of skin cancer each year
  • Daily sunscreen use cuts the incidence of melanoma in half
• Having more than 50 moles, atypical moles or a family history of melanoma
• Melanoma survivors have a nine-fold increase of developing another melanoma

Recognizing changes in the skin is the best way to detect early melanoma. To do so, use the ABCDEs of melanoma:

u  A stands for ASYMMETRY – One half is unlike the other half.

u  B stands for BORDER – An irregular, scalloped or poorly defined border.

u  C stands for COLOR – Color varies from one area to another; has shades of tan, brown or black; or is sometimes white, red or blue.

u  D stands for DIAMETER – While melanomas are usually greater than 6mm, the size of a pencil eraser, when diagnosed, they can be smaller.

u  E stands for EVOLVING – A mole or skin lesion that looks different from the rest or is changing in size, shape or color.

The American Academy of Dermatology urges everyone to examine their skin regularly. This means looking over your entire body including your back, your scalp, the soles of your feet, between your toes and the palms of your hands. If you notice a mole that is different from others, or that changes, itches or bleeds, even if it is small, you should make an appointment to see a board-certified dermatologist as soon as possible.

Supportive Oncodermatology

In addition to diagnosing and treating skin cancers, at OCSRI skin cancer center, we provide supportive oncodermatology for our cancer patients. Supportive oncodermatology is a relatively new field within dermatology that emerged due to the frequent skin side effects of chemotherapy. The mission of supportive oncodermatology is to identify and manage dermatologic symptoms that occur during anticancer therapy and, by doing so, improve the patient’s quality of life so that they may continue to receive lifesaving anti-cancer therapies.