Keeping skin protected pays dividends in the long run
With summer in full swing, most people plan to spend time outside at the pool or beach. Being outside is a great way to relax, get some exercise, and take in a little vitamin D. While being exposed to too much sun does raise the risk of developing skin cancer, with some simple precautions you can protect your skin from the sun.
Skin cancer is caused by too much exposure to ultraviolet (UV) light. This light comes from the sun, tanning beds and sunlamps. Ultraviolet (UV) light has shorter wavelengths than visible light, making them invisible to the human eye. The CDC states that protection from UV rays is important all year, not just during the summer. UV rays can reach you on cloudy and cool days, and they reflect off surfaces like water, cement, sand, and snow.
The precautions to mitigate UV exposure are common-sense measures for the most part. First, avoid being outside when the sun is strongest. In the continental United States, UV rays tend to be strongest from 10 a.m. to 4 p.m. daylight saving time (9 a.m. to 3 p.m. standard time). “If you stay out of the sun during those hours as much as possible, stay in shaded areas, that’s ideal if you’re outside,” said Dr. Richard Carvajal, MD, a leader in rare melanoma research at Northwell Health.
(Photo by Amanda Olsen)
Second, make sure your clothing blocks the sun’s rays. Clothing is available with an SPF rating, which measures how well it protects your skin from the harmful radiation. “There’s sun-safe clothing that you can wear that has kind of SPF protection in it. Which is really great, particularly for the kids, you know, who may not be wearing sunscreen as much as you want them to,” Dr. Carvajal said. He also recommends a broad-brimmed hat that shields the eyes and covers the back of the neck.
When it comes to sunscreen, the best option is the one you are most likely to use, whether a spray or a lotion. According to Dr. Carvajal, “Apply it, apply a lot and apply it often. I think the issue with sunscreen is people sometimes forget to use it altogether. So you have to remember to put it on, but also remember to reapply every couple of hours. After you go in the pool or something, make sure to reapply at that point as well.”
There are a few key areas of the body that are often overlooked. These include ears and feet. “People always forget behind the ears. People always forget the top of their feet, right so if you’re wearing sandals, those feet will always get burned. With the sprays, always make sure that it’s coating the entire body.” One advantage of mineral-based sunscreens is that they need to be rubbed in, forcing a little extra attention to parts that might otherwise get overlooked.
Because of awareness campaigns, sunscreen has become ubiquitous at some public areas. “There’s been so much awareness of this if you go to the public pools and stuff, they’ll frequently have just canisters of sunscreen there for public use. More and more you’re seeing sunscreen in public places as well,” said Dr. Carvajal. Still, making sunscreen a regular part of the family’s routine helps them remember to use it. Adding a bottle of sunscreen to the kids’ school bag will make sure they always have it on hand.
Right now, there is not enough evidence to support a recommendation for an annual skin exam by a dermatologist. The CDC states that “Checking your skin for moles regularly will help you find any suspicious changes. Be sure to check less visible areas of your skin like the soles of your feet. Tell your doctor about any unusual moles or changes in your skin. Also talk to your doctor if you are at increased risk of skin cancer.” Based on this, it makes sense to do a once a month skin check to become familiar with your particular moles and other concerns. Dr Carvajal agrees. “Look at your skin, have your partner look at your back, and just do that periodically. I say, just look once a month. It’s easy, and it’s free. If you’re at higher risk, or if there’s something weird, then it might be more frequent with that.” A person with fair skin and blue eyes is most high-risk, as is a person with a history of childhood sunburn or a family history of melanoma. Freckles are another risk factor. Additionally, people with a suppressed immune system, whether from a medical condition or medication, also need to pay extra attention.
An easy way to keep track of skin changes is the alphabet mnemonic- ABCDE. This stands for asymmetric, border, color, diameter, and evolving. Dr. Carvajal explained that “If it’s asymmetric or if the borders are irregular, if the color is a little bit kind of patchy, if the diameter is bigger than the size of the pencil eraser, or if it is changing. And those are the features that make us think, ‘this is something we should probably bring to the attention of the dermatologist.’”
Even in the worst case scenario, most skin cancers are treatable and have very good outcomes. Dr. Carvajal presented an optimistic picture: “Bottom line is that all of these skin cancers are easier to cure when they’re caught early. You know, when we talk about our skin cancers, and the most common ones that we see are these basal cell cancers and the Squamish cell cancers, are almost always cured by surgery. And even with the melanomas, the small ones they’re less than a millimeter thick, really thin. but as they get deeper, even two or three millimeters, the likelihood of those spreading and causing problems increases.
So you really do want to catch, particularly the melanomas, as early as possible. And those are those moles, the funny little moles, you want to catch them early, when they’re easier to cure. When you catch them in the early stage, the likelihood of cure is 99 98%. It’s not 100, but it’s pretty good. So let’s catch these early.”
