Skin Cancer: It’s a Son of a Beach

Limit your risk in the summer sun.

By Tanya Munger, DNP, FNP-BC

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. Skin cancer occurs when errors (mutations) occur in the DNA of skin cells. The mutations cause the cells to grow out of control and form a mass of cancer cells. Most damage to DNA in skin cells results from ultraviolet (UV) radiation found in sunlight and in the lights used in tanning beds. There are three types of skin cancer: basal cell, squamous cell, and melanoma. Melanoma is the most serious and deadly. Howerver, skin cancer, including melanoma, is highly treatable when detected early.

Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms, hands, and on the legs. It can also form on areas that rarely see the light of day — your palms, beneath your fingernails or toenails, and your genital area.

Caucasians are not the only individuals who are at risk for skin cancer. Skin cancer affects people of all skin colors, including those with darker complexions. When melanoma occurs in people with dark skin tones, it’s more likely to occur in areas not normally exposed to the sun, such as the palms of the hands and soles of the feet. It is typically diagnosed in later stages among those with darker skin tones when melanoma is more advanced and difficult to treat.

Risk Factors

The biggest risk factor for all types of skin cancer is too much exposure to UV radiation. The main source of UV light is the sun but also includes tanning beds. Using indoor tanning beds before age 35 can increase your risk of melanoma by 59 percent, the risk increases with each use. A history of excessive sun exposure or repeated sunburns also increases risk. Other risk factors for skin cancer include skin that burns easily, fair-colored or freckled skin, or having blonde or red hair. Use of immune-suppressing medications, weak immune systems, or a past history of radiation may also pose a risk. Those with a personal or strong family history of skin cancer are at greater risk. People with more than 50 moles, atypical moles, or large moles are also at an increased risk of developing melanoma.

Prevention

Skin cancer is largely preventable, and if caught early, it’s usually curable. Since most skin cancers are linked to sun exposure, it’s important to take precautions when spending time outdoors, no matter what time of year. You can reduce your risk of skin cancer by limiting or avoiding exposure to UV radiation. The sun’s rays are typically the strongest from 10 a.m. to 4 p.m.

The American Academy of Dermatology encourages everyone to protect their skin from the sun’s harmful UV rays by seeking shade, wearing protective clothing and using a sunscreen. A broad spectrum sunscreen with Sun Protection Factor (SPF) 30 or higher for protection from ultraviolet A (UVA) and ultraviolet B (UVB) radiation should be applied 15 minutes before going outdoors; this should be reapplied every two hours while in the sun. This includes wearing sunscreen year-round. Use extra precaution when near water, snow, and sand, as these surfaces reflect the sun’s rays and can increase your chance of sunburn. If you are out in the sun, consider wearing protective clothing such as a wide-brimmed hat or long sleeves.

Skin Assessment

Checking your skin for suspicious changes can help detect skin cancer at its earliest stages. Early detection of skin cancer gives you the greatest chance for successful treatment. Carefully examine your skin once a month looking for any new or changing spots. Knowing the ABCs of skin assessment can save your life. Use the following mnemonic to check your skin at home.

• A (Asymmetry) | Melanomas often have an asymmetrical border, whereas benign moles are usually symmetrical.
• B (Border irregularity) | Melanomas often have ragged or notched borders, whereas benign moles usually don’t.
• C (Color) | Melanomas often contain multiple shades of brown or black within a single mole, whereas benign moles are generally one shade.
• D (Diameter) | Early melanomas are often 6mm or larger, while benign moles are generally less than 6mm.
• E (Evolution) | The symmetry, border, color or diameter of a mole has changed over time.

The ABCDE rule is a good guide to identify the common signs of melanoma. Notify your primary care doctor or dermatologist if you find spots that match the descriptions above. Some melanomas don’t fit the ABCDE rule, so be aware of changes on your skin.

Conclusion

Individuals with excessive sun exposure, regardless of skin color, are at risk for skin cancer. Remember that skin cancer is preventable and when caught early it is treatable. Perform a monthly skin assessment at home and follow up with your health care provider to address any changes. •