Staying safe in the sun

As June arrives, we are looking forward to the warm, sunny days of summer and perhaps the nice tan from a beach vacation.

While small amounts of sunshine are important to produce vitamin D and regulate our calcium metabolism, like many things we over-indulge in, extensive sun exposure has a long-term downside – skin cancer.

Skin cancer is the most common human cancer with about 1 million new cases each year. It has been estimated that almost half of all Americans who live to age 65 will develop skin cancer at least once in their lifetime. As a result, it is important to be vigilant about changes in your skin.

The face is the most common location for skin cancers because it is the area most exposed to UV radiation from the sun. Any new growths, sores that do not heal, or unexplained skin changes lasting longer than two weeks should be evaluated by your physician.

There are three types of skin cancer, including basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal cell carcinoma is the most common, accounting for 90 percent of all skin cancer, and it is the least likely to spread to other organs. Melanoma is the least common skin cancer, but it causes the most deaths due to rapid spread to adjacent organs.

Basal cell carcinoma usually appears as a small, pearly, dome-shaped bump covered by tiny blood vessels. A biopsy done by your physician is the best way to diagnose basal cell carcinoma. There are multiple methods of treating basal cell carcinoma. The most common treatment is excision of the questionable area. Treatment is determined by the location, risk of scarring, age and health of the patient. Treatment is successful more than 90 percent of the time.

Squamous cell carcinoma begins as actinic keratosis or rough, red bumps on the scalp, face, ears and back of hands. The area is often sore and tender, out of proportion to its appearance. As actinic keratosis progresses it becomes a squamous cell carcinoma. Unlike basal cell carcinoma, there is a chance that it could metastasize, or spread to other areas. Again, the best way to diagnose a squamous cell carcinoma is for your physician to do a biopsy. Early treatment is important to prevent the risk of spread, but numerous treatment options exist similar to basal cell carcinoma.

The risk factors for basal and squamous cell carcinomas are the same, including light-colored skin, sun exposure and increased age. The best way to prevent the non-melanoma forms of skin cancer is to avoid sun exposure. Limit recreational sun exposure, avoid tanning booths, and avoid unprotected sun exposure between 10 a.m. and 4 p.m., the peak radiation time. When exposed to the sun, wear hats, tightly woven protective clothing and SPF 30 water-proof sunscreen with UVA and UVB protection. It is important to reapply sunscreen every two to three hours, especially after swimming or heavy sweating.

Melanoma is the most dangerous of the skin cancers, but it is curable if diagnosed and treated early. Melanoma is a malignant tumor originating in melanocytes-the cells that produce the pigment melanin that colors hair, skin and eyes. Risk factors include a first degree relative (mother, father, sister, or brother) with melanoma, sun exposure, total number of moles and skin type.

The warning signs of melanoma can be recognized using the ABCDE method:

A: Asymmetry – the two halves of a mole do not match

B: Border – an uneven, scalloped, or notched edge

C: Color – a variety of colors, one symmetric color is best

D: Diameter – larger than a pencil eraser or larger than 6mm

E: Evolving or changing – any change in size, shape, color, elevation, bleeding, itching or crusting should be evaluated by a physician.

All three types of skin cancer are rising, but most skin cancers can be prevented by limiting or avoiding exposure to ultraviolet radiation, and with early detection, there are successful treatments for most skin cancers, even the most aggressive forms.

Dowd is a dermatologist at Susquehanna Health Dermatology at Rural Avenue.