I am always amazed by the dichotomy that I see in some of my patients, especially young women. Most have a profound awareness of their skin–what is new, what is changing. I am always so happy to see that women are paying such close attention to their skin. At the same time I see many young women who are not only uninformed about the signs and symptoms of skin cancer, but seem to engage in potentially dangerous behavior for the health of their skin.
I see skin cancer daily in the office. Fortunately, most skin cancers are not deadly, as melanoma potentially can be. However, the incidence of melanoma is on the rise and evidence suggests a doubling of the rate of melanoma every ten to twenty years. Last year alone, in the United States there where over 60,000 new cases of melanoma–over half of which were in women. In fact, women under 40 are almost twice as likely to develop melanoma as men.
I always teach my patients what to look for when doing self skin exams. After all, a well informed patient who does regular self exams is the best way to ensure that skin cancers are detected early. The A, B, C, D, Es of melanoma is a great screening tool:
A — Asymmetry — any lesion that is asymmetric; one half is not like the other
B — Boarder irregularity — an uneven, irregular, or scalloped boarder
C — Color variation — a mole that is varied from one area to another; has shades of tan, brown, or black; is sometimes white, red, or blue
D — Diameter — melanomas oftern have a diameter greater than 6mm in size — the size of a pencil eraser
E — Evolution – A mole or skin lesion that looks different from the rest or is changing in size, shape, or color
Here are some simple tips for preventing skin cancer
Look for any changes in your skin — Do a monthly skin exam! I helps to use a hand held mirror for those hard to visualize parts of the body such as the backs of the thighs
Wear sunscreen daily — Sunscreen is not just important on beach days. Passive sun exposure, the type you get through your car window or running into the mall adds up over time! This leads to wrinkles, sunspot, premature aging, and skin cancer. And remember, 80% of the sun’s ultraviolet rays reach the earth even on an overcast day.
Pick the right sunscreen — While sunscreen with an spf of 15 provides protection from 93% of ultraviolet B light, that is assuming it is applied correctly. The average person uses 25-30% of the density of sunscreen that they should. The sunscreen manufacturers intend for us the apply the sunscreen thick and white–like frosting a cake. I tell my patients to take the spf and divide it by three (so an spf of 15 is really a 5) and that is the level of protection that you are getting. So aim high, an spf of 45 really is not that outrageous. And if age spots are a concern for you, look for a sunscreen that also contains zinc or titanium. These ingredients are great at reflecting the light that causes darkening of the skin.
Practice sun avoidance — be aware of when the sun is at its strongest. It is between the hours of eleven and four that the sun’s rays are most intense and damaging. These are the times when you want to be most vigilant about covering up and reapplying your sunscreen.
Avoid tanning beds – While a women’s risk of melanoma doubles if she has had five or more sunburns in her life, a single tanning bed exposure before the age of 30 increases a women’s lifetime risk of melanoma by 75%.