Saving your skin

With summer here, millions of people are flocking to beaches and pool sides to acquire that much-admired tan--and cancer! We know that too much sun is the biggest risk factor for skin cancer, but too often people choose to ignore the dangers of sun exposure. Close to 700,000 new cases of skin cancer will be diagnosed this year and 6,500 Americans will die from melanoma, the deadliest form of skin cancer.

GET THE FACTS
There is no such thing as a safe tan. A tan or sunburn is the skin's response to sun damage. The sun's rays contain both ultraviolet B (UVB) or short wave-length sun rays and ultraviolet A (UVA) rays which are longer and deeper penetrating. Both types cause skin damage and skin cancer.

Tanning in a salon is just as dangerous to your skin as the sun's rays, perhaps more so. The intensity of just one tanning visit can cause skin damage and increase the risk of skin cancer.

The risk of skin cancer begins in childhood. Just one or more serious sunburns during childhood or adolescence can double a person's risk of skin cancer. Melanoma often strikes people who have experienced blistering sunburns or have worked at three or more outdoor jobs during their childhood or teenage years.

SKIN CANCER
There are three types of skin cancer:

Basal cell carcinoma
As the most common form of skin cancer, it manifests as a sore that won't heal or begins as a red, irritated patch that itches and bleeds.

Squamous cell carcinoma
A shallow, crusty lesion with a wide, raised border that grows rapidly, but is rarely fatal.

Melanoma
The most deadly form of skin cancer, it can look like an ordinary mole; it has an irregularly shaped border and varies in color. However, unlike a benign mole, it usually grows rapidly and eventually spreads to the lymph nodes and other parts of the body.

Fortunately, while some cancers are difficult to detect because they affect organs deep within the body, skin cancer is often readily visible and easy to examine and treat if diagnosed early.

KNOW YOUR SKIN
There are several different skin types. People with very sensitive to moderately sensitive skin are prone to developing skin cancer.

Very Sensitive Skin-- Fair-skinned people with blue, brown or hazel eyes and red, blond or brown hair. They burn easily, don't tan much and peel after every burn. Their unexposed skin is white and freckled.

Sensitive Skin-- Average white-skinned people who burn moderately and tan a little. Their unexposed skin is white.

Moderately sensitive-- White or light brown-skinned people who have dark brown hair and dark eyes. They only burn minimally, and tan easily. Their skin darkens with each exposure to the sun.

Minimally sensitive-- Brown-skinned people who rarely burn and tan substantially with every exposure. Their unexposed skin is brown.

Non-Sensitive-- Black-skinned people who never burn and tan profusely. Their unexposed skin is black.

EXAMINE YOUR SKIN
Perform a skin self-exam every six months. Know what your skin is normally like so you can monitor any changes that might occur. Do a thoroughly complete self-exam, undress completely and stand in front of a full-length mirror in a well-lit room. Notice the shape, size and color of moles and any other skin spots. If you find a sore or mole that won't heal or bleeds recurrently or a red patch that itches or crusts over, please see a dermatologist immediately. Many skin lesions are non-cancerous, but only a trained skin specialist can make that distinction.

If you don't find any problems, visit a dermatologist for a baseline skin examination and yearly follow-ups as a preventive measure, especially if you have cancer-prone sensitive skin or are of English, Irish or Scandinavian decent.

PRACTICE PREVENTION
Wear Sunscreen--Almost 90 percent of skin cancers arise on areas of the body that are not protected from the sun's ray. If there is only one thing you are willing to do to save your skin, wear a sunscreen whenever you're in the sun.

Choose a sunscreen with a sun protection factor (SPF) of at least 15. SPF 15 sunscreen blocks out 98 percent of the sun's rays. SPFs of less than 15 are of little value, and those above 15 could be more marketing hype than actual skin help.

Remember to apply sunscreen liberally and re-apply it every two hours or after swimming if you don't use a waterproof type. Don't forget to apply also to your ears, nose and any balding areas.

Wear sunscreen on overcast days because ultraviolet rays can damage skin through cloud cover. Average light clothing has an SPF of only 6 or 8, so if you will be outdoors with just a single layer of thin clothing, apply sunscreen prior to dressing. If you use a self-tanning lotion, use sunscreen as well.

Wear Protective Gear-- Sunglasses, visors and hats are a must. Sunglasses are now available that shield UVA and UVB ultraviolet light. They can protect your eyes from damage that can lead cataracts and degeneration of the retina as well as skin cancer of the eyelid.

Women who wear bikinis are at least 10 times more likely to develop skin cancer than women who wear one-piece swim suits. Men and women who sunbath in the nude are at a high risk as well.

Reduce Sun Exposure-- The sun is at its peak intensity between 11 a.m. and 3 p.m. Try to plan outdoor activities before or after this time.

The allure of a tawny tan pales in light of the dangers inherent in exposure to the sun. As you head for the great outdoors, consider that practicing "safe sun" will give you the inner glow that comes from protecting your skin, and your life.

PHOTO: Two people sunbathing on a beach.

PHOTO: A woman being examined by a doctor.

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By Ronald S. Scott, M.D., Ph.D

Ronald S. Scott, M.D., Ph.D. is president and medical director of the South Coast Tumor Institute in San Diego, as well as founder and CEO of CancerQuest, dedicated to the prevention of cancer. Dr. Scott is also assistant clinical professor at the University of California, San Diego School of Medicine; and president-elect of the Association of Freestanding Radiation Oncology Centers.

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