Skin cancer prevention helps avoid treatment

You don’t need sunscreen just when you’re on the sand.

To have the best chance of bypassing melanoma, cancer of the skin, we should all avoid a burn and excessive sun while driving in the car and even walking to and from work.

Skin cancers don’t materialize instantaneously after a sunburn, saus Dr. Guy Webster, of Webster Dermatology in Hockessin.

“Each burn damages your skin a little bit. Some of which get repaired and some of which persist,” Webster said.

The American Cancer Society estimates that there will be 280 new cases of melanoma skin cancer in Delaware this year – 10 fewer than last year’s estimate.

If caught early, melanoma, which develops from melanocytes, the pigment-making cells of the skin, is curable. But it’s still the most aggressive skin cancer and more likely to spread to other parts of the body.

State data shows that about 27 Delawareans die from the disease annually. Rates of other skin cancers, such as basal cells and squamous cell cancers, are harder to track because they are not required to be reported by cancer registries.

“Prevention is probably better than treatment,” says Dr. Joseph Andrews, a dermatologist with Delaware Dermatology in Dover.

With the summer season unofficially starting this Memorial Day weekend, we talked to Andrews, Webster and Dr. Michael Saruk of Delaware Valley Dermatology Group for suggestions about how to avoid sun overexposure and check for any trouble spots.

Know your ABCDEs

Treat moles as more than beauty marks. The Skin Cancer Foundation touts the “ABCDEs” of moles, which offers to tips to spotting changes in them.

A mole should not have asymmetry, Andrews says. A mole shouldn’t look uneven; it should be symmetrical.

“If it’s (the mole) not a mirror image, that would be one of the warning signs,” he said.

The border of a mole should be crisp, not uneven. The color should be uniform, not have different light or dark layers. Moles with a diameter the size of a pencil eraser or larger are suspicious, he added.

Finally, if a mole evolves or changes, have it checked. If a mole has doubled in size in the course of three months, it’s possible it may need to be removed, Andrews said.

Keep in mind r isk factors

Personal or family history of melanoma raises a person’s risk of the disease. People who have more than 50 moles also may be at risk.

Overall, those who sunburn easily, have natural blond or red hair, use tanning beds or have a history of long-term sun exposure should be vigilant with skincare.

Skin cancer can hit at any age, Andrews said, and you don’t necessarily have to have a lot of sun exposure to develop it either.

“Just like a non smoker can get lung cancer,” he said.

The only risk factor that you have control over is exposure to ultraviolet light – or being in the sun.

“You can’t change your genes,” he said.

Saruk said he thinks everybody should have a skin check once every year, which is on par with recommendations with the Skin Cancer Foundation.

Check yourself

Check your body and moles every month, Andrews says. On each check, moles should all look about the same each check. If you have a lot, snap some photos so you can reference them each month.

Most people do a pretty good job monitoring skin changes on their face and upper body, Andrews says, but the lower extremities often get overlooked.

“Women have a greater rate of malignant melanoma on the lower extremities,” Andrews says. “They stop at the waist.”

Be vigilant about checking your legs, especially behind the knees and around the back. But also the ears, back of the neck and back of the hands, Webster adds.

“Ears are the big one. It’s a shame because they are among the most susceptible to getting bad sun damage,” he said.

Use your fingers

Run your fingertips on your skin to feel for any rough, scaly, crusty lesions. Known as actinic keratoses, they are precancerous spots caused by damaging ultraviolet rays and typically they appear on the face, scalp, lips and back of hands

“You shouldn’t be growing new things when you are in your 30s and 40s,” Webster says, adding that melanoma spots are particularly scary because no one suspects them and they are often more advanced.

Also look for a pimple in a sun-exposed area that doesn’t go away, Saruk added, or a new bump you haven’t seen before. Some bumps, may have a “translucent character” he says, where you can see blood vessels on the surface.

Lather up

If you are putting on sunscreen with a 4 SPF, you are kidding yourself, Andrews said.

“The higher the better, ” he says.

But you still need to reapply depending on how long you spend in the sun and how much you sweat.

“So a 60 isn’t going to be twice as good as the 30, but it’s still better,” Andrews added.

The sunglasses you buy also matter. They should have UV protection, Andrews said.

“People fall into this trap – they go into a store and they see sunglasses on sale ... It might be very dark, but it doesn’t block 100 percent ultraviolet light,” he said.

Your eyes’ pupils dilate when you wear sunglasses and, because they are dark, the lenses allow more ultraviolet to go into the eye. That increases a person’s risk of developing malignant melanoma of the eye, Andrews said.

“It’s worth it to spend a little bit extra,” he said.

Your eyes aren’t the only things that need special protection. In addition to lathering up with sunscreen, it’s worth investing in light, long-sleeve shirts, a hat and loose pants if you are spending a lot of time outside, Saruk said.

The Skin Cancer Foundation recommends applying two tablespoons of sunscreen on your entire body 30 minutes before heading outside. Then reapply every two hours or immediately after swimming or excessive sweating.

Don’t lather up at breakfast and think it will protect you at three in the afternoon, Webster said.

And look for suncreens with UVA/UVB broad spectrum and water-resistance labeling, Saruk added. The sprays, though convenient, do not really offer the best protection, Saruk said. Try to choose sunscreens that are lotions or gels.

“If you’re at Rehoboth Beach in August, apply every hour,” Saruk said.

Jen Rini can be reached at (302) 324-2386 or jrini@delawareonline.com. Follow @JenRini on Twitter.