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A lifetime in the sun? You can still cut your risk By Harvard Health Letters
It's not too late to minimize the chance of melanoma
"The biggest misconception is that there is no turning back once you have accumulated sun damage and sunburn," says Dr. Daniela Kroshinsky, an assistant professor at Harvard Medical School and medical dermatologist at Massachusetts General Hospital. "But adopting good sun habits prevents accumulation of additional damage that could contribute to the overall risk for melanoma and even more so for non-melanoma skin cancers and pre-cancers."
Add to that a reasonable level of surveillance for suspicious skin blemishes, and you can drastically reduce the chance of getting into the danger zone.
Sunlight primarily consists of three wavelengths: UVA, UVB and UVC. Earth's ozone layer filters the most damaging UVC rays. UVA represents 95 percent of the sun's energy that reaches Earth's surface, and penetrates deepest into the skin. UVB carries just 5 percent of the sun's energy but can still burn the skin's outermost layer.
MEN AT RISK
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"That's the beauty of dermatology--the skin is an accessible organ," Dr. Kroshinsky notes. "This isn't like your heart or lungs, where you have to wait until you have chest pain or develop a cough that won't go away. It's an organ that you can look at every day."
Skin's accessibility also means it is vulnerable to damage from exposure to UV radiation in sunlight. That is why it's so important, especially after accruing a lifetime of UV exposure, to adopt good sun-protection habits and keep an eye out for suspicious skin blemishes.
TYPES OF CANCER
WHAT DETERMINES YOUR RISK?
Genes: Do you have red hair, fair skin, and blue eyes? Then you are at higher risk than someone with darker skin. Do you have a first-degree relative (parent, sibling) who has been diagnosed with melanoma? Do you or others in your family tend to develop a lot of moles and skin blemishes, some of which have turned out to be "atypical" or abnormal in growth, shape, size, or color? These are all risk factors for skin cancer.
Exposure: The more sun exposure in your life, the higher your overall risk for skin cancer. In particular, repeated sunburns or blistering sunburns boost your lifetime risk.
ASSESS YOUR RISK
"Talk to your doctor," she advises. "Ask if, based on moles and amount of sun damage, you should be looked at by a dermatologist."
The risk assessment should include a quick check of your medications. Some can leave you more sensitive to the sun. These include the commonly prescribed fluoroquinolone antibiotics like Cipro and some blood pressure medications.
CHECK YOUR SKIN
Your role: Learn how to identify worrisome skin blemishes. Certain features indicate that a mole should be examined by a doctor.
"Look for anything that is new, that looks different from other things on your body, or anything that's changing, growing, or bleeding," Dr. Kroshinsky says. "Also, anything that doesn't heal in a week or two."
A simple rubric, the ABCDE of malignant melanoma, should guide your self-exams. Make sure to include areas hidden from your view, with the help of a spouse, intimate partner, or friend. These areas include the back, buttocks, and rear thighs; the neck and top of the head; and the soles of the feet and between the toes. Skin checks can save your life.
"Most of these cancers, if you catch them early and remove them, they're cured," Dr. Kroshinsky says.
DEVELOP SAFE SUN HABITS
"We counsel people to avoid prolonged sun exposure between 9 a.m. and 4 p.m.," Dr. Kroshinsky says. "But that's the peak time when people like to do things."
If you are out, take these steps:
1. Wear a hat with a brim that covers the ears and shades the nose.
2. Always use sunscreen.
3. If it is comfortable, wear long sleeves and pants. Boaters and fisherman beware: The reflected light off the water surface can increase exposure.
USE SUNSCREEN PROPERLY
When: Apply the sunscreen at least 20 to 30 minutes before you go out in the open sun.
What: Use a broad-spectrum sunscreen that protects against UVA as well as UVB rays. Use a sunscreen with an SPF rating of at least 45.
How much: Adults should apply 6 teaspoons (1 ounce) on your body and face, or about the volume of a shot glass. Be sure to coat the ears, back of the neck, and exposed skin on the head.
How often: Reapply every hour if you are in the water or sweating heavily. Reapply every two to three hours if not in the water or not sweating. Reapply the sunscreen frequently even if the product you buy is formulated to be sweat- or water-resistant.
THE A, B, C, D, E OF MELANOMA
1. Asymmetry: One half does not match the other half.
2. Border irregularity: The edges are ragged, notched, or blurred.
3. Color. The pigmentation is not uniform. Different shades of tan, brown, or black are often present. Dashes of red, while, and blue can add to the mottle appearance.
4. Diameter: Melanomas usually are greater than 1/4 inch (6mm) in diameter, or about the width of a pencil eraser, when diagnosed, but they can be smaller.
5. Evolving: A mole or skin lesion looks different from the rest or is changing in size, shape, or color.
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© 2012, PRESIDENT AND FELLOWS OF HARVARD COLLEGE. ALL RIGHTS RESERVED. DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.
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