Suspicious Skin Lesions and Skin Cancer
Skin cancer is the number one cancer in the United States, with one in five (20%) of Americans developing skin cancer in their lifetime. Each year there are more cases of new skin cancer than of breast, prostate, lung and colon combined.
Fortunately, most of the cancers that can appear on our skin if treated early are completely curable. At some point in everyone’s life, they will experience a change in skin texture, a mole which looks different, or a new lesion or blemish. Many of these lesions are non- cancerous, but it very important to have any new spot checked by a specialist with experience in diagnosing and treating skin cancers.
Prevention of Skin Cancer
It is now common knowledge that limiting sun exposure is probably the best thing one can do to prevent skin cancer. Seeking shade on a sunny day would seem to make the most sense, but shade is not 100% effective at avoiding harmful radiation from the sun. This is because UVB radiation, which is considered to be the most harmful, can penetrate shady areas or reach the skin indirectly. It is essential to use sunscreen and cover your skin even while in the shade.
There are literally hundreds of different bands, formulations, and SPF numbers that can make choosing the right product seem impossible. If nothing else, remember this: use at a minimum SPF 15 and re-apply frequently while exposed to the sun.
SPF can be confusing terminology. Think of sunscreen in terms of percentages of UV radiation that sunscreen can block out:
SPF 15 filters out approximately 93 percent of all incoming UVB rays.
SPF 30 keeps out 97 percent.
SPF 50 keeps out 98 percent.
The difference between 97 and 98 percent blockage may seem insignificant, but if you are light-sensitive, or have a history of skin cancer, those extra percentages will make a large difference. It is important to remember that no sunscreen can block out all of the sun’s harmful rays, so covering up with a hat and limiting the time you are exposed to the sun is critical.
Sunscreen and Sun Safety for Children
It only takes one blistering sunburn during childhood to more than double the risk of developing melanoma later in life. Avoiding sun damage early in life is critically important to protecting the health of your child’s skin for the rest of their life. Below are some guidelines courtesy of the Skin Cancer Foundation for keeping your child’s skin healthy:
Infants 0-6 months:
Infants under 6 months of age should be kept out of the sun. Their skin is too sensitive for sunscreen. An infant’s skin possesses little melanin, the pigment that gives color to skin, hair and eyes and provides some sun protection. Therefore, babies are especially susceptible to the sun’s damaging effects.
Use removable mesh window shields to keep direct sunlight from coming in through the windows of your car or invest in UV window film, which can screen almost 100 percent of ultraviolet radiation without reducing visibility.
Take walks early in the morning before 10 AM or after 4 PM and use a stroller with a sun-protective cover.
Dress baby in lightweight clothing that covers the arms and legs.
Choose a wide-brimmed hat or bonnet that protects the baby’s face, neck, and ears. A baby who wears a hat during the first few months will get used to having it on.
Babies 6-12 months:
At this age it is safe to use sunscreen on babies.
All the protection methods explained above still apply, however now sunscreen use should be incorporated.
Apply broad-spectrum, SPF 15+ sunscreen to areas left uncovered such as baby’s hands. Many companies have tear-free formulas that won’t sting baby’s eyes.
Most importantly, sunscreen must be applied 30 minutes before going outside and reapplied every two hours or after swimming or excessive sweating.
Protecting toddlers from the sun requires a little more thought and effort. It is important to educate your child and caregivers.
Make sure your child seeks the shade between 10 AM and 4 PM. Check the outdoor area where your child plays to make sure there is adequate shade.
Make sure toddlers are covered. Long-sleeved, unbleached cotton clothing is cool and comfortable, while also highly protective. Clothing with an Ultraviolet Protection Factor (UPF) listing on the label offers extra security. The Skin Cancer Foundation recommends clothing with a UPF of 30 or higher.
Don’t forget hats and sunglasses. Choose a wide-brimmed hat that protects face, neck, and ears.
Water-resistant, spray-on sunscreens are a good choice for toddlers who won’t sit still. Look for broad-spectrum sunscreens with an SPF 15 or higher.
Risk Factors for Skin Cancer
Fair Skin. People with less pigment in their skin have less protection against the damage that UV radiation from the sun causes. If you have blonde or red hair with blue or green eyes and sunburn, you are at a high risk for developing skin cancer. However, it is important to remember that anyone, regardless of skin color, can develop skin cancer.
A history of sun exposure. We all know that tanning or being out in the sun unprotected is dangerous, but still forget to put on sunscreen consistently. UV radiation from the sun causes damage to the DNA in the cells of our skin. Over time, this repeated damage can lead to the formation of cancer cells. People with a history of repeated, blistering burns as a child are at the greatest risk. Indoor tanning beds are especially risky and even worse than the sun in terms of the damage they do to the skin.
A family history of skin cancer. If your parents or a sibling has has a skin cancer, you have an increased chance of developing one yourself.
A personal history of skin cancer. People who have had one skin cancer are at a much greater risk of developing a subsequent cancer in the future, or of having a recurrence.
Precancerous Skin Lesions. There are many benign lesions that arise as a result of sun damage that can change into cancer. These lesions may be scaly, patchy, red, or look like a mole or other dark spot.
Moles. Individuals who have many moles on their skin or moles with many different colors known as dysplastic nevi are at increased risk. Any mole which has changed shape size or color she be checked out by a skin cancer specialist immediately.
A Weakened Immune System. People who have a lowered immune response as a result of chemotherapy, immune system diseases such as HIV, or who are immunosuppressed as a result of steroid use or have undergone an organ transplant have a higher risk of skin cancer. This is because one of the important functions of our immune system is to fight cancers as well as infections.
Warning Signs for Skin Cancer
Any changes to the texture, color or shape of a specific area of your skin should be examined by a skin cancer specialist.
An easy method to stay in touch with your skin’s health is a self exam performed once a month. Take note of any color changes, moles, or new growths and point them out to your physician. Lesions that itch, bleed, or do not heal can be a sign of a cancer or precancerous lesions. Moles which have changed in size, shape or color are also to be considered suspicious and should warrant a biopsy. Taking a photo and dating it is very helpful to monitor any changes. Be sure to check behind the ears and in the hairline as these are hard to see areas and places where lesions may hide.
Physicians have come up with two methods of detecting skin cancers, specifically melanomas, in their early stages which gives the best chance of cure. These are known as the ABCDE’s and The Ugly Duckling Sign.
Evaluation and Diagnosis of Skin Cancer
If you have a lesion or mole which has any of the ABCDE’s above or is painful, itchy, or does not heal, you need to see a skin cancer specialist such as a facial plastic surgeon, plastic surgeon, or dermatologist. Most skin lesions tend to be benign, but if they are cancerous, the earlier they are caught and treated the greater the chance of complete cure. This is especially important if you are fair skinned or have a history of sun exposure.
During your evaluation by a doctor, a biopsy may be performed to send a sample of tissue to be examined by a pathologist. This is a simple procedure and causes little to no pain. We perform this procedure quite often in our office. By obtaining a biopsy, your doctor can have a firm diagnosis and make an effective plan for treatment for you.
If a lesion is determined to be a skin cancer, treatment generally consists of surgical removal of the area and a small amount of surrounding tissue. In the case of melanoma, futher blood testing or X-Ray imaging is often required as this is the most dangerous type of skin cancer and can spread to other parts of the body (metastasis).
One specialized skin cancer procedure is known as MOHS surgery. MOHS surgeons are dermatologists who have had additional training in skin surgery and reconstruction. Dr Shaw works closely with several local MOHS surgeons and often assists them with complicated facial reconstruction.