Is It Skin Cancer?
June 2019 Issue
You may worship the sun, but the relationship isn’t mutual. Living in the Deep South, especially
on the coast, urges us to spend time on boats, courts, courses, sandbars and beaches—activities none of us are willing to forfeit. The good news is you don’t have to give up relishing your sunny days! Read on as our local medical experts shine the light on how to protect your skin from cancer.
It’s not always obvious when you’re getting burned. It takes redness 3 to 5 hours after the damage is done to develop and doesn’t peak for 12 to 24 hours.
Carmen Traywick, MD – LUX~A Medical Spa
When should I be concerned about a mole?
Nevi, more commonly referred to as “moles” are benign skin lesions, present on almost every person on the planet. Some babies are born with moles that can be large and rather dark. These are called congenital nevi, or birthmarks. As children grow, they develop more moles on the body, and as a child increases in age, the moles grow in proportion. During puberty, the release of hormones causes some moles to get larger and darker. If one parent has a lot of moles, then it is likely the children could have a lot, as well. In a child, any mole that is growing rapidly, or changing shape quickly should be evaluated. In addition, any birthmark mole should be evaluated by a dermatology office if they are developing new darker areas or bumpy spots. Moles developing into skin cancer or melanoma is extremely uncommon in this age group.
After age 30 to 40 most people do not produce any new moles. A new mole at this age is always a concern. At this stage of life, we follow the “ABCDE” rules for evaluating existing moles.
• A-asymmetry: A mole that is not the same on one half to the other half can be concerning.
• B - Border: If a mole has a jagged, irregular or fuzzy border it could be changing into something malignant.
• C - Color: This rule is very important. Any very dark moles that have areas of almost black color are a potential problem. In addition, moles with multiple colors like tan, brown, pink all in the same mole should be checked, even if they are not very dark.
• D - Diameter: This rule has recently fallen out of favor. In the past anything larger than a pencil eraser was worrisome. These days we can catch melanoma much sooner, so don’t we don’t wait until they are this size, if one of the other rules applies.
• E - Evolving: This new rule applies to being concerned about any mole that is changing—even if it is not discolored, asymmetric, or does not have an irregular border.
One common misconception is for a mole to be worrisome it has to be raised or bumpy. On the contrary, most melanomas diagnosed are completely flat in the early stages of disease. Just because a mole is flat does not mean it is OK. Due to experience and years of training, dermatologists and dermatologic providers are now able to detect melanoma developing in moles at a much earlier stage. If you notice a mole that fits any of the criteria for concern, it is important to have a professional, who is trained specifically to detect melanoma, evaluate the mole(s). Dermatologists and their staff are absolutely the most qualified professionals to check your moles.
Carmen Traywick, MD, FAAD is a graduate of Emory University Medical School in Atlanta, Georgia, and completed her Internship and Dermatology Residency at Emory University School of Medicine. She is a board certified Dermatologist, who specializes in medical Dermatology, but has a unique talent and passion for non-surgical cosmetic procedures.
Black and dark skin can burn, too. A minimum SPF of 15 is recommended for darker skin, with special attention to the feet and palms of the hands.
Dr. Audrey Klenke – Pinnacle Plastic Surgery
If you could tell sun worshippers one thing what would it be?
“My patients move to the Lowcountry to enjoy the great outdoors, so living in a cave is not an option. I recommend avoiding the sun from 10 a.m. to 2 p.m., slathering up with an SPF 30 or higher every single day, especially above the neck and on the hands, and wearing the new breathable clothing that has a UPF rating of 50 or higher. Oh, and don’t forget to have a full body, preventive skin check every year.
Dr. Audrey A. Klenke, owner of Pinnacle Plastic Surgery and Pure Medical Spa, is a board-certified plastic surgeon and offers full-body preventative skin checks. She is on staff at the Bluffton-Okatie Outpatient Center, Hilton Head Hospital, and Beaufort Memorial Hospital. For more information go to: www.btlaesthetics.com/en/ultra-femme-360 www.PinnacleMD.com
Sun exposure is responsible for up to
90% of the visible signs of aging.
Emi Rendon Pope, MD – Beaufort Memorial Hospital
What should I look for in a sunscreen?
Summertime is the season for beach, outdoor fun, and sun damage. The ultraviolet rays are well known to lead to skin damage, early aging, and skin cancers. Every year at this time, I talk to my patients about the importance of protecting their skin to avoid more complications down the line.
Dermatologists have indicated that the majority of skin damage actually occurs in our younger years, making sun protection important not only for adults, but also for children, too.
When it comes to sunscreen, options have exploded, making shopping for the “right one” more difficult for the consumer. So, it’s good to know the American Academy of Dermatology recommends a SPF 30 or higher, with broad spectrum UVA and UVB ray coverage, and water resistant.
However, recent studies have revealed that most adults do not apply enough sunscreen to actually get the full SPF protection. (For example, if you apply only half as much SPF 30 sunscreen as you should, you are actually only achieving an SPF of 15). Be sure to apply sunscreen liberally and reapply at least every 2 hours and immediately after swimming or excessive sweating to remain protected.
Many dermatologists will tell you they prefer sunscreens with blocking agents such as micronized zinc oxide and titanium dioxide. These agents work immediately and give the best protection against UVA and UVB rays. For people with sensitive skin, there are organic sunscreens, but these are shown to be less effective.
Of course, there are other options to protect yourself. Nothing beats wearing skin protective clothing, such as wide brim hats, long sleeves, and sunglasses. Avoiding the sun’s most powerful hours between 10 a.m. and 2 p.m. is a good idea, but if you’re heading to the beach, bring an umbrella to create some shade. And don’t be fooled into thinking you can skip protection on a cloudy day. The sun is constantly producing harmful radiation, and your risk of damage can be even greater on partly cloudy days.
Dr. Emi Rendon Pope is a board-certified internal medicine specialist with Beaufort Memorial Lowcountry Medical Group. A graduate of Medical College of Georgia, Dr. Rendon Pope completed her residency at Memorial Health University Medical Center in Savannah. Born in Mexico City, she grew up in the Savannah area and is fluent in Spanish.
Various medications, including ibuprofen and some antibiotics and birth control, can increase your risk of sunburn. Be sure to talk to your doctor or pharmacist about your meds and how they may interact with the sun. However, ibuprofen and acetaminophen can help relieve sunburn pain.
Dr. David Reid – Hilton Head Regional Healthcare
Who is most at risk for skin cancer?
The skin is the largest organ in the human body. It weighs about six pounds and performs many incredible, life-sustaining functions. Skin helps shield against heat and light, protect from injury and infection, regulate body temperature, store water and fat, and make vitamin D. That’s why it’s so important to take care of your skin and slather on the sunscreen, dress to protect against harmful ultraviolet (UV) rays, and reduce your risk of skin cancer.
Skin cancer is the most common form of cancer. According to the American Cancer Society, it affects more than 3.5 million Americans each year and accounts for nearly half of all cancers in the United States. Approximately 12,000 people die from the disease annually.
There are three main types of skin cancer, basal cell, squamous cell, and melanoma. Basal cell carcinoma is the most common form of skin cancer. It tends to grow slowly on areas exposed to the sun, such as the head and neck, and rarely spreads to other parts of the body. Basal cell cancer can recur; approximately half of people treated for the disease will develop a new skin cancer within five years. Squamous cell carcinoma usually appears on skin areas exposed to the sun and can spread to other parts of the body. Melanoma is a potentially deadly form of skin cancer that can appear suddenly, or start near or in a mole, or other dark area of skin.
> People at increased risk for developing skin cancer tend to have:
> A fair complexion and family history of the disease.
> Many atypical-shaped moles.
> Severe sunburns during childhood.
> Excessive or unprotected exposure to ultraviolet radiation.
> Exposure through work to coal tar, pitch, creosote, arsenic compounds, or radium.
If you notice a change in the appearance of your skin, see your doctor. Skin cancer is highly curable when detected early and treated properly.
Dr. David Reid specializes in cosmetic surgery, reconstructive surgery, and hand surgery. He is committed to maintaining the best standards in the industry and is dedicated to rejuvenating and enhancing what already makes you beautiful. Dr. Reid only uses the best technology and procedures that will yield optimal, natural-looking results. Dr. Reid tailors every surgery to fit a patient’s needs in order to achieve the patient’s aesthetic goal.
Sunscreen does not prevent your body from making Vitamin D.
Dr. Laura Knobel - Laura Knobel, M.D., LLC
How often should I get checked for skin cancer?
Your primary care physician should be checking your skin when you go for your annual exam. If your risk factors are low, no history of excessive sun exposure (sunburns, etc) and no personal or family history of melanoma, once a year should be fine. If you or a family member have a history of melanoma, you should follow up with a dermatologist at least once, if not twice a year. If you have a history of other skin cancers, such as basal or squamous cell cancer, you also should follow up with dermatology. Also, if you notice a new skin lesion, or one that is changing, you should have your physician check it.
Dr. Laura Knobel is a board certified Family Physician seeing patients of all ages in Plantation Park in Bluffton. She has a direct primary care practice where you can get your primary care for $50 a month or less. Office phone: 843-836-2200. Website: www.knobelmd.com
Wear sunscreen everyday! UV rays can be reflected from surfaces. Concrete, sand, and water reflect up to 85% of the sun’s UV rays.