SAVE YOUR SKIN: Safety under the sun

Limit your exposure, use sunblock and examine your skin carefully

Jupiter ImagesThe sun can damage your skin even on a cloudy day, so it?s important to apply sunblock with a sufficient sun protection factor. Many physicians recommend using a product rated at least 30 SPF. Advertisement

The cause of skin cancer is no mystery. In fact, it's as certain as the sun rising in the morning. Ninety percent of the most common form of cancer -- that of the skin -- is caused by exposure to the sun's ultraviolet rays, according to The Skin Cancer Foundation. Harmful ultraviolet radiation also comes from sunlamps, tanning beds and tanning booths.

Ultraviolet wavelengths harm the skin or epidermis, the human body's largest organ. With time and repeated exposure, the same radiation that causes temporary sunburn damages the skin cells' DNA structure, resulting in cancerous growth.

WHO IS AT RISK?

Knowing your risk and what steps can be taken to protect yourself can go a long way toward saving your skin.

More than 1 million skin cancers are diagnosed each year, according to the National Cancer Society's 2007 database. One in five Americans will face a skin cancer diagnosis over the course of a lifetime. That chance increases to one in three for Caucasians. Fair-skinned people with light hair and eyes are most susceptible.

Risk factors that increase the likelihood of skin cancer include overexposure to the sun as a child or young adult, and living in a climate that is sunny year-round or most of the year. Even one blistering sunburn in childhood more than doubles a person's chances of developing melanoma (the most serious form of skin cancer) later in life, according to a 2006 study by the Mayo Clinic.

Men are from two to three times more likely than women to have the most common forms of skin cancer (basal and squamous cell), probably because they spend more time outdoors for work or recreation.

Hamidreza Sanatinia, a medical oncologist at Comprehensive Cancer Centers of Nevada, says cases are on the rise.

"Rates of skin cancer have definitely increased, including melanoma," Sanatinia said. "The ozone layer has been depleted compared to 40 or 50 years ago. There's also a genetic predisposition for skin cancer in some people that is higher for them if they live here."

Sanatinia emphasized that the risk in this region is higher.

"This is the sunbelt area where we get a lot of sun and the chances of getting skin cancer are higher than the rest of the nation," he said. "Try to avoid going outside around noontime."

Don't forget that UV light can penetrate clouds, so you still need sunblock on a cloudy day.

"The higher the number the better, that's the rule," Sanatinia said. "My rule is about 30 SPF."

NOT JUST FOR SENIORS ANYMORE

Once thought to be a concern primarily for middle-aged or older adults, skin cancer is increasingly prevalent in younger generations. Melanoma is the most common form of cancer for young adults 25 to 29 years of age and the second most common form of cancer for adolescents and young adults ages 15 to 29, according to the American Academy of Dermatology. The AAD's Web site also notes that melanoma is increasing faster in females 15 to 29 years old than males in the same age group. In females 15 to 29 years old, the torso is the most common location for developing melanoma which may be due to high-risk tanning behaviors.

Dr. Summer R. Youker, a dermatologic surgeon and assistant professor of dermatology at Saint Louis University, says indoor tanning is of great concern to professionals in her field. A common misconception she finds among patients is that tanning beds or booths provide a "safe" way to tan.

"There is no 'safe' tan except one achieved with a self-tanner -- sprays and lotions that temporarily pigment the skin," she said. "Indoor tanning increases the risk of melanoma, especially when indoor tanning begins at an early age."

Only about 50 percent of states have legislation limiting teen tanning, and those that do have little means of enforcement, Youker said.

"A study published in the Journal of the American Academy of Dermatology in March, 2007, showed that exposure to UV light can be addictive because of the production of endorphins," she added. " Indoor tanning users are more likely to display signs of such addiction."

COMMON FORMS

The most common form of skin cancer is basal cell cancer, named for the layer of cells that become cancerous. Basal cell cancer usually occurs on the face, ears, neck, scalp, shoulders and back -- the areas most exposed to the sun. While the visible part of the tumor sometimes resembles psoriasis or eczema, usually tumors appear as a persistent, nonhealing sore, a shiny bump or nodule that can be confused with a mole, or a pink growth.

Squamous cell cancer is the second most common form of skin cancer, and it occurs in the upper layer of the skin. Most are not considered serious if detected and treated early. Squamous cell cancers tend to look like a crusty sore or wart-like growth that sometimes bleed. This type of cancer also appears in areas commonly exposed to the sun including the face, lips and back of hands. Squamous cell cancers also sometimes appear in areas not exposed to the sun, such as the genital area.

Melanoma, though not the most common form of skin cancer, is the most serious because it is most likely to spread to other parts of the body and cause death. Melanoma is a malignant tumor that grows in cells that produce melanin -- the pigment that colors skin, hair and eyes. Most melanomas are black or brown, but they can be skin-colored, pink, red, purple, blue or white. Risk factors for melanoma include sun exposure (both in early childhood and over the lifetime), the number of moles on the skin, fair skin and a family history of melanoma. Melanomas can develop in areas of the body exposed to the sun or in so-called "hidden" places such as under a nail, in the mouth or eye.

"Blistering sunburns in childhood can raise the risk of future skin cancer," Sanatinia said.

DIAGNOSIS AND TREATMENT

Skin cancer is diagnosed through biopsy. A dermatologist removes a portion or all of a suspicious area of skin, and a pathologist examines the sample under a microscope. Though it is always chilling to await the findings of a biopsy, it is important to note that that the survival rate for skin cancer is about 99 percent with early detection, according to the National Cancer Institute.

If all the cancer is removed in the biopsy, no other treatment may be needed. In other cases, your doctor may prescribe surgery, chemotherapy or radiation therapy. Photodynamic therapy, or PDT, uses a chemical injected or applied to the cancerous cells which are later treated with a light source such as a laser. When the chemical is activated by the light source, it destroys nearby cancer cells.

The good news with skin cancer is that its cause is known, and products have been developed to protect the skin from UV damage.

PRACTICE SAFE SUN

While no one would suggest avoiding the sun altogether, it is a good idea to avoid being outside during the hours of 10 a.m. and 4 p.m. when the sun's rays are strongest. Wear sunscreen of at least 15 SPF, and be sure to put it on at least 30 minutes before going outside. The American Academy of Dermatology notes that most people do not apply enough sunscreen. The AAD recommends that an ounce of sunscreen -- about enough to fill a shot glass -- be applied before going outdoors. Re-apply sunscreen at least every two hours. And don't forget lipscreen as well!

Although sunscreen has a shelf life of up to three years, it is a good idea to replace it more often if the lotion has been exposed to extreme heat. Wearing sunglasses that protect again UV rays will help avoid melanoma of the eye and other eye damage.

Loose, tightly-woven dry clothing can provide some protection against skin damage. Hats that provide shade on the nose and neck are recommended. If a ball cap is worn, the wearer should be sure to use sunscreen on the neck and ears.

Parents should be sure to protect young children from overexposure to the sun. Babies under the age of 6 months should be exposed to the sun as little as possible, according to the Skin Cancer Foundation. Their skin is not yet protected by melanin, and sun screen is not recommended until after 6 months of age. Make sure a baby's stroller provides shade and use a sun hat or bonnet.

"Sun exposure is the No. 1 contributor to the development of skin cancer and is almost completely avoidable," Youker said.