with Dr. Jane H Lisko of Associated Skin Care specialists
Who should be worrying about skin cancer?
Everyone needs to worry about skin cancer considering it occurs in all skin types. Certainly, there are some skin types that are more prone (think fair skinned, blue-eyed, blondes), but I have removed skin cancers from every skin type. Skin cancer is at epidemic proportions. In fact, melanoma is one of the most prevalent cancers in women under the age of 40.
What are the different types of skin cancer that we should be aware of?
There are 3 most common skin cancers that we treat in dermatology – basal cell carcinoma, while it is often diagnosed early and treated, it can metastasize if not recognized. Melanoma is the most lethal of the skin cancers that we treat. While it only represents 4% of all skin cancers, it causes 80% of the deaths related to skin cancer.
What are some signs of having skin cancer?
Basal cell and squamous cell skin cancers often present as a pimple-like lesion or tender scaly spot that bleeds easily and never completely resolves. Melanoma can arise in a mole or can develop as a new spot on the skin. Classically these lesions are darkly or unevenly pigmented spots; they may or may not be symptomatic. If you see a suspicious lesion, it should be evaluated by a board-certified dermatologist. Dermatologists train for 4 years after medical school specializing only in skin diseases. They are the best trained for complete skin checks. Dermatology is not a requirement in all medical training programs, so general practitioners are not as skilled in examining the skin.
What’s the relation between tanning beds and getting skin cancer?
Ultraviolet exposure plays the biggest factor in the development of skin cancer. There are 2 types of ultraviolet that commonly cause skin damage – UVA and UVB. Natural sun is mostly UVB while tanning beds are mostly UVA. While all UV damage is cancer causing (carcinogenic), UVA rays are more damaging. These rays penetrate more deeply. In addition to skin cancer, UVA also plays a huge role in the aging of the skin.
How much sunscreen should we actually be wearing?
When spending time in the sun, it is smart to apply a good coat of sunscreen 30 minutes prior to exposure. Both chemical and physical blockers are protective. Since physical blockers such as zinc or titanium do not sting if eyes are exposed, it may be best to use these on the face. Sunscreen should be re-applied every 90-120 minutes – sooner if exposed to water. A general rule of thumb is that a shot glass – or one ounce – of sunscreen is needed to coat an average size adult.
Any other tips for protecting our skin?
In addition to using sunscreen, I recommend using an anti-oxidant serum once daily prior to applying sunscreen. While my favorite product is SkinMedica TNS Essential serum, I also recommend the SkinCeuticals C+E Ferulic Acid. When used with sunscreen, antioxidants give 8-10 times more sun protection than sunscreen alone. Unless you have really dry skin, I suggest using a combination moisturizer with sunscreen. This can be applied on top of the anti-oxidant.
We also encourage that our patients wear sun protective clothing such as rash guard shirts when in the sun. In addition, hats and sunglasses are also important. Finally, try to plan activities early in the day or late in the afternoon when the sun I not as intense.
How do I prepare for a full-body skin exam with the doctor?
The board-certified dermatologists at Associated Skin Care Specialists recommend annual full body skin checks. This can be scheduled easily through our front desk. No special preparation is needed for this type of exam, but knowing your personal and family medical history is important.
If you are diagnosed with skin cancer, it can often be treated readily in our office with one of our skin cancer surgeons. In addition to completing a full residency in dermatology (4-year program following medical school), our skin cancer surgeons have done an additional year of surgical fellowship training. Our fellowship trained surgeons perform a specialized technique known as Mohs micrographic surgery (named after Dr. Frederic Mohs). This technique assures the highest cure rate for skin cancer (only 1-2% chance of recurrence) while removing the least amount of skin possible which then translates to the smallest scar possible.