By Mwatsveruka N. Munhutu, MD, MPH, FAAD
American Board Certified Dermatologist
It is fun to be out in the warm sunshine! When sunlight hits our skin, we produce vitamin D which helps with calcium absorption for healthy bones and teeth. However, too much exposure can severely damage the skin leading to hyper-pigmentation, ageing and skin cancer.
Skin cancer is the most common form of cancer worldwide. Approximately, 2 to 3 million non-melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year. Most skin cancers are caused by too much exposure to ultraviolet light (UV), specifically UVA and UVB. UVA has a longer wavelength and is associated with skin ageing prematurely, wrinkles and age spots. UVB has a shorter wavelength and is the primary cause of sunburn. UVA and UVB are naturally found in sunlight but are also created by artificial sources of light such as tanning booths and sunlamps.
The two most common non-melanoma skin cancer types are basal cell carcinoma (“BCC”) and squamous cell carcinoma (“SCC”). These cancers occur in the basal and squamous cell layers at the top of the skin and usually form on the head, face, neck, hands, and arms. They are almost always painless and grow slowly. If found early, these cancers are easy to treat.
Melanoma is a less common but more aggressive form of skin cancer. It occurs in skin cells that make a skin colour pigment called melanin. If it is not found early, melanoma will likely spread to other tissues. It can spread through the whole body and may cause death. Although melanoma accounts for only 2% of skin cancer cases, melanoma causes the most deaths from skin cancer.
Know your risk factors. Although anyone can get skin cancer, some individuals have a higher risk than others. The most common risk factors include chronic sun exposure (that is, excessive sunbathing or sun-tanning), having a family member with a history of skin cancer, having fair skin and being over the age of 50.
Check your skin. The main symptom of skin cancer is a new or changing bump, growth, lesion, mole, or rough patch of skin. Other signs of cancer could include a mole (nevus) that itches or bleeds; a fast-growing mole; scaly or crusted growth on the skin; a sore that will not heal or a patch of skin that has changed colour. Not all skin cancers look alike so it is important to seek care from a dermatologist if you find a new lesion on your skin.
The ABCDE rules can help you remember what to look for when you are checking for moles. If you notice any of these signs, talk to your skin doctor right away.
The good news is that skin cancer is usually one of the most curable types of cancer especially when caught and treated early. Treatment depends on factors such as the type of cancer, where it is located, how big it is, how far it has spread, and your general health. Precancerous lesions can be removed with freezing, medicated chemotherapeutic creams, or surgical therapy. Cancerous lesions require more aggressive modalities including surgery, radiation therapy, chemotherapy, and biologic therapy. If not treated, certain skin cancer cells may spread to other tissues and organs resulting in more complications. Most cases of non-melanoma cancers can be taken care of through surgical removal of the mole or lesions. While treatment for melanoma can be more complex, if caught early, the cancerous tissue can be removed with surgery.
Prevention is key. A lot of people who live in sunny climate areas and spend a great deal of time in the sun must know what to watch out for to maintain healthy cancer-free skin. Avoid being in the sun or using sunlamps. If you are going to be in the sun for any length of time, follow safe-sun guidelines to protect your skin and reduce your risk of skin cancer.
- Avoid the sun.
Avoid being in the sun between 10 a.m. and 4 p.m. when the sun is at its strongest and causes the most damage to your skin. Sunburns and suntans are signs that your skin is injured. The more damage, the more likely you are to have complications such as early wrinkles, hyperpigmentation, or skin cancer.
- Use sunscreen.
Use a zinc oxide-based broad-spectrum sunscreen with an SPF of at least 30. Use it on cloudy days, too as the ultraviolet rays are still making it to the earth! Check the expiration date as some ingredients break down over time. Apply sunscreen at least 15 minutes before you go into the sun. Apply sunscreen everywhere your skin is exposed. This includes your ears, the back of your neck, and any bald areas on the top of the head. Apply more sunscreen at least every 2 hours and after swimming, sweating, or towelling off.
- Wear a wide-brimmed hat, protective clothing, and sunglasses.
If you must be out in the sun, cover up. A wide-brimmed hat with a brim of 15 cm all around protects your face, neck, and ears. Baseball caps do not protect the back of your neck or the tops of your ears. Wear protective clothing, such as long-sleeved shirts and long pants made of tightly woven fabric. If the clothes fit loosely, you will feel cooler. Choose sunglasses that protect the sides of your eyes and block both UVA and UVB rays.
- Protect your kids.
Children younger than 6 months of age should never be in direct sunshine but should be in the shade. Children older than 6 months should wear sunscreen every day if playing outdoors. Getting numerous bad sunburns as a child increases your risk of developing skin cancer later in life because each exposure to UVB light induces mutations in the DNA of your skin cells. The cumulative damage to your skin cell DNA over time is what causes skin cancer later in life.
- Establish care with a dermatologist to have annual full-body skin examinations.
During these skin checks, a dermatologist examines the skin to check for any suspicious skin lesions and any changes in the way your skin looks. Report any changes in your skin. If a suspicious skin lesion is observed, then the dermatologist will biopsy the lesion to investigate it for potential skin cancers.
Your skin is a wonderful and resilient organ that protects you by regulating body temperature, maintaining fluid balance, and controlling moisture loss. Treat your skin well so it lasts a lifetime, and you reap the benefits of healthy skin.
Images courtesy American Academy of Dermatology
Originally published in the 2nd Newsletter Issue of Ndeipi.