In recognition of May as Melanoma Awareness Month, this month’s blog article will focus on some of our practical tips on sun avoidance and protection (the most important measure you can take to reduce the risk of skin cancer). Unfortunately, there is a lot of misinformation and misunderstanding on this subject; we hope to provide insight from our collective experience diagnosing and treating thousands of skin cancers (including melanomas) since our practice was established more than a decade ago.
Some basic Statistics:
- 1 in 5 Americans will develop some form of skin cancer in their lifetime
- More than 3.5 million skin cancers in more than 2 million people are diagnosed in the United States each year. One American dies of melanoma almost every hour.
- Melanoma is the most common form of cancer among young adults 25-29 year of age, and the second most common form of cancer in those aged 15-29 years.
- Patients with melanomas that are detected and treated before spreading to the lymph nodes have a five-year survival rate of 98 percent.
- Patients with melanomas that have spread to the lymph nodes or other organs have a five-year survival rate of only 16%.
So, what can we do to reduce our risk of skin cancer? Given that sun exposure is the most preventable risk factor for skin cancer (including melanoma), sun protection and avoidance measures are the most important steps that we can take to minimize our risk. Although we focus much of our discussions on sunscreens (and we’ll cover that shortly), of even more importance is understanding how to minimize harmful ultraviolet rays without necessarily having to live in a cave. We encourage active, outdoor, healthy lifestyles; however, when possible (and let’s face it, it usually is) try to find some shade. Understanding that the sun’s rays are strongest between 10:00 AM and 4:00 PM, if you have a choice to play tennis early in the morning or late in the afternoon, that is certainly preferable to midday. Also, be vigilant about activities near water, snow, sand or at high altitude, as the sun’s rays may be amplified in these settings. In fact, the combination of high altitude and snow can increase UV exposure by as much as 100%.
Most importantly, in our experience, is the absolute avoidance of artificial tanning. A review of seven studies found a 75% increase in the risk of melanoma in those who had been exposed to UV radiation from indoor tanning. The United States Department of Health & Human Services and the World Health Organization’s (WHO) International Agency for Research on Cancer panel have declared UV radiation from artificial sources, such as tanning beds and sun lamps, as known carcinogens (cancer-causing substance).
Detecting skin cancer – Check your birthday suit on your birthday.
It is of vital importance to stay vigilant about your own skin. If you notice anything changing, growing, or bleeding on your skin, please see your dermatologist or call PCD for an appointment. Skin cancer is treatable when caught early.
Selection and utilizing sunscreen properly:
When using sunscreen, the most important thing to do is to use it correctly. Studies have demonstrated that most people just don’t apply enough nor do they apply it frequently enough. Sunscreens should be applied liberally to dry skin 15-30 minutes before going outdoors. Pay particular attention to the face, ears, hands and arms. One ounce (about the amount to fill shot glass) is generally considered to be the appropriate amount to cover the exposed surfaces of the body. Sunscreens should be re-applied every 2 hours or after swimming or after sweating heavily.
Selecting a sunscreen can be a bit overwhelming. Fortunately, your providers at the Pennsylvania Centre for Dermatology can provide personalized recommendations based on your level of risk, skin type, body location, intended use, and formulation preference. Additionally, sunscreen science is advancing rapidly with a body of emerging evidence regarding incorporation of antioxidants and even non-topical agents (e.g. oral agents such as niacinamide and the extract from the Brazilian fern tree, Polypodium leucotomos).
In the past, sunscreens were mainly compared based on their Sun Protective Factor (SPF) rating; however, SPF ratings only pertain to protection from one type damaging ray from the sun (UVB). It is now known that UVA, which penetrates deeper into the skin, plays a role in premature aging of the skin and is linked to skin cancer. In addition to considering the SPF rating of a sunscreen, if a sunscreen has “Broad Spectrum” on the label, then it also has passed testing regarding protection from UVA rays.
Dr. Crawford’s favorite sunscreens:
I typically recommend higher SPF sunscreens for my patients (many of whom have struggled with skin cancers and pre-cancers). For daily use on the face and neck (and even the scalp for men with thinning hair), I often recommend sunscreen products from EltaMD (www.eltamd.com) and Neutrogena (http://www.neutrogena.com/category/sun.do).
For the face, especially for patients with sensitive skin or who are prone to acne, I often recommend EltaMD UV Clear for daily use. This SPF46 broad spectrum sunscreen contains hyaluronic acid (a fantastic moisturizer) and niacinamide (see our blog article on niacinamide), and provides excellent moisturization while still maintaining a pleasant silky and lightweight texture, and is appropriate for men and women alike. For women looking for a tinted product, the EltaMD UV Clear product is also available in a tinted version.
For those interested in a 100% physical sunscreen in a tinted moisturizing base, I recommend EltaMD UV Elements Broad Spectrum SPF44. These mineral-based UV filters work with ultra-hydrating hyaluronic acid to protect and hydrate the skin, and the tint enhances most skin tones.
You can purchase these sunscreens at our practice.
Make sure to take a selfie wearing a hat protecting yourself from the summer sun and tag us on Facebook to enter to win a facial!