Saving One's Skin

Memorial Day is just around the corner and so is a lot of sun exposure. It is fun and exhilarating to feel the heat and brightness of the sun after a cold, gloomy winter. As a result, a lot of us take advantage of the sun's rays to get some color while participating in outdoor recreation.

Being a water bug and a member of a family that loves outdoor activities, I grew up being in the sun for long hours. As a teenager, I worked very hard to have that deep dark tan. Back in those days I could tan very well. On my mother's side there is some Native American heritage and some of the folks in my family could and still can tan very well. However, through the years, my skin has changed and I am taking after my father's side where there are blond and red haired traits.

I went to my podiatrist for a foot problem a couple of years ago and he saw two moles on my feet that he found to be strange. When he told me his assessment of them, I have to say that I was really skeptical of his opinion. No one in my family, at least to my knowledge, had any problems with skin cancer. The moles looked pretty harmless to me. I tried to dismiss his view, but almost a year later when my husband spotted yet another strange looking mole on my back., the words of the podiatrist were very clear in my memory. I immediately made an appointment with my physician who referred me to a dermatologist. I went to the dermatologist and, sure enough, the two moles on my feet had to come off and the mole on my back was to be watched. I went through foot surgery over Christmas break and I found out the results of the two biopsies: very early stages of skin cancer. It is thought that when I laid out on my raft on my belly to tan my back and the back of my legs, my feet were not covered with skin block or lotion. I was shaken and stunned, mad and resentful. I knew that life as I knew it would change... again. Even though I have been pretty good about sun block in recent years, I was reaping the results of a youth spent baking in the sun.

I am not really the type one thinks would suffer from skin cancer: I am not blond or red-haired, blue, green, or gray-eyed, nor is my skin all that fair; in fact it is a light olive. But, the past few years, I have found that I freckle more and my skin tone has changed slightly. In fact, there have been cases of persons getting melanoma who are very dark-skinned, with dark eyes and hair.

So, who is at risk for skin cancer?

• Men and women over the age of 40
• As far as I am concerned, EVERYONE, but particularly people who have fair complexions, many freckles, blonde or red hair, blue, green, or gray eyes, a greater than average number of moles, atypical moles, a large congenital mole.
• Family history xeroderma pigmentosum, albinism, basal-cell nevus syndrome, dysplastic nevus syndrome and/or familial; atypical multiple mole melanoma (FAMMM) syndrome
• Family history of melanoma

Here are the ABCD's of gauging whether or not a mole is a potential melanoma:

A= Asymmetrical: One half is shaped differently than the other.

B= Border: The border is irregular, its edges are ragged, blurred or notched.

C= Color: The color appears uneven or changes over time. Blemishes usually begin as mottled brown or black, but may eventually assume shades of blue, white or red.

D= Diameter: The diameter exceeds a quarter inch; about the size of a pencil eraser.

A mole with these characteristics should be examined by a dermatologist. Not all of the atypical nevi warrant immediate removal and in such cases are carefully watched for future changes.

So, if you like to be in the sun, here are a few tips to avoid some risks of skin cancer:

Avoidance: Avoiding solar radiation between 11 a.m. and 1 p.m. reduces your exposure by half. Do note that this all depends on where you are on the Earth's surface. Also, avoid tanning booths. Tanning in such booths is not safer than sunning outside.

Cover up: When out in the sun, cover up. Nine out of ten skin cancers that are removed are taken from areas where the skin was not covered by clothing. Interestingly enough, women suffer more from skin cancer than men because of skirts and dresses. Wear a hat, long sleeved shirt, and slacks or long skirt. Tightly woven fabrics are best, due to the sun not being able to penetrate. Also, wear dark or bright colors and avoid white clothing when out in the sun. Contrary to popular belief white clothing magnifies sun radiation. Wet clothing serves as a conduit for radiation as well.

Sun Screen: Wear sunscreen. Put it on 20 minutes before going out in the sun and be sure to reapply it once every two hours while you are outside. If you are swimming, apply it every time you come out of the water. If you are perspiring, also reapply it. Remember that the higher the SPF (Sun Protection Factor) number, the more protection. For example SPF 10 may give a person who burns in about 10 minutes 150 minutes of protection. The more fair you are, the higher the SPF sun block you should apply. Avoid sunscreens with the following chemicals in them: bensophenones, oxygenzone, sulisobenzone, Parsol 1789 (butyl methoxydibenzoylmethane, also known as avobenzone), titanium dioxide, and zinc oxide. Please note that since some folks are allergic to PABA (para-aminobenzoic acid), which is the major ingredient in most sunscreens, there are alternative sunscreen ingredients as mentioned above.

Self-Examinations: Get to know your body and examine it every three to four months. Have someone help you with your scalp and areas that you cannot see very well.

Dermatologist Examinations: If you find a mole that you think may be cancerous, get an appointment with a dermatologist. He or she will be able to determine whether or not the mole is skin cancer. If there is a doubt, a biopsy can be performed.

With preventative action, life in the sun doesn't have come to an end due to skin cancer. For more information, I recommend additional reading which includes the following book:

Cancer free: The comprehensive cancer prevention program, by the Pacific West Cancer Fund. New York : A Fireside Book. Call number: RC268 .C356 1996