Summer Skin Smarts

by Molly M. Ginty

Linda Talbott loved the sun. As a child growing up in the Midwest, she spent hours playing outdoors every day, and made a game of popping the blisters that blossomed on her sunburned face.

Ten years ago, Talbott’s summer fun came back to haunt her when she was diagnosed with melanoma, the most malignant form of skin cancer, which is spurred by overexposure to the sun.

"My doctor took biopsies of two moles on my left cheek," says Talbott, 68, of Kansas City, Missouri. "Both were cancerous and required immediate surgery."

A former model, Talbott is now permanently scarred by her treatment, with a left eye that doesn’t close completely and a left cheek that is mostly gone. Even so, she’s grateful to have survived skin cancer, which has spiked dramatically among women in recent decades.

"Since 1976, some forms of skin cancer have increased sevenfold in women," says Dr. Randall Roenigk, a professor of dermatology at the Mayo Clinic in Rochester, Minnesota.

Roenigk says, "Women’s lifestyles are changing, so they are more likely to work in the sun and travel to the tropics. Young women are flocking to tanning booths that can boost the risk of skin cancer, and older women are living longer and increasing the likelihood that they will eventually develop this disease."

How can you avoid joining the trend? By making sure you protect yourself from skin cancer’s three most common forms.

Your number one foe: melanoma, which accounts for only 5 percent of skin cancers (affecting 62,000 Americans per year) but causes 80 percent of skin cancer deaths. Caused by damage to pigment cells that begin to grow unchecked, melanoma usually develops on the trunk or legs and is characterized by moles with ABCD changes: Asymmetry, Border irregularity, Color variations, and a Diameter of more than a quarter inch.

Your other adversaries? Basal–cell carcinoma and squamous-cell carcinoma, which are non–melanoma cancers caused by damage to non-pigment cells. Typically found on the head, neck, and other sun-exposed areas, these cancers are signaled by sores that don’t heal after two or three months. In the case of basal-cell carcinoma, which afflicts 1 million Americans per year, the growths can be flat, firm, and pale, or small, raised, and pink. Squamous–cell carcinoma, which affects 250,000 Americans, usually shows up as a red, rough, and scaly sore.

To guard against these cancers, watch your skin carefully for growths or a profusion of moles, which requires full-body, monthly self exams. Immediately report any changes to your doctor.

Even if you seem to be growth–and mole–free, avoid the sun from 10 a.m. to 4 p.m., when skin–damaging ultraviolet (UV–A and UV–B) rays are strongest. Note that cloud cover is no guarantee of safety, and that sunlight that glints off water or is at high altitudes can be especially dangerous.

Always wear sunscreen outdoors, choosing brands that contain avobenzone, zinc oxide, or titanium dioxide and thus offer the most protection against ultraviolet light. Make sure the product you use has a sun protection factor (SPF) of at least 15, meaning you’re exposed to one minute of ultraviolet rays for every 15 minutes in the sun.

Apply sunscreen 20 minutes before you head outdoors so that it takes effect in advance, and reapply at least once every two hours (or immediately after swimming or working out, even if the product is labeled "waterproof").

Boost skin protection even more by wearing loose–fitting, tightly–woven, light–colored clothing that covers as much skin as possible  — plus a widebrimmed hat and sunglasses that block 100 percent of ultraviolet radiation (labeled "UV absorption up to 400 nm").

Remember that even though a summer tan may be considered attractive, repeated studies show that tanning, like sunburning, can raise your risk of skin cancer. "There’s only one healthy color for your skin," says Dr. Martin A. Weinstock, a professor of dermatology at Brown University in Providence, Rhode Island. "And that’s the color you were born with."

As you follow these sun safety tips, make sure you remain outdoors long enough for your body to make vitamin D, an essential nutrient produced when the skin is exposed to sunlight that protects against diabetes and colon, breast, and lung cancer. To get sufficient D, enjoy 10 to 15 minutes of sun exposure three or four times a week — and consume at least 400 IUs of vitamin D (found in salmon, mackerel, fortified milk, cereals, and orange juice) every day.

Even if you’re vigilant about sun safety, note that it’s still possible to develop skin cancer if you’ve suffered repeated sunburns or have freckles, fair skin, or a family history of the disease. Unfortunately, there’s little you can do about these risk factors — or about the fact that UV rays are flooding the atmosphere as pollution shrinks the ozone layer.

The good news?

Even though skin cancer can be disfiguring, it nevertheless carries a high survival rate (92 percent for melanoma and 99 percent for other forms) if it is detected early and treated with excision, freezing, laser therapy, radiation, or chemotherapy. "Skin cancer is highly preventable," says Weinstock. "And fortunately, it’s also highly treatable."

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.

Article published in Lutheran Woman Today, June 2007