Skin Cancer
The Dark Side of the Sun
Remember summers on the patio with an aluminum foil reflector and nothing but an itsy-bitsy bikini between you and the sun? Or slathering baby oil all over yourself in hopes of getting a deep, dark tan?
Ouch. The truth is, just one bad burn in childhood doubles your risk of skin cancer as an adult. Add a few more decades of sun exposure--even if you've always tanned without burning--and your risk goes up even more, along with the cosmetic age of your skin, which will look older because of sun damage. Fair-skinned, light-eyed ancestors also boost your chances. And if a parent or grandparent has had a skin cancer removed, you may be next in line.
Like many women, you probably give a lot of attention to the appearance of your skin. If it looks good, you assume it's healthy. That's why skin cancer can be such a shock--it seems like an ambush from nowhere. (It can be 20 years between the initial damage and the cancer.) And many of us are being ambushed in our late forties or early fifties instead of in our seventies and later, the ages that used to supply the majority of victims. Researchers speculate that damage to the planet's ozone layer, which protects us from the worst of the sun's radiation, is one likely reason.
Fortunately, the skin cancers that occur most often--the forms known as basal cell and squamous cell--very rarely spread, though if they're stubborn, they can recur, says Thomas Griffin, M.D., a dermatologist with Graduate Hospital and clinical assistant professor of dermatology at the University of Pennsylvania School of Medicine, both in Philadelphia. They appear as small bumps on the skin, usually on sun-exposed areas including your back, which receives radiation right through light fabrics. They can be flesh-toned or brown to gray, and some have tiny ulcers at the center of the growth that bleed easily. Squamous cell cancers may also have a hard spot within the growth.
The shark of skin cancers is melanoma. It occurs much less frequently than other skin cancers, but it can be fatal. Once melanoma grows deeper than one millimeter into the skin, it has a higher risk of spreading to other organs. It may start from a mole, though it can also begin in a large, flat brown freckle or bleeding spot.
Although men have a higher rate of melanoma than women, it is increasing more rapidly in young women than in any other age group, says David J. Leffell, M.D., chief of dermatologic surgery at Yale University School of Medicine in New Haven, Connecticut. "We're not sure why, but it may be that women now in their thirties had enormous sun exposure in the 1960s when they were children," he says.
Yet doctors say skin cancer is cause for caution, not for alarm. In most cases, it's nearly 100 percent curable, as long as it's caught in time. And best of all, it's preventable.
Tanning Parlors: Fountains of Aging
Don't buy the hype that tanning under a sunlamp or on a tanning bed is somehow safer than the radiation you get from the sun. Or that a "base tan" you acquire in a tanning parlor will somehow protect you from deeper sun damage. Both claims are dangerously false, says Vincent DeLeo, M.D., associate professor of dermatology at Columbia Presbyterian Medical Center in New York City. "Tanning parlors and sunlamps are the most worthless things you can pay money for--and very damaging to the skin," he says. A report from the National Institutes of Health says that some tanning lamps generate over five times more ultraviolet radiation (UVA) than you'd get sitting for the same amount of time on a beach at the equator. If you feel desperate for the golden look, use a self-tanning lotion, suggests Dr. DeLeo. But don't forget to use a sunscreen, too. |
Reducing Your Odds
Even if you've spent quite a few summers in the sun, you can dramatically reduce your chances of developing skin cancer by controlling your exposure from now on. You also need to know how to detect cancer on sun-exposed skin or in an abnormal mole before it grows to the danger point. Here are the top tactics for saving your skin.
Screen it. Wear a full-spectrum sunscreen that blocks both kinds of ultraviolet radiation (UVA and UVB)--and wear it every day, summer and winter, says Perry Robins, M.D., associate professor of dermatology at New York University in New York City, president of the Skin Cancer Foundation and author of Sun Sense. Check to be sure that your sunscreen has a sun protection factor (SPF) of at least 15.
Spend noon indoors. Try to limit your outdoor activities during the hours when the sun's rays are the strongest--from 10:00 a.m. to 2:00 p.m., says Dr. Griffin.
Check for changes. Examine your skin thoroughly twice a year, with a hand mirror or with help from a friend or spouse. Look for any kind of spot that changes, says Dr. Robins. The change can be in color, texture or size (the spot gets bigger), or the spot can begin to bleed, he says. If you have a family history of skin cancer or you've had severe sunburns, ask your dermatologist to "map" your body for potential trouble spots and to keep track of any changes with follow-up visits.
Memorize the ABCDs. This will help you monitor moles for signs of melanoma, says Vincent DeLeo, M.D., associate professor of dermatology at Columbia Presbyterian Medical Center in New York City:
* A is for asymmetry (no symmetrical shape).
* B is for border (an irregular border).
* C is for color change (a dark area arises within a mole, or a mole shows areas of lightening).
* D is for diameter (the mole gets larger or is larger than a pencil eraser).
If you have any of the ABCDs, get to a doctor immediately, says Dr. DeLeo.
A Safe Tan in a Tube
Today's self-tanning lotions won't turn you the awful streaky orange that skin dyes did years ago, thank goodness. The new breeds of tan-in-a-bottle are easy to apply, look natural and won't harm your skin. A self-tanner actually interacts with your skin to turn it a natural, golden-looking color, says Yveline Duchesne, international training director for New York Citybased Clarins Cosmetics. The tan fades gradually as you shed your dead skin cells, usually within a few days. The main active ingredient in self-tanning lotions is a chemical called dihydroxyacetone (DHA). DHA combines with certain amino acids and keratin on the very superficial cell layers of skin to produce the color. With the new products, you can be attractively tanned without damage to your skin--if you continue to wear sunscreen. Most self-tanners have sunscreen with only a low sun protection factor (SPF), so it's best to also use your own sunscreen of SPF 15 or higher. The best timing? Since self-tanners take a few hours to develop, apply them the night before, Duchesne suggests. Then apply your sunscreen the next morning, at least an hour before going out. Other tips for making the most of your self-tanner: Always allergy-test. Before you try a self-tanner all over, apply the lotion to a small patch of skin and leave it on overnight to see if your skin is sensitive to DHA. (If it reacts, a bronzing gel or tinted sunscreen is your best bet for color.) Exfoliate before you apply. DHA can take unevenly in areas where there's a buildup of dead cells. Be sure to include hands, elbows and knees. Start at the top. Work down from your forehead, covering all exposed areas, but skip the eyebrows, where color can concentrate. Apply evenly, including your ears and under your jaw. Moisturize the rough spots. Elbows and knees will look more natural if you moisturize first and apply self-tanner lightly. Wait for results. How often you reapply, not how much, determines the depth of your tan. It takes from three to five hours for color to develop, so don't reapply until you've seen the full results. Let it dry. Wait a half-hour before dressing or going to bed, since some tanners can stain fabric. Wash up. Wash your hands after you apply your self-tanner, or you'll end up with tan palms. |
Early Detection, Early Cure
What happens when your early detection efforts pay off? You've called your dermatologist's attention to a growth, and she confirms that it must be removed.
For most cancers, local anesthetic is all that you'll need, and the removal won't leave a noticeable scar. Depending on the depth and nature of the growth, your doctor will use one or a combination of procedures. They include burning, scraping, freezing and cutting out the growth. Some shallow cancers can be treated with a topical chemotherapy cream.
For difficult or recurring cancers, a surgeon can remove malignant cells in very thin layers, leaving healthy skin untouched. Even melanoma has a potent new enemy--a melanoma cell vaccine that significantly increases survival rates.
