As winter approaches and the days grow shorter, you may be ready to forgo the summer sunscreen, but don’t toss it yet. Protecting your skin is a year-round commitment. Although the sun’s rays may not be quite as direct in the colder months, ultraviolet (UV) rays are still strongest between 10 a.m. and 4 p.m. and there can be significant UV reflection that causes sunburn, skin cancers, and other forms of skin damage. So if you need more motivation to keep applying the SPF, know this: skin cancer is the most common cancer in the United States and one in five Americans will develop some form of skin cancer before the age of 70, according to the Centers for Disease Control and Prevention. Appealing to the vanity factor, wearing sunscreen can also slow the effects of age on your skin by nearly 25 percent.
So what are the skin cancers?
The two most common types of skin cancer are the non-melanoma basal cell and the squamous cell carcinomas, and both are curable as long as they are found early. Melanoma, the third most common skin cancer, is more lethal, as it is more aggressive and can spread to other organs.
What are the signs?
With skin cancer, regardless of the season, it is important to stay vigilant. Know your skin, your freckles, lumps and bumps and learn to recognize the signs, such as any changes in mole or freckle asymmetry, borders, color, diameter, or anything that looks like it is evolving.
A dysplastic nevus is an example of an unusual mole. It does not have the symmetric round or oval shape of a common mole. It is normally larger (wider than a pencil eraser), contains a mixture of colors from pink or red to tan or dark brown, and may contain an irregular edge. Some are flat, but may be slightly scaly, or have a rough surface. People with many dysplastic nevi have an increased chance of developing melanoma.
What are the risk factors and treatments?
Skin cancers affect people of all colors and races, although it is more common in people who are light-skinned and sunburn easily, who have multiple atypical moles or had an overexposure to X-rays, or a compromised immune system.
Research shows that indoor tanning beds and sun lamps increase the risk for skin cancers, as well as a personal or family history of skin cancer.The good news is that skin cancer has a high cure rate if it you catch it early and get the best possible treatment from a team of skin cancer specialists. Even melanoma, which in some cases can be fatal, has a cure rate of almost 100 percent when treated early. Otherwise, the skin cancer can grow deep into body tissue at its original site and then surgery may involve cutting out muscle and even bone. If left untreated, skin cancer can spread to other parts of body and vital organs.
Preferred skin cancer treatment starts with excision, in which the surgeon numbs the skin, then cuts out the skin cancer and a section of surrounding skin that looks normal. Most excisions can be performed in a physician’s office. Specimens of the tumor are then sent to a dermatopathologist for analysis.
What else can you do?
Prevention is key. Do your best to avoid direct sunlight between 10 a.m. and 4 p.m. Use sunscreen year round, or, as the cold weather arrives, use a moisturizer with SPF. Products with SPF from 30 to 50 are recommended, and make sure to reapply if you are going to be in direct sunlight for several hours, even if it is cold outside.
There are currently no recommended guidelines issued by the American Academy of Dermatology for screening for the average person without a personal or strong family history of skin cancer. The U.S. Preventative Services Task Force, the governing body that establishes the screening guidelines along with national academies, does not have enough evidence to support yearly skin cancer screenings for the average adult. With this in mind, they provide a caveat that you should determine with your primary care physician your personal risk factors, which then dictate whether you should get a baseline screening and at what age.
You can also regularly check the skin all over your body for any abnormalities that last two weeks or longer and are either growing, changing shape, bleeding, or itching. If you detect any change, make an appointment with a dermatologist for a skin cancer check. And make sure to avoid known risks for skin cancer such as sun and tanning beds, for example.
Angela J. Lamb, M.Dd is an Associate Professor of Dermatology for the Mount Sinai Health System