By: Joseph J. Thornton, M.D., Kyo A. Kim, M.D.,
Ellen E. Radziewicz, PA-C,
Lawrence D. Chang, M.D.

The warmth of the summer sun.  The golden sand beneath your feet.  The smell of the salty surf.  Summer’s here, boosting our spirits but with a dangerous tradeoff.  The longer days and more intense sunlight exposes you to the sun’s dangerous ultraviolet radiation (UVR).  This ‘dark’ side of the sun leads to more than 3.5 million cases of skin cancer in the US each year. Also, most of the skin damage associated with aging, such as wrinkling, sagging, leathering, is UVR related.
Many people consider skin cancer to be a minor health concern, however, someone dies from skin cancer every hour.  This is unfortunate, since most skin cancers are preventable or at least curable when detected at an early stage.

What’s the harm in sunburn?
Sunburn, the skin reddening caused by overexposure to the sun’s harmful UVR, may seem like a temporary irritation, however, it causes long-lasting damage to the skin.  One blistering sunburn in childhood or adolescence more than doubles a person’s chance of developing melanoma later in life; and even five ‘mild’ sunburns at any age will do the same.
Now you’re worried the damage is already done, so why do anything different now?  This is because the two most common skin cancers, basal cell and squamous cell directly correlate with sun exposure.  More sun equals more skin cancer.
Ultraviolet radiation from the sun is the #1 cause of skin cancer, but UV light from tanning beds is similarly harmful.  People who use tanning beds, nearly 30 million people every year, are 1.5-2.5 times more likely to develop skin cancer.

What is skin cancer?
Skin cancer occurs when malignant cells are found in the outer layers of the skin, particularly in areas exposed to sunlight such as the face, neck, hands, and arms.  Some risks of developing skin cancer include time spent in the sun, overexposure/sunburn, artificial ultraviolet radiation (tanning beds), skin type, abundance of moles or freckles, and family history.
There are three main types of skin cancers:  basal cell carcinoma, squamous cell carcinoma, and melanoma.

Basal Cell Carcinoma (BCC)
• Most common form of skin cancer
• Appear as a small pearly or waxy bump which can often bleed easily
• Cut that won’t heal

Squamous Cell Carcinoma (SCC)
• Growths appear as flat and red, becoming scaly-raised mounds
• The most common form of non-melanoma cancer that can spread
Both BCC and SCC mainly occur on areas of the skin frequently exposed to the sun, but can occur anywhere on the body.

Melanoma
• Appear as a dark flat or raised area on the skin and follow the ABCD rule:
Asymmetry: the shape of one half does not match the other
Border:  edges are ragged or blurred
Color:  uneven shades of brown, black, tan, red, white, or blue
Diameter:  significant change in size (> 6mm)
• Can spread to other parts of the body through the lymph system or blood

Skin Cancer Surgery
The diagnosis of “skin cancer” is scary, but the good news is that most skin cancers are curable if detected at an early stage.  Plastic surgeons can surgically remove skin cancers using specialized techniques to preserve one’s health and appearance.
Skin cancer is diagnosed by performing a biopsy.  This involves taking a sample of tissue, which is placed under a microscope and examined by a pathologist.  Sometimes a biopsy can remove all the cancer tissue, and no further treatment is needed.  However, further surgical intervention may be needed to remove additional cancer tissue or reconstruct the area.  Although no surgery is without scars, a plastic surgeon will make every effort to treat the skin cancer without dramatically changing your appearance.

Prevention
Sunscreen
Sunscreens are chemical agents that help prevent the sun’s ultraviolet radiation (UVR) from reaching the skin.  Two types of UVR, UVA and UVB, damage the skin and increase the risk of skin cancer.  UVB is the chief culprit behind sunburns, however UVA rays, which penetrate the skin more deeply, are the cause of photoaging.  Therefore, a broad-spectrum sunscreen which offers protection against both UVA and UVB rays is recommended.
Most sunscreens with an SPF of 15 or higher do an excellent job of protection.  SPF, Sun Protection Factor, is a measure of the sunscreen’s ability to prevent UVB from damaging the skin.  But what does this mean?  If it takes 20 minutes for unprotected skin to start to turn red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer—about 5 hours.  In addition, SPF 15 blocks approximately 93% of all incoming UVB rays, 30 blocks 97%, and 50 blocks 98%.
To ensure that you get the full SPF of the sunscreen, 1 ounce, the size of a shot glass, should be applied to your entire body 30 minutes before going outside and reapplied every 2 hours.

Self Examination
Most people have freckles, birthmarks, or moles, but any irregularities or a change in the shape, edge, color, or size can be a warning sign of skin cancer.  Since most skin cancers are treatable, early detection is key.  A self examination every 6 months is recommended.  This could take no longer than 10 minutes, a short amount of time to save your life.  Concerning areas should be brought to the attention of your primary care physician for further evaluation.

Advanced Plastic Surgery Center is located at
774 Christiana Road, Suite 101. For more information call (302)623-4004 or visit www.advancedplasticde.com