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PREVENTION & EARLY DETECTION

Prevention of skin cancer requires active participation from patients. UV exposure from the sun and/or tanning beds is highly linked to the development of skin cancer. As such, protection from UV exposure is paramount in preventing skin cancer. Protection from UV exposure includes the following strategies:
  • Seek shade, especially between 10 AM and 4 PM.
  • Avoid getting sunburns.
  • Avoid tanning and never use UV tanning beds.
  • Wear protective clothing, including a broad-brimmed hat and UV-blocking sunglasses.
  • Use a broad-spectrum (UVA/UVB) sunscreens with an SPF of 30 or higher every day.
  • Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or after swimming or excessive sweating.
  • Keep newborns and children out of the sun. Sunscreens can be used on babies over age six months.
It’s often stated that the best sunscreen is the one that you use regularly. Most dermatologists agree that an effective sunscreen should have a Sun Protection Factor (SPF) of 30 or greater and be broad-spectrum. This means that it protects from both UVA and UVB rays. UVA rays are thought to contribute to skin aging, while UVB to skin cancer. Sunscreens can be grouped into either chemical blockers or physical blockers. Chemical sunscreens absorb into the skin and then absorb UV rays, converting the rays into heat, and releasing them from the body. The active ingredients in chemical sunscreens typically include avobenzone, octinoxate, and oxybenzone. Physical blockers sit on top of the skin and reflect the sun’s rays. The minerals titanium dioxide and zinc oxide are the main active ingredients in physical blocks. In general, sunscreens should be worn every day you are outdoors and should be re-applied every two hours. Even on cloudy days, up to 80% of the sun’s rays reach your skin. If exercising or swimming, it is important to re-apply your sunscreen after finishing your workout or coming out of the water. Even “water-resistant” sunscreens should be re-applied. It takes approximately one ounce (a shot glass) of sunscreen to cover your skin not protected by shorts and a T-shirt. And don’t forget your ears and lips! Use a ChapStick or lip balm with SPF to protect your lips. Regarding safety, sunscreens, when used correctly, have not been shown to cause toxicity. In some people, sunscreens can cause irritation or rarely an allergic reaction. If you develop a rash after using sunscreen, stop its use, and contact your dermatologist or medical doctor. Some sunscreens can be sprayed onto the skin. The FDA is currently investigating the risks of accidental inhalation of spray sunscreens. It is recommended that you do not spray these sunscreens around your face or mouth.

There are clothing options available for sun protection. Special clothing with an Ultraviolet Protection Factor (UPF) can offer broad-spectrum protection from the sun. The following companies sell UPF clothing online: Coolibar® (www.coolibar.com) and Solumbra® (www.sunprecautions.com). Outdoor companies, such as REI, Columbia, The North Face, and Patagonia also sell UPF clothing. Look for clothing with a UPF of 30 or greater.

Nicotinamide: A recent scientific study published in the New England Journal of Medicine has shown that taking 500 mg of nicotinamide twice daily can reduce the development of actinic keratosis, as well as both basal and squamous cell skin cancers. Nicotinamide is a derivative of Vitamin B3 that enhances DNA repair and keeps the immune system strong. This can be purchased inexpensively online if it is not available at your local pharmacy. It is important to purchase either nicotinamide or niacinamide but not niacin. Niacin is similar but can cause intense facial flushing and discomfort.

The best form of sun protection for babies is to keep them out of the sun and in the shade. Babies have thinner skin and therefore are more sensitive and can burn easily relative to adults. Sunscreens can be applied to infants over 6 months old and to toddlers. Choose a broad-spectrum sunscreen made for babies or children with an SPF of 30 or greater. The most effective sunscreens contain physical blockers, such as zinc oxide and titanium dioxide.

Early detection of skin cancer allows for a wider range and more effective skin cancer treatment options. When skin cancer is detected early, it can be treated more effectively with minimal scarring. Several strategies help with early detection, including:

  • Self-Examination of your skin head-to-toe every month.
  • Seeing your dermatologist at least once a year for a professional skin exam.

Full Body Skin Exams performed by a dermatologist on a regular basis are important for detecting skin cancers early. Depending on your personal and family history of skin cancer, your dermatologist may wish to fully examine your skin every 3, 6, or 12 months. A full-body skin exam should include an examination of entire your body, head-to-toe. In addition, if you have a history of high-risk skin cancers, an examination of your lymph nodes may also be performed.

With an organized approach, self-skin exams are also an important method for routinely checking your skin. Most dermatologists recommend that you examine your own skin at least once monthly for any new or changing lesions, particularly changing moles. The sooner you identify that something is new or changing on your skin, the sooner you can get it checked out by your dermatologist.

There are several imaging devices available for skin examination. A dermatoscope is a special magnifying light that can be used when examining your skin. These devices are particularly useful for examining moles. They allow your dermatologist to see pigment architecture below the skin’s surface. Seeing this architecture in more detail helps your doctor determine if the mole is suspicious and might warrant a skin biopsy.

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