Melanoma :: Skin care safety in the sun

Physicians and staff at UCSD Medical Center say this is the perfect time to remind San Diegans that they can take care of their skin and still have fun in the sun.

Brian Jiang, M.D., associate clinical professor in the Division of Dermatology understands why the sun is such a draw. Having moved from the East Coast to join the faculty at UCSD Medical Center not long ago, Jiang appreciates the sunny skies. But he also advises patients to have a healthy respect for the sun?s powerful rays to avoid skin damage that can lead to wrinkles, discoloration and even cancer.

Melanoma: Malignant and Cancerous

According to experts at the Moores UCSD Cancer Center, there is a rising epidemic of melanoma. One in approximately 34 Americans will eventually develop it — up dramatically from an estimated 1 in 1,000 at the turn of the 20th century?and some studies link melanoma and other skin cancers to sun-induced damage. When skin cancers and melanomas are detected early, most can be cured by treatment including simple surgery. Some patients, however, have a high risk for recurrence or spread of melanoma and require an integrated care plan. Melanoma is a difficult disease with inadequate therapies in the advanced stages.

ABCs of Melanoma

A: Asymmetry- Melanoma lesions are typically irregular in shape. Benign, non-cancerous moles are typically round.

B: Border- Melanoma lesions often have uneven borders. Moles have smooth, even borders.

C: Color- Melanoma lesions often contain many shades of brown or black. Moles are usually a single shade of brown.

D: Diameter- Melanoma lesions are often bigger than the size of a pencil eraser. Moles are usually smaller.

E: Evolution- Represents the history of change in the lesion.

WHAT TO DO?

1) Wear sunscreen that is labeled as broad-spectrum, with a sun protection factor (SPF) of at least 15. That provides for protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Apply that sunscreen 15 to 30 minutes before going outside. Re-apply at least every 2 hours.

2) Limit exposure time. ?Try to get in your outdoor activities before 10 a.m. or after 4 p.m. The sun is not as strong during those times,? says Dr. Jiang. ?And clouds do not protect you. UVA still goes through the clouds. You can burn even on a very overcast day.?

3) Wear protective clothing. While avoiding sun exposure is the best way to protect the skin, wearing long sleeves, long pants, a wide brimmed hat and sunglasses in addition to wearing sunscreen is the next best thing. All of these help cut down on the amount of sun exposure. The American Academy of Dermatology (AAD) has approved certain brands which are good for sun protection. http://www.aad.org

4) Protect children from sun exposure. Children over six months of age should be protected by applying sunscreen and limiting sun exposure. Babies less than six months should not be sun exposed at all.

5) Avoid Tanning Beds. Ultraviolet light from tanning beds can cause skin cancer. If you want a sun-tanned look, consider using a sunless self-tanning product, along with sunscreen.

6) Do a monthly self-check, and if you notice any odd-looking moles or marking, contact your doctor as soon as possible. Jiang reminds patients that early detection can save your life. The AAD recommends checking yourself once a month, usually after a bath or shower, while standing in front of a full-length mirror, holding a hand mirror.

?Front and Back
?Right & Left Side
?Bend your elbow and look carefully at forearms, back of upper arms and your palms.
?Look at the backs of your legs and feet, space between the toes and soles of your feet.
?Examine the back of your neck and scalp with a hand-held mirror. Part your hair and lift.
?Finally, check your back and buttocks using a hand mirror.

Where Does Your City Rank?

Recently, the AAD ?identified the cities that take sun protection seriously and those that fail to make the grade despite repeated health warnings.?

The ?RAYS: Your Grade? survey polled adults in 32 U.S. metropolitan regions on their knowledge, attitudes and behaviors toward tanning and sun protection. Cities were then ranked based on the percentage of people who scored A?s and B?s. San Diego ranked 24th out of 32 cities, tying with Cincinnati. Washington, D.C. scored highest, followed by New York City.

What?s the Diagnosis? Complicated!

According to Gregory Daniels, M.D., Ph.D., coordinator of the clinical program in melanoma at the Moores UCSD Cancer Center, the relationship between sun exposure and melanoma is not simple.

?The rates of melanoma continue to go up even though people are taking more precautions,? said Daniels. ?There are no studies clearly demonstrating that sun avoidance leads to lower death rates for melanoma. I tell patients to actually get some sun. We need at least 15 minutes each day for vitamin D, healthy bones and it may be preventive for certain cancers such as prostate, colon and breast. To make it more confusing, there are studies showing lower mortality from melanoma in patients with higher sun exposure. The best proven protection, so far, is early detection and knowing your skin.?

Open House

If you or someone you know has questions or concerns about melanoma, plan to attend a free Melanoma Open House sponsored by the Moores UCSD Cancer Center from 6:30 to 8:30 p.m. Thursday, May 24.

Melanoma experts from the Cancer Center will share the latest information on prevention, detection, and medical and surgical therapies, and will answer questions.

Guests will also have the opportunity to use the ?DermaScan? skin assessment device to view sun damage to their skin, which is often invisible to the naked eye.

The event will be held in the Goldberg Auditorium at the Cancer Center, 3855 Health Sciences Dr., La Jolla. Refreshments provided. Free parking. To attend, please call (858) 822-6189 with name and the number attending.


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