Surgeon General finally warns about Skin Cancer

Look how the sun hits your body while swimming and playing...

Look how the sun hits your body while swimming and playing…

This past Tuesday, the United States surgeon general issued a call to action to prevent skin cancer, calling it a major public health problem that requires immediate action.

Nearly 5 million people are treated for skin cancer each year. According to the American Cancer Society,  more cases of skin cancer are diagnosed annually than breast, prostate, lung and colon cancer cases combined and skin cancer rates are increasing.

“We all need to take an active role to prevent skin cancer by protecting our skin outdoors and avoiding intentional sun exposure and indoor tanning,” said Acting Surgeon General Boris D. Lushniak, MD, MPH.

I say this all the time, but it bears repeating as often as possible:

“Most skin cancer is 100 percent preventable.” 

Most cases of melanoma – as many as 90 percent – are believed to be caused by cumulative exposure to UV rays. UV rays are also a major risk factor for the most common curable forms of skin cancer,  basal and squamous cell skin cancers. Exposure to UV rays comes from the sun and other sources like tanning beds and sunlamps and the U.S. Food and Drug Administration (FDA) now requires that tanning beds and sunlamps carry a warning stating people under 18 should not use them. Lushniak said there is a flawed perception in the US that tanned skin looks healthy, and that needs to change. I always say,

“Tanned skin is damaged skin.”

According to the Melanoma Education Foundation, One blistering sunburn before age 20 doubles your lifetime risk of melanoma. Three or more blistering sunburns before age 20 multiplies your lifetime risk by five.

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How many times have you gotten a bad sunburn?

Reduce your risk of skin cancer for yourself and your children:

-Jodi, proud owner of a lily white complexion.

Can babies go in the sun?

Question:  I’ve heard conflicting opinions about what age babies can go in the sun. Is there a sun exposure rule for healthy skin for babies?

Always have baby wear a had to shade her face in addition to sunscreen in babies over 6 months

Always have babies over 6 months in age wear a hat plus sunscreen and other protective clothing

Answer:  I  second the advice of the The American Academy of Pediatrics, the U.S. Food and Drug Administration and the American Cancer Society: Keep babies under 6 months old out of the sun entirely and do not apply sunscreen on babies younger than 6 months.  Babies who are 6 months or older should be protected with clothing, hats, a broad-spectrum sunscreen and shade. Look for broad-spectrum formulations specifically for babies and toddlers who have more sensitive skin than adults. The time that they spend in the sun should be very limited.

Did you know? More than half of a person’s lifetime sun exposure occurs before age 20. Remember, skin keeps impeccable records, so every minute spent in the sun adds up as skin damage and possibly skin cancer. More than one million Americans develop skin cancer every year mostly from long-term exposure to ultraviolet radiation from the sun.

UV exposure makes you look old before your time and causes:

• Wrinkling

• Blotching

• Drying

• Leathering of the skin

Beginning with babies 6 months and older, limit time in the sun and protect skin with sunscreen and protective hats and clothing whenever exposed.

-Jodi

UV rays and location, location, location…

Question:  Is it true that the sun’s UV rays are stronger in the South?

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That big line on the globe is the equator – Do you live near it on either side?

Answer: Yes, this is true. The closer your location is  to the equator (the line that is equally distant from the South Pole and the North Pole which also separates the Northern Hemisphere from the Southern Hemisphere on a map or globe), the more potent the sun’s rays. This is because they hit the earth more directly for a greater part of the year which accounts for the higher skin cancer rates in  “sun belt” locations. People who live or vacation in the Southern United States  or in Central and parts of South America and Africa should be especially aware and diligant of the need for sunscreen, hats and protective clothing and eye glasses whenever outside.

You may see lots of tanner people in these locations and that’s because they are exposed so much more to the UV rays from the sun. Remember, there is no such thing as a healthy tan (no matter what society would lead us to believe) because tanning is the skin’s response to the sun’s damaging rays.

If you’re unsure how close you are to the equator, check this global equator map.

-Jodi

Want to be 25% less likely to get age spots?

Well, I’ve been saying this to my patients for years:  Daily sunscreen use prevents the ugly results of photo-aging (spots, roughness and wrinkles caused by years of cumulative sun exposure which speeds up your skin’s natural aging process)  and finally a study published in a June issue of the Annals of Internal Medicine entitled, “Sunscreen and Prevention of Skin Aging,” has proven this to be true.

shutterstock_124869277Studies have already proven that sunscreen prevents skin cancer, but previous studies on photo-aging had always been done on mice so this new study performed on over 900 white people in Australia under the age of 55 and measured over 4 years just confirms what we dermatologists have been saying to our patients:

“If you want to keep spots and wrinkles at bay,  use sunscreen every day.”

Initially, the researchers weren’t sure exactly what effect regular comprehensive use of sunscreen would have on skin aging caused by the sun over the years and they were also curious about the effect of taking dietary antioxidants such as β-carotene supplements to delay skin aging so they tested both.

The study was broken randomly into 4 sunscreen use groups:

  1. Specific daily use of broad-spectrum (protects against both UVA & UVB rays) sunscreen of SPF 15 applied to head, neck, arms, and hands each morning and after bathing, after spending more than a few hours in the sun, or after sweating heavily and 30 mg of β-carotene.
  2. Specific daily use (as described above) of the broad-spectrum SPF 15 sunscreen and placebo.
  3. Use of broad-spectrum SPF 15 sunscreen at the discretion of the participant and 30 mg of β-carotene.
  4. Use broad-spectrum SPF 15 sunscreen at the discretion of the participant and placebo.

Photos were taken of the backs of participants’ hands at the beginning of the study and 4.5 years later and were examined for microscopic changes of skin aging by researchers without the knowledge of  which study groups the participants had been assigned.

The sunscreen use findings:

Interestingly, not all of those in the daily use group applied their sunscreen daily as directed. But more participants assigned to the daily sunscreen use group reported applying sunscreen at least 3 to 4 days each week compared to the participants in the discretionary-use group. Those in the daily-use group were 24% less likely to have increased skin aging after 4.5 years than were those in the discretionary-use group.

No overall effect of taking β-carotene supplements on skin aging was found.

My advice:  If you want to prevent discolorations, spots and wrinkles from forming due to cumulative exposure to the sun’s rays as you age, use a broad-spectrum sunscreen (and make sure it specifies so on the label) daily of at least SPF 15 whenever you are outside and exposed to the sun.  Also,  seek the shade whenever possible and wear a broad-brimmed floppy hat and sun glasses to protect facial skin and your eyes!

-Jodi

Black Salve no skin cancer salvation!

Question:  I’ve read many accounts online about an alternative therapy of using an herbal “Black Salve” to treat skin cancer, but then I also saw many scary photographs and read many scary stories of disfiguring skin damage from the treatment. What’s your opinion?

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Just say “NO” to Black Salve and alternative cures you see online as skin cancer cures!

Answer: My opinion is firm:  When it comes to any type of skin cancer, medical treatment has more than a 90 percent cure rate when lesions are caught early and removed and conventional medicine has an excellent track record in successfully treating skin cancer and restoring health. In fact, while there may be a genetic predisposition (family history or skin type) to skin cancer, statistics show that 90 percent of all skin cancers are caused by long-term, unprotected exposure to the sun’s UV rays. Those at highest risk are people with fair skin, blond or red hair, and those with blue, green or grey eyes and workers in outdoor occupations.  So skin cancer prevention falls on you for keeping unprotected sun exposure to a minimum and in checking your own skin for suspicious growths and actively having them checked at least once per year by a dermatologic practitioner.

The skin cancer fear factor…

Once cancer is diagnosed, patients can get scared and can fall prey to online cure scams and alternative therapies that can do more harm than good, according to a 2009 FDA release entitled, “Beware of Online Cancer Fraud.”   “Anyone who suffers from cancer, or knows someone who does, understands the fear and desperation that can set in,” said Gary Coody, R.Ph., the National Health Fraud Coordinator and a Consumer Safety Officer with the Food and Drug Administration’s (FDA) Office of Regulatory Affairs. “There can be a great temptation to jump at anything that appears to offer a chance for a cure.”

Black Salve on the FDA list of Fake Cancer Cures

From what I’ve read, Black Salve is the most the most widely known alternative therapy you will find online. It is an herbal topical treatment classified as an escharotic which is a substance applied to the skin that causes tissue to die and fall off.  The types of Black Salve available on the internet today can be made from ingredients such as zinc chloride, chapparal (larrea tridentata) or bloodroot which are all caustic (or escharotic) to the skin.

The FDA release outlines how the salves are sold online despite being illegal and how they are sold with false promises that they will cure cancer by “drawing out” the disease from beneath the skin. “However, there is no scientific evidence that black salves are effective,” says Janet Woodcock, Director of FDA’s Center for Drug Evaluation and Research (CDER). “Even worse, black salves can cause direct harm to the patient.” The corrosive, oily salves “essentially burn off layers of the skin and surrounding normal tissue,” says Woodcock. “This is not a simple, painless process. There are documented cases of these salves destroying large parts of people’s skin and underlying tissue, leaving terrible scars.”

Black Salve does not distinguish diseased from healthy skin.

If you are questioning an alternative cancer cure you see online, check the FDA list, “187 Fake Cancer Cures Consumers Should Avoid.”

That being said, I would not recommend desperate attempts at using Black Salve or other alternative therapies once skin cancer has already taken hold, especially since Melanoma is dangerous and can spread. Here’s why:

  • Alternative therapies have not been medically and scientifically tested for efficacy and safety .
  • The use and sale of alternative therapies online is completely unregulated so you cannot be sure the purity or concentration of ingredients you are putting on your skin.
  • Alternative therapies can contain unknown compounds with questionable benefit and the potential for great harm and they are promoted on the internet illegally without full consideration or information about potential toxicity.
  • With alternative therapies instead of surgical procedures and medically researched treatments, there is a large risk of incomplete tumor removal and tumor growth and metastases (spreading).
  • Alternative therapies untested on healthy skin leaves unwary patients open to damage of surrounding healthy tissues and marked scarring with poor cosmetic outcomes

If you think you have a lesion, spot or growth that could be skin cancer, go directly to the dermatologist who will test the tissue via a biopsy and advise you whether the tumor needs to be removed.  In cases such as skin cancer, when medical treatment has a high success rate, don’t look elsewhere at alternative therapies.

Have you been tempted by Black Salve? Did the online photos scare you away?

Today is Melanoma Monday

Take an extra moment today to check your moles because today is Melanoma Monday®.

Have your skin checked at least once per year with a dermatologist to avoid any type of skin cancer, especially if your skin has been or is overexposed to the sun or UV radiation from outdoor activities or indoor tanning. Check  for any moles with the following characteristics and remember these warning sign ABC’s in between:

Asymmetry: Half of the mole does not match the other half.

Border irregularity: The mole’s border is irregular or jagged.

Colors: The mole has a variety of colors such as shades of brown, tan, black, red or blue.

Diameter: The mole is 6 millimeters wide (about the width of a pencil eraser) or larger.

Evolution: The mole has either changed color or growth in width or height or the mole has become bloody, crusty or itchy.

If a mole anywhere on your skin or scalp displays any one or more of these warning signs have it checked and possibly biopsied by your dermatologist as soon as possible.

Skin cancer terms

Skin Cancer

A tumor arising in the skin caused by uncontrolled cell division. Classified as melanoma and non-melanoma skin cancer (basal and squamous cell carcinoma).

Basal Cell Carcinoma (BCC)

The most common type of skin cancer, it originates from the basal cells in skin and usually appears as a red lump or scaly area. It rarely spreads to other organs (metastasizes).

Squamous Cell Carcinoma (SCC)

A scaly or plate-like malignant tumor of the skin that sometimes spreads (metastasizes) to other organs. The second most common form of skin cancer

Malignant Melanoma (Melanoma)

Malignant Melanoma is a cancer of melanocytes and usually has an irregular outline and patchy coloring. It is the most dangerous type of skin cancer that can spread to other organs (metastasize).