Safer fun in the sun

As you prepare for the day’s excursions, it’s important to maintain skin safety while enjoying that warm sunshine. Over time, unprotected exposure to the sun’s UVA and UVB rays can damage skin and lead to DNA mutations that cause skin cancer.

Fortunately, there are many ways to enjoy a safer day outdoors. Dr. Gloria Xu, a dermatologist and micrographic surgeon, and Dr. Vincent Ma, a medical oncologist who specializes in advanced skin cancer, offer their expert advice on how best to protect your body’s largest organ.

Types of cancer

The three main categories of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal cell is the most common type, followed by squamous cell. Both can be effectively treated when caught early, and Mohs surgery is the most common treatment.

This procedure, pioneered at UW in the 1930s by Dr. Frederic Mohs, involves a multi-stage surgery to remove cancerous tissue as well as examining the margins of the tumor area to ensure that all identifiable cancerous tissue is removed while preserving as much healthy skin as possible.

“It’s a very precise cutting, and it has a high cure rate,” Xu said.

Melanoma is the deadliest type of skin cancer because of its ability to grow quickly and spread to other parts of the body. Ma said the vast majority of melanoma that is caught early can be treated effectively with surgery.

Advanced-stage melanoma treatment is more intensive, but patient outlook has improved significantly in the past decade thanks to advances in immunotherapy. This treatment harnesses methods to reinvigorate the patient’s immune system to fight cancer cells.

“Stage 4 melanoma used to be a death sentence,” Ma said. “Immunotherapy has revolutionized how we treat patients. These patients can now live longer than ever before.”

Saving your skin

There are many easy ways to keep your skin safe. The most effective is to avoid spending a lot of time in the sun during the hours of 10 a.m. to 3 p.m., when the sun’s rays are strongest. Find shade whenever possible to avoid direct exposure.

For the times you will be out in the sun doing activities, Xu and Ma urged diligent use of sunscreen.

“Make sure you lather up and you reapply,” Xu said. Sunscreen should be reapplied every 80 minutes or so, and more frequently if you’re sweating a lot or are swimming. And don’t be stingy with the amount you use.

Xu suggests using broad spectrum sunscreen that protects against UVA and UVB rays and is at least SPF30. Pay extra attention to the skin on the head and neck, which is particularly vulnerable to sun exposure. Xu said they’re the most common site she sees cancerous spots on patients.

Sunscreen use is an especially important habit to start with children, even though they aren’t always cooperative about it.

“Try experimenting with different brands, like the gels and sprays, and see what they tolerate,” Xu said.

Sunglasses and a wide brim hat also can help shield your vulnerable face and neck. Men also need to be conscious of covering thinning or bald areas of their scalp, either with a hat or sunscreen.

There are also many options of long-sleeve lightweight clothing for both kids and adults, to give extra coverage on arms, shoulders and chest.

Xu and Ma agreed that, while people with lighter skin and hair tone are most at risk of sun damage, people of every skin tone are susceptible to skin cancer and need to take precautions.

For those vacationing in tropical places close to the equator, wearing sunscreen and protective clothing is even more important. The sun’s rays are stronger in those regions, which puts you at a higher risk of severe blistering sunburn.

“A history of blistering sunburns put you at a significant risk for melanoma development,” Ma said.

Ma and Xu suggested that people keep a close eye on their skin to look for any new, questionable spots or changes to existing moles. The acronym ABCDE — asymmetrical, border, color, diameter (greater than 6 mm) and evolution — helps you remember the details to pay attention to for both new and existing moles.

If your family has a history of skin cancer, it’s even more important to be vigilant and look for questionable skin spots.

“The earlier you catch it, the better the long-term outcome,” Ma said.