May is Melanoma/Skin Cancer Detection and Prevention Month. Skin cancer is one of the more preventable cancers and we should all be aware of the risk factors and prevention goals. It is useful for all of us to perform regular skin checks for moles (raised or flat) with concerning features. A ‘changing mole’ is the most concerning characteristic, therefore, it is wise to have an idea what and where your moles are currently. Remember, one in 5 Americans and one in 3 Caucasians will develop skin cancer in the course of a lifetime, 90% of which is attributable to sun exposure. Click here for a summary of self-exams and the things to look for (“A,B,C,D,E” of skin cancer).
There has been recent controversy regarding ingredients of sunscreens and their safety. Ongoing research is investigating this at many levels. Until then, it is still safest to always use a sunscreen as there is a very real cancer risk from ultraviolet light. We recommend sunscreens with both UVA and UVB protection, try for titanium dioxide or zinc oxide screens (although oxybenzone, sulisobenzone, avobenzone have recently been reviewed and found safe for topical use), avoid added fragrances or preservatives as these may be irritants, and use no less than SPF 30.
Some further information about sunscreens can be found at the AAD website: Sunscreens/Sunblocks, the CDC website: Skin Cancer Questions and Answers, and the Mayo Clinic website: Sunscreen (what to look for).
The below excerpt discusses very high risk and high risk patients. Reviewing the criteria may be useful:
Very high risk of skin cancer
Individuals with any of the following risk factors have a very high risk of skin cancer (approximately 10 or more times the risk of the general population):
- On immunosuppressive therapy after organ transplantation
- A personal history of skin cancer
- Two or more first-degree relatives with melanoma
- More than 100 nevi in total or 5+ atypical nevi
- Have received more than 250 treatments with psoralen-ultraviolet light (PUVA) for psoriasis
- Received radiation therapy for cancer as a child
High risk of skin cancer
Individuals with two or more of the main identified susceptibility factors are at a high risk for skin cancer (roughly 5 times the risk of the general population):
- A first-degree relative with melanoma
- Many (50-100) nevi
- One or more atypical (dysplastic) nevi
- Naturally red or blond hair
- A tendency to freckle
- Skin that burns easily and tans poorly or not at all
Individuals at high risk should be identified by their primary health care provider and counseled about skin self-examination (specifically focused on the site of radiation for those having had therapeutic radiation) and skin cancer prevention by a health care provider. High-risk individuals should be seen once a year by a health care provider trained in screening for skin cancers.
If you have any concerning spots, your Executive Healthcare Services physicians are available to evaluate and discuss the best course of action. We encourage a yearly physical exam for all clients which is also a good time to review your risks and check for concerning skin changes.
Yours in health,