Summer is the perfect time to enjoy being relaxed and carefree. While you are enjoying these long, lazy days, there is one thing that you need to remain vigilant about and that is protecting your skin from all those glorious rays of sunshine. I know, this is advice that you hear often, especially this time of year. However, skin cancer is the number one most diagnosed type of cancer in the United States. In fact, it is estimated 40%-50% of fair skinned people will develop some form of skin cancer by the age of 65. I think we would all like to see this number go down, and the number one way of achieving that is through awareness.

The statistics on skin cancer are alarming, but it is important to know that many skin cancers are highly treatable, especially if caught early. Even more important is the fact that most types of skin cancer are completely preventable.

One of the common misconceptions about skin cancer is that there is only one type and many people erroneously use the terms “Skin cancer” and “melanoma” interchangeably. While, yes, melanoma is a form of skin cancer, it accounts for less than one percent of all skin cancer cases. Knowing the different types of skin cancer and being able to recognize the warning signs are an important first step in catching them in their early, most treatable stage. Here is a quick description of the different types of skin cancer and how they present themselves. If you would like more information, I recommend the Skin Cancer Foundation’s site as one comprehensive, expert resource.

Actinic Keratosis

These are crusty, scaly patches that develop on the skin because of years of sun exposure. They may be either flat or raised, lightly colored or not. Actinic Keratosis is not defined as skin cancer, but rather as precancerous changes to the skin that have the potential to develop into skin cancer.

This is most common in people over the age of 40 since the changes to the damaged skin tissue take years to develop. They also tend to develop on areas that are subject to frequent sun exposure but often left untouched by sunscreen such as the scalp, ears and back of the hands, but can show up anywhere.

You might notice these types of growth by touch first before sight. If you run your fingers over your skin and notice an area that feels a little rough, no matter how small, you should have it looked at by a dermatologist, especially if there is no known cause and it doesn’t go away on its own.

Basal Cell Carcinoma

Basal cell carcinoma is the most commonly occurring form of skin cancer. This type of cancer is defined by uncontrolled growths or legions in the skin’s basal cells. Basal cell carcinoma can present in a few different ways. You might notice something that looks like a small, open sore that doesn’t heal. They might also appear as shiny, pale bumps, red patches or slightly raised pinkish growth, often with a slight indent in the center.

This type of cancer is caused by repeated exposure to the sun without sunscreen, the type of exposure that might result in a serious sun burn. The good news is that basal cell carcinoma very rarely metastasizes, meaning that it does not spread to the rest of the body, but instead stays localized.

While basal cell carcinoma is likely not to spread, it should still be treated with urgency. Because there is always a chance, no matter how small, that it could spread, it needs to be removed. The longer that it is left untreated, the more likely it is that the damage has gone several layers deep into the skin. This means that removal is more complicated, costly and more likely to cause scarring.

Squamous Cell Carcinoma

The second most common type of skin cancer, squamous cell carcinoma, is also the type with one of the fastest growing rates of occurrence. In the last thirty years, incidence of squamous cell carcinoma has increased by more than 200%.

This type of skin cancer is the result of uncontrolled abnormal cell growth in the outer most layer of cells, also known as squamous cells. This cancer can present itself in very much the same way that basal cell carcinoma, except that the lesions are more likely to crust over or bleed. While this type of cancer is highly treatable when found early, it can metastasize to other parts of the body, making treatment more complicated and possibly less effective.

Squamous cell carcinoma develops because of years of repeated UV exposure. People who are exposed to the sun year-round and those who make a habit of never wearing sunscreen are at a greater risk of developing this type of skin cancer.

Melanoma

Melanoma is the type of skin cancer that most people are familiar with. Unfortunately, it is also the most serious, especially when not caught early. Melanoma is caused by genetic mutations to the skin cells because of exposure to UV radiation, mostly through sunlight and the use of tanning beds. This type of cancer forms in the melanocytes, which are the pigment producers found in the basal layer of your skin. Because of their place of origin, melanoma tumors are often dark in color, ranging from brown to black, and sometimes even red or purplish.

Melanoma, while not the most common of skin cancers, results in the greatest number of skin cancer related deaths. However, melanoma is treatable and even curable when caught early. There is a simple acronym that can be used for assessing moles and changes in your skin that can indicate the development of melanoma.  Keep in mind that if you have a mole on your body that fits these descriptions, that it does not necessarily mean that you have skin cancer. It does mean that you should visit a dermatologist and keep up annual visits to assess any changes to existing moles and beauty marks.

• A: Asymmetry. Benign moles are typically symmetrical. This means if you were to draw a line down the center at any point, that the two halves would mirror each other. Moles that are not symmetrical have a higher chance of being, or developing into, skin cancer.
• B: Border. Melanoma tumors tend to have ragged, uneven borders where benign moles are generally smooth all the way around.
• C: Color. Melanoma tumors might have a variety of colors including different shades of brown, black, red, white and sometimes blue.
• D: Diameter. Benign moles are generally smaller than melanoma tumors. A mole that is approximately ¼ inch, or about the size of a pencil eraser, should be looked at and monitored by a dermatologist.
• E: Evolving. Many people have benign atypical moles that are not melanomas. Of all the potential warning signs of melanoma, one of the most important is noticing any changes. Healthy, non-cancerous moles do not change significantly over time. If you notice any change in the size, color or texture of one of your moles, consult a dermatologist as soon as possible.

Being able to recognize the warning signs of the different types of skin cancer is important for early diagnosis and treatment. However, the most important thing you can do is take steps to protect yourself and reduce your risk of developing skin cancer in the first place. Applying sunscreen regularly is an important, but it is also only one component of a thorough skin cancer prevention plan. Preventing skin cancer requires a lifelong commitment to prevention. Here are a few tips for keeping you, and your loved ones, safe and skin-cancer free while still enjoying the sun and spending time in the great outdoors.

First, it is important to know your risks. Everyone is at risk of developing skin cancer, but some have a higher chance than others.

• People with fair skin that burns easily have a greater overall risk of developing skin cancer. This includes skin types with lots of freckles. Many guidelines note that people with blonde or red hair and lighter colored eyes are at an increased risk. However, it is entirely possible to be fair skinned with darker features as well.
• If you have a large number of moles or “beauty marks”, you have an increased risk of developing skin cancer.
• Dysplastic nevi are benign, atypical moles that share characteristics with melanoma. While dysplastic nevi are non-cancerous, having these on your body increases your chance of developing skin cancer by about 10%

Other general factors that increase your chance of developing skin cancer include:

• Skin cancer is a result of years of accumulated damage, therefore people are more likely to develop skin cancer when they are older.
• Gender: Men have an overall higher rate of skin cancer occurrence. This likely is the result of intense sun exposure from outside jobs, such as construction, and the fact that men in general are less likely to use sunscreen as regularly as women.
• Family history of skin cancer
• Smoking
• Weakened immune system
• Exposure to radiation

Assessing your risk is only step one. It is important to know that even if your overall risk of developing skin cancer is relatively low, you still need to take steps to protect your skin from long term damage. Here are ways you can do just that.

• Use a broad-spectrum sunscreen, with an SPF of at least 15, every day. While and SPF of 15 is good, an SPF of 30 is even better. Be wary of paying more for sunscreens that promise an SPF of 50 or above. Research shows that these products in general do not supply more protection than their lower SPF counterparts, and may be harmful because they promote the idea that you are safer for a longer period of time.
• Know how to apply sunscreen. If you are applying just a dollop over your body, chances are you are not giving yourself adequate coverage. For an adult sized body, you need a full ounce of sunscreen to fully protect yourself. This is the amount that would fit in a standard sized shot glass. You should apply sunscreen approximately thirty minutes before heading outdoors and at least once every two hours once you are out there. This rule goes out the window if you have been swimming or sweating heavily, which will require more frequent applications, even if the bottle says that it is waterproof.
• Cover your entire body. Apply sunscreen to absolutely every bit of exposed skin, and even skin that will be under light layers of clothing. Areas like the back of the neck, ears and soles of the feet are common places that skin cancer develops because we tend to forget about them when applying sunscreen.
• Sun damage starts early. Don’t let children run around outside without proper protection just because they are young. The damage that can eventually lead to cancer can start in these early years. You can start using sunscreen on children at around 6 months of age. Children younger than that should be shaded from and kept out of the sun as much as possible.
• Don’t use tanning beds. Research shows that people who use tanning beds are 74% more likely to develop melanoma than their abstaining counterparts. Tanning bed users are also more likely to develop other types of skin cancers, including squamous cell and basal cell carcinomas.
• Avoid spending lengthy amounts of time outdoors when sunlight is the most direct. Aim for the shade between the hours of 10 a.m. and 4 p.m.
• Remember that UV rays travel through glass, open windows and light layers of clothing. This means that you still need to be protected even if you are sitting by a window in your house, riding in a car or wearing lighter weight, long sleeve shirts and pants.
• Don’t let the chill in the air fool you. Damaging rays from the sun can be reflected off snow, rain, bodies of water and sand.
• Vitamin D is important, and the only way that our bodies can synthesize it naturally is through exposure to sunlight. You can still get your vitamin D while protecting your skin. It typically only takes about 15-20 minutes of exposure to the sun to pack in a full days’ worth of vitamin D. So, take a quick walk outside in the morning before the sun get scorching hot and then reach for your sunscreen.
• Enjoy foods that boost your skin’s natural sun protection system. Leafy greens, berries, green tea, watermelon, pomegranate, citrus fruits, grapes, tomatoes and coffee help to protect your skin from cancer.
• Don’t feel safe because of your skin color or ethnicity. True, ethnicities with darker skin are less likely to develop skin cancer. Unfortunately, they also have a higher rate of mortality if skin cancer develops. This is almost always because it was detected at a later stage. Applying sunscreen is important no matter how light or dark your skin naturally is.
• Visit your dermatologist regularly and once a month, take a few minutes to do a thorough check of your skin and existing moles. Make an appointment with your doctor immediately if you notice any changes.

A little prevention goes a long way in protecting your health. In this case, it can mean protecting yourself from the devastating effects of skin cancer. We are all at risk, but we also all have the ability to lower the rates of skin cancer occurrence, staring with ourselves. Go out and enjoy the beautiful sunshine, just do so with a little preventative care for your precious skin.

"Cancer;Compromised Immune System;Poor Lifesyle Choices;Skin Cancer " "Diet/Nutrition;Environment;Healthy Choices " "Actinic Keratosis;Moles;Skin Cancer;UV Damage " "Caffeine;Camellia Sinensis Leaf Extract;Lycopene;Zinc Oxide "