May is Skin Cancer Awareness Month, and we've been sharing information all month about skin cancer and sun safety. Many local dermatologists participated in our free skin cancer screening in April, including Dr. Chris Schach and Dr. Eric Stewart of Ozark Dermatology Clinic. We thought you might want to know the answers to a few questions we recently asked their staff - which also includes Dr. Kevin St. Clair, Dr. Robert Brown, and Physician's Assistants Robert Stevens and Joshua Matthews. Feel free to post your own questions in the comments section at the end of the post.
Question: How have your cases changed over the last 10 years with respect to the skin cancer you are seeing?
Answer: Overall, the rate of nonmelanoma skin cancer (primary basal cell and squamous cell carcinomas) has remained about the same. As the baby boomer generation continues to age, however, we are seeing an increased number of nonmelanoma skin cancer in that population. The main concerning change that we have seen is the increased rate of melanoma in younger and younger women. It is not unusual to see malignant melanoma now in women in their late 20s or early 30s. Hopefully, increased awareness of measures to take to prevent sunburn and minimize sun exposure will pay off over time with decreasing rates of all types of skin cancer.
Question: There has been a lot in the news about the danger of tanning beds. Is any indoor tanning safe? What about outdoor tanning - is any level of sun exposure okay?
Answer: There are many efforts underway at the state level to regulate tanning bed use and to prevent minors from using or abusing tanning beds. If the skin darkens in response to exposure to ultraviolet radiation, whether the source is sunlight or a tanning bed, this does result in damage to the skin. This not only increases skin cancer risk, but also the risk of premature aging of the skin. Despite advertising to the contrary by the tanning bed industry, there is no such thing as a "safe tan." There are only degrees of injury. The only tanning that would be considered safe is the spray-on variety where no ultraviolet radiation is used at all. Of course, it is not necessary to avoid sunlight - only avoid sunburn and minimize your overall exposure.
Question: What should we look for in a sunscreen?
Answer: As of June 2012*, the FDA is changing labeling requirements for sunscreen. The new guidelines will include a comment addressing whether or not the sunscreen is "broad spectrum". If the sunscreen product is broad spectrum, this will imply that it provides UVA protection in addition to UVB protection. The Sun Protection Factor, or SPF, which has been used to label sunscreens for many years, implies only the degree of protection against UVB radiation. If a product is considered broad spectrum, a 4-star labeling system will be employed to give consumers some idea of the degree of UVA protection the product provides, with 1 being relatively less protection, and 4 being the maximum.
Another new requirement will be labeling to indicate whether the product is water resistant for 40 minutes or water resistant for up to 80 minutes. Claims of being "waterproof" will no longer be allowed. In my opinion, the best overall sunscreens are titanium dioxide and zinc oxide, which are now available in small enough particles that the sunscreen can be rubbed in without leaving a white film.
*the new label requirements have been delayed by six months.
Question: If the sun is not out, do I need to wear sunscreen?
Answer: Yes, because even though it does not feel as warm and it is not as bright if it is a cloudy day, a significant proportion of ultraviolet radiation will penetrate through clouds and can still cause sunburn. In addition, quite a bit of ultraviolet radiation, especially UVA, can be reflected and scattered, and this is why many people have noticed that one can sunburn even standing under a tree or in a shaded area.
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