We Montanans experienced yet another long and blustery Rocky Mountain winter this year, so odds are you and your family can’t wait to get out and enjoy the sunshine which has finally rolled into town! However, there's one thing I’d encourage you to consider before heading outdoors for work or pleasure: Sun Safety.
In the United States skin cancer is the most common of all cancers. Only about 1 percent of all skin cancers are diagnosed as melanoma – but melanoma causes the largest number of skin cancer-related deaths. The American Cancer Society reports that nearly 100,000 new melanomas will be diagnosed this year and that rates have been going up steadily over the last 30 years. This is especially true of young adults – and particularly young women!
In August of 2015 I was diagnosed with melanoma. I had a small growth on my scalp and after about a month, I knew I needed to see my doctor. The biopsy was positive and initiated a long trail of events which have resulted in me being clear of any melanoma for 2½ years, even though it had spread to local areas! At the time, I had thick, dark hair and I can’t recall ever having a sunburn there.
Melanoma is a tumor composed of the cells which produce melanin – the pigment which gives our skin color. Melanin also acts, in part, as natural protection against damaging ultraviolet (UV) radiation. If skin cells are damaged by UV radiation, they begin to mutate, and these become a tumor which starts to develop at a microscopic level. By the time you notice it, the melanoma may be like a mole, especially as the majority (though not all) are brown or black. Unlike a mole, however, they are asymmetric in shape and lack a smooth, defined border.
Remember the ABCDE rule: Asymmetry (one half of the mole doesn't match the other), Border irregularity, Color that is not uniform, Diameter greater than 6 mm (about the size of a pencil eraser), and Evolving size, shape or color (meaning the mole is changing). You can also use the Ugly Duckling Rule, this refers to one mole among many that sticks out and looks different (“the ugly duck”) and should raise suspicion for melanoma.
Some people are more likely to develop melanoma than others, but all of us are at risk and we all need to limit our exposure to UV rays. The first step is to say “no” to tanning beds, which have been strongly linked to an increased risk for melanoma and extensive skin damage. The American Cancer Society notes this is especially true for those who begin using a tanning bed before the age of 30. There is no such thing as a “safe” tanning bed!
The second step is to avoid being in the sun between the hours of 10 am and 2 pm, when the sun is at its most intense. If at all possible, work or play indoors, or seek shade during these peak hours. It’s important to note that our high altitude here in the Rocky Mountains means the UV rays don’t get filtered out as much as they do at lower elevations – so our risk is even higher! It’s the same reason it takes less time in the sun to burn here than it does at sea level.
If your work requires you to be in the sun, wear clothing that keeps your skin covered as much as possible. If you’re able to, wear clothing with a designed SPF factor. Wear a hat that provides protection for your face and neck—not just a baseball cap. Look for and wear wrap-around sunglasses so that you can protect the sensitive skin around your eyes, as well as your eyes themselves.
Whenever you plan to be outside at all, use a quality sunscreen designed to protect your skin against UV rays and reapply it often, especially if you are in the water or are sweating. Parents and caregivers need to be particularly vigilant when it comes to children. In addition to taking the same steps I’ve outlined above, talk to kids from the time they’re young about why too much sun isn’t a good thing.
The good news is that even if you did get too much sun when you were younger, there is a high cure rate when melanomas are caught early. Talk to your healthcare provider about how to check your own skin and about the importance of regular skin checks by your doctor or other medical provider.
Here are some web sites where you can seek more information:
We live in Montana because we like the outdoors – and that’s really healthy. But not being Sun Safe is dangerous and just plain foolish. Be wise and have fun!
-Dennis Salisbury, MD, FAAFP
SCL Health Medical Group - Butte