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Skin Deep

As the snow melts and the freezing temperatures begin to abate, I cannot help but look forward to temperate days and the ability to warm my chilblained body in the sun. Ah, I can see myself now: wearing only a bathing suit, sitting in a comfortable beach chair, with a cool beverage in one hand and a good book in the other, wriggling my toes in the warm sand while the bright yellow sun beams down on my bare skin. At least that’s what I would do in the “good old days,” when “getting a little color” wasn’t considered a bad thing. 

Oh, how times have changed! We have since learned that the sun is the enemy of our skin and one of the leading causes of skin cancer (tanning beds are the other).1 These days, we get daily warnings about the ill effects of too much sun exposure and cautions about avoiding those harmful UV rays. Even exposure years ago can increase our risk for skin cancer now or in future.

Current estimates are that one in five Americans will develop skin cancer in his/her  lifetime.2 The incidence of nonmelanoma (basal and squamous cell) skin cancer in the United States has been reported at 3.5 million new cases annually; for melanoma, nearly 77,000 new cases were expected to be diagnosed in 2013 alone.3 More than 9,000 people die of melanoma annually.3

While these statistics are disturbing, the cure rate offers some reassurance. If melanoma is detected and treated early, before it has the chance to spread to the lymph nodes, the cure rate can be as high as 100%. The five-year survival rate for localized melanoma is 98%.3 And while not all melanoma is preventable, we can take an active role in reducing our risk—and educating our patients on how to protect themselves.

Continued on next page >>

 

 

The American Academy of Dermatology (AAD) has designated May as National Melanoma Skin Cancer Prevention Month. As we progress from spring to summer, the position of the sun rises in the sky, the days become longer, and our vulnerability to skin cancer increases. Our colleagues at AAD have impeccable timing; we are a captive audience and eager to greet the summer and sunshine—responsibly. Here is what the AAD “strongly recommends” to accomplish this goal:  

Seek shade when appropriate. This is especially important between 10 am and 2 pm, when the sun’s rays are strongest. The AAD’s tip: If your shadow appears to be shorter than you are, seek shade.

Wear protective clothing. It may not meet your fashion standards, but wearing a long-sleeved shirt and pants, as well as a wide-brimmed hat and sunglasses, offers better protection.

Generously apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or more to all exposed skin. (Broad-spectrum sunscreens provide protection from both UVA and UVB rays.) Sunscreen should be reapplied every two hours or so, even on cloudy days, and after you’ve gone swimming or gotten sweaty.

Use extra caution near water, snow, and sand. These reflect and intensify the sun’s damaging rays and can increase your risk for sunburn.

Avoid tanning beds. UV light from tanning beds (as well as the sun) can cause skin cancer and wrinkling. Resent being pale? Consider using a self-tanning product or spray—but continue to use sunscreen with it!4

Continued on next page >>

 

 

The American Cancer Society has a skin protection campaign with a catchy slogan (adapted from an Australian campaign that launched in the 1980s) that may appeal to the younger (and most vulnerable) population: Slip, Slop, Slap® and Wrap. It stands for: Slip on a shirt. Slop on sunscreen. Slap on a hat. Wrap on sunglasses (to protect the eyes and sensitive skin around them).5

If our own (or our patients’) history of sun exposure has increased our risk for melanoma, remember that early detection is vital. Learn the signs and symptoms of melanoma; teach them to your family, friends, and patients. 

Know that any mole can be suspicious and should be evaluated. The following mnemonic (ABCDE) provides clues to potential malignancy:

Asymmetry: Is the mole asymmetrical? 

Border: Does the border or edge of the mole look uneven? 

Color: Is the mole one uniform color? Several colors or shades of color within a mole could be a warning sign. 

Diameter: How big is the mole? Melanomas often have a diameter of 6 mm (0.25 in) or more.

Evolving: Has the mole changed in shape, size, or color? Are there any other changes (eg, bleeding, itching, or pus)? 

Many—but not all—melanomas present with the signs and symptoms listed above. But as our resident derm guru Joe Monroe regularly points out, there are different types of melanoma. The key is to know your skin and your moles. The AAD suggests that your birthday is a great day to “check your birthday suit.”6 While this is good advice (and perhaps easier to remember), I suggest you check your skin more often—and if you notice something, however insignificant it may seem, get it checked out by a professional. (And don’t assume that skin color or type offers immunity from skin cancer.)

I never gave much thought to sun exposure when I was younger—despite the many painful sunburns I endured. Today, my skin bears the scars of my early ignorance. Now I wear a hat (ugh) and slather on sunscreen. And that bathing suit? Now it is covered as much and as often as feasible. As for the sun, well, it now beats down on the umbrella that provides shade for that comfortable beach chair. My dermatology NP would be so proud!

So I challenge you to observe Melanoma Month and save your (and your patients’) skin—and potentially, your lives.

References on next page >>

 

 

REFERENCES

1. American Academy of Dermatology. Skin cancer: who gets and causes. www.aad.org/dermatology-a-to-z/diseases-and-treatments/ q---t/skin-cancer/who-gets-causes. Accessed April 15, 2014.

2. American Academy of Dermatology. Skin cancer. www.aad.org/media-resources/stats-and-facts/conditions/skin-cancer. Accessed April 15, 2014.

3. American Cancer Society. Cancer Facts and Figures 2013. www.cancer.org/acs/groups/content/@epidemiologysurveilance/docu ments/document/acspc-036845.pdf. Accessed April 15, 2014.

4. American Academy of Dermatology. How do I prevent skin cancer? www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-prevent-skin-cancer. Accessed April 15, 2014.

5. American Cancer Society. Skin cancer prevention activities. www.cancer.org/healthy/more waysacshelpsyoustaywell/acs-skin-cancer-prevention-activities. Accessed April 15, 2014.

6. American Academy of Dermatology. Skin cancer prevention tips. www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-prevent-skin-cancer/skin-cancer-preven tion-tips. Accessed April 15, 2014.

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Marie-Eileen Onieal PhD, CPNP, FAANP

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As the snow melts and the freezing temperatures begin to abate, I cannot help but look forward to temperate days and the ability to warm my chilblained body in the sun. Ah, I can see myself now: wearing only a bathing suit, sitting in a comfortable beach chair, with a cool beverage in one hand and a good book in the other, wriggling my toes in the warm sand while the bright yellow sun beams down on my bare skin. At least that’s what I would do in the “good old days,” when “getting a little color” wasn’t considered a bad thing. 

Oh, how times have changed! We have since learned that the sun is the enemy of our skin and one of the leading causes of skin cancer (tanning beds are the other).1 These days, we get daily warnings about the ill effects of too much sun exposure and cautions about avoiding those harmful UV rays. Even exposure years ago can increase our risk for skin cancer now or in future.

Current estimates are that one in five Americans will develop skin cancer in his/her  lifetime.2 The incidence of nonmelanoma (basal and squamous cell) skin cancer in the United States has been reported at 3.5 million new cases annually; for melanoma, nearly 77,000 new cases were expected to be diagnosed in 2013 alone.3 More than 9,000 people die of melanoma annually.3

While these statistics are disturbing, the cure rate offers some reassurance. If melanoma is detected and treated early, before it has the chance to spread to the lymph nodes, the cure rate can be as high as 100%. The five-year survival rate for localized melanoma is 98%.3 And while not all melanoma is preventable, we can take an active role in reducing our risk—and educating our patients on how to protect themselves.

Continued on next page >>

 

 

The American Academy of Dermatology (AAD) has designated May as National Melanoma Skin Cancer Prevention Month. As we progress from spring to summer, the position of the sun rises in the sky, the days become longer, and our vulnerability to skin cancer increases. Our colleagues at AAD have impeccable timing; we are a captive audience and eager to greet the summer and sunshine—responsibly. Here is what the AAD “strongly recommends” to accomplish this goal:  

Seek shade when appropriate. This is especially important between 10 am and 2 pm, when the sun’s rays are strongest. The AAD’s tip: If your shadow appears to be shorter than you are, seek shade.

Wear protective clothing. It may not meet your fashion standards, but wearing a long-sleeved shirt and pants, as well as a wide-brimmed hat and sunglasses, offers better protection.

Generously apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or more to all exposed skin. (Broad-spectrum sunscreens provide protection from both UVA and UVB rays.) Sunscreen should be reapplied every two hours or so, even on cloudy days, and after you’ve gone swimming or gotten sweaty.

Use extra caution near water, snow, and sand. These reflect and intensify the sun’s damaging rays and can increase your risk for sunburn.

Avoid tanning beds. UV light from tanning beds (as well as the sun) can cause skin cancer and wrinkling. Resent being pale? Consider using a self-tanning product or spray—but continue to use sunscreen with it!4

Continued on next page >>

 

 

The American Cancer Society has a skin protection campaign with a catchy slogan (adapted from an Australian campaign that launched in the 1980s) that may appeal to the younger (and most vulnerable) population: Slip, Slop, Slap® and Wrap. It stands for: Slip on a shirt. Slop on sunscreen. Slap on a hat. Wrap on sunglasses (to protect the eyes and sensitive skin around them).5

If our own (or our patients’) history of sun exposure has increased our risk for melanoma, remember that early detection is vital. Learn the signs and symptoms of melanoma; teach them to your family, friends, and patients. 

Know that any mole can be suspicious and should be evaluated. The following mnemonic (ABCDE) provides clues to potential malignancy:

Asymmetry: Is the mole asymmetrical? 

Border: Does the border or edge of the mole look uneven? 

Color: Is the mole one uniform color? Several colors or shades of color within a mole could be a warning sign. 

Diameter: How big is the mole? Melanomas often have a diameter of 6 mm (0.25 in) or more.

Evolving: Has the mole changed in shape, size, or color? Are there any other changes (eg, bleeding, itching, or pus)? 

Many—but not all—melanomas present with the signs and symptoms listed above. But as our resident derm guru Joe Monroe regularly points out, there are different types of melanoma. The key is to know your skin and your moles. The AAD suggests that your birthday is a great day to “check your birthday suit.”6 While this is good advice (and perhaps easier to remember), I suggest you check your skin more often—and if you notice something, however insignificant it may seem, get it checked out by a professional. (And don’t assume that skin color or type offers immunity from skin cancer.)

I never gave much thought to sun exposure when I was younger—despite the many painful sunburns I endured. Today, my skin bears the scars of my early ignorance. Now I wear a hat (ugh) and slather on sunscreen. And that bathing suit? Now it is covered as much and as often as feasible. As for the sun, well, it now beats down on the umbrella that provides shade for that comfortable beach chair. My dermatology NP would be so proud!

So I challenge you to observe Melanoma Month and save your (and your patients’) skin—and potentially, your lives.

References on next page >>

 

 

REFERENCES

1. American Academy of Dermatology. Skin cancer: who gets and causes. www.aad.org/dermatology-a-to-z/diseases-and-treatments/ q---t/skin-cancer/who-gets-causes. Accessed April 15, 2014.

2. American Academy of Dermatology. Skin cancer. www.aad.org/media-resources/stats-and-facts/conditions/skin-cancer. Accessed April 15, 2014.

3. American Cancer Society. Cancer Facts and Figures 2013. www.cancer.org/acs/groups/content/@epidemiologysurveilance/docu ments/document/acspc-036845.pdf. Accessed April 15, 2014.

4. American Academy of Dermatology. How do I prevent skin cancer? www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-prevent-skin-cancer. Accessed April 15, 2014.

5. American Cancer Society. Skin cancer prevention activities. www.cancer.org/healthy/more waysacshelpsyoustaywell/acs-skin-cancer-prevention-activities. Accessed April 15, 2014.

6. American Academy of Dermatology. Skin cancer prevention tips. www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-prevent-skin-cancer/skin-cancer-preven tion-tips. Accessed April 15, 2014.

As the snow melts and the freezing temperatures begin to abate, I cannot help but look forward to temperate days and the ability to warm my chilblained body in the sun. Ah, I can see myself now: wearing only a bathing suit, sitting in a comfortable beach chair, with a cool beverage in one hand and a good book in the other, wriggling my toes in the warm sand while the bright yellow sun beams down on my bare skin. At least that’s what I would do in the “good old days,” when “getting a little color” wasn’t considered a bad thing. 

Oh, how times have changed! We have since learned that the sun is the enemy of our skin and one of the leading causes of skin cancer (tanning beds are the other).1 These days, we get daily warnings about the ill effects of too much sun exposure and cautions about avoiding those harmful UV rays. Even exposure years ago can increase our risk for skin cancer now or in future.

Current estimates are that one in five Americans will develop skin cancer in his/her  lifetime.2 The incidence of nonmelanoma (basal and squamous cell) skin cancer in the United States has been reported at 3.5 million new cases annually; for melanoma, nearly 77,000 new cases were expected to be diagnosed in 2013 alone.3 More than 9,000 people die of melanoma annually.3

While these statistics are disturbing, the cure rate offers some reassurance. If melanoma is detected and treated early, before it has the chance to spread to the lymph nodes, the cure rate can be as high as 100%. The five-year survival rate for localized melanoma is 98%.3 And while not all melanoma is preventable, we can take an active role in reducing our risk—and educating our patients on how to protect themselves.

Continued on next page >>

 

 

The American Academy of Dermatology (AAD) has designated May as National Melanoma Skin Cancer Prevention Month. As we progress from spring to summer, the position of the sun rises in the sky, the days become longer, and our vulnerability to skin cancer increases. Our colleagues at AAD have impeccable timing; we are a captive audience and eager to greet the summer and sunshine—responsibly. Here is what the AAD “strongly recommends” to accomplish this goal:  

Seek shade when appropriate. This is especially important between 10 am and 2 pm, when the sun’s rays are strongest. The AAD’s tip: If your shadow appears to be shorter than you are, seek shade.

Wear protective clothing. It may not meet your fashion standards, but wearing a long-sleeved shirt and pants, as well as a wide-brimmed hat and sunglasses, offers better protection.

Generously apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or more to all exposed skin. (Broad-spectrum sunscreens provide protection from both UVA and UVB rays.) Sunscreen should be reapplied every two hours or so, even on cloudy days, and after you’ve gone swimming or gotten sweaty.

Use extra caution near water, snow, and sand. These reflect and intensify the sun’s damaging rays and can increase your risk for sunburn.

Avoid tanning beds. UV light from tanning beds (as well as the sun) can cause skin cancer and wrinkling. Resent being pale? Consider using a self-tanning product or spray—but continue to use sunscreen with it!4

Continued on next page >>

 

 

The American Cancer Society has a skin protection campaign with a catchy slogan (adapted from an Australian campaign that launched in the 1980s) that may appeal to the younger (and most vulnerable) population: Slip, Slop, Slap® and Wrap. It stands for: Slip on a shirt. Slop on sunscreen. Slap on a hat. Wrap on sunglasses (to protect the eyes and sensitive skin around them).5

If our own (or our patients’) history of sun exposure has increased our risk for melanoma, remember that early detection is vital. Learn the signs and symptoms of melanoma; teach them to your family, friends, and patients. 

Know that any mole can be suspicious and should be evaluated. The following mnemonic (ABCDE) provides clues to potential malignancy:

Asymmetry: Is the mole asymmetrical? 

Border: Does the border or edge of the mole look uneven? 

Color: Is the mole one uniform color? Several colors or shades of color within a mole could be a warning sign. 

Diameter: How big is the mole? Melanomas often have a diameter of 6 mm (0.25 in) or more.

Evolving: Has the mole changed in shape, size, or color? Are there any other changes (eg, bleeding, itching, or pus)? 

Many—but not all—melanomas present with the signs and symptoms listed above. But as our resident derm guru Joe Monroe regularly points out, there are different types of melanoma. The key is to know your skin and your moles. The AAD suggests that your birthday is a great day to “check your birthday suit.”6 While this is good advice (and perhaps easier to remember), I suggest you check your skin more often—and if you notice something, however insignificant it may seem, get it checked out by a professional. (And don’t assume that skin color or type offers immunity from skin cancer.)

I never gave much thought to sun exposure when I was younger—despite the many painful sunburns I endured. Today, my skin bears the scars of my early ignorance. Now I wear a hat (ugh) and slather on sunscreen. And that bathing suit? Now it is covered as much and as often as feasible. As for the sun, well, it now beats down on the umbrella that provides shade for that comfortable beach chair. My dermatology NP would be so proud!

So I challenge you to observe Melanoma Month and save your (and your patients’) skin—and potentially, your lives.

References on next page >>

 

 

REFERENCES

1. American Academy of Dermatology. Skin cancer: who gets and causes. www.aad.org/dermatology-a-to-z/diseases-and-treatments/ q---t/skin-cancer/who-gets-causes. Accessed April 15, 2014.

2. American Academy of Dermatology. Skin cancer. www.aad.org/media-resources/stats-and-facts/conditions/skin-cancer. Accessed April 15, 2014.

3. American Cancer Society. Cancer Facts and Figures 2013. www.cancer.org/acs/groups/content/@epidemiologysurveilance/docu ments/document/acspc-036845.pdf. Accessed April 15, 2014.

4. American Academy of Dermatology. How do I prevent skin cancer? www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-prevent-skin-cancer. Accessed April 15, 2014.

5. American Cancer Society. Skin cancer prevention activities. www.cancer.org/healthy/more waysacshelpsyoustaywell/acs-skin-cancer-prevention-activities. Accessed April 15, 2014.

6. American Academy of Dermatology. Skin cancer prevention tips. www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-prevent-skin-cancer/skin-cancer-preven tion-tips. Accessed April 15, 2014.

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