I mentioned some personal hypocrisy on the air last Saturday evening. The hypocrisy pertains to not adequately following my own advice about following good sun protection steps consistently enough over the years. Since I was talking about the high UV index I was forecasting for the next day – an easy call – it was a good time to bring it up ... a very good time.
In fact, I had just scheduled a hurry-up appointment with a board certified dermatologist in Orchard Park recommended to me by my primary care physician. My concern was the sudden appearance of a mostly round, flat mole with some uneven coloring on my left forearm. I did some online research with reputable dermatological websites online, and realized this rapid appearance meant it had at least a small chance of being an early melanoma. Were it not for its rapid development, it didn’t look particularly ominous to me. But I was overdue for a skin checkup, to be sure.
Skin cancer is the most common cancer. Most skin cancers are readily treatable. However, many of you already know melanoma is the most dangerous of skin cancers and must be caught as early as possible for a favorable prognosis. Melanoma can present itself in many different forms. Here are a few of the more common appearances, from the Mayo Clinic.
Increased exposure to ultraviolet radiation is the main reason for rising rates of virtually all skin cancers, including potentially deadly melanoma. There are the UVA rays, the longer and weaker rays which are associated with tanning, and UVB, the shorter rays associated more with burning. It was once thought most damage from UVA was to the deeper layers of our skin, but it is now known to cause damage to the epidermis in terms of aging, wrinkling and possible basal and squamous cell cancers. Tanning salons expose customers to mainly UVA rays. However, epidemiological studies show indoor tanning presents a significant increased risk of skin cancer and damage. That exposure added to normal exposure to UV from the sun certainly ups the ante to your skin cancer chances.
In no way is indoor tanning safer than outdoor exposure to the sun, and anyone who tells you it is safer is either misleading you or misinformed.
Interestingly, automobile glass does not provide as much protection from UV as many of us think. Windshields are fine; they give us the equivalent of SPF/Sun Protection Factor 50. But most side windows offer much less protection, equivalent to around SPF 15 or 16. Given the amount of time most of us spend driving, SPF 15 may sound just fine, but it isn’t. Dermatologists have long noted more prevalent skin damage and more frequent lesions on the left side of the face and the left forearm among frequent drivers. This image from the New England Journal of Medicine helps to tell the story.
Let’s face it: vanity is at the root of most tanning and burning. My own vanity is most definitely included here. Tan skin looks healthy and enhances many people’s appearance. The latter may be true, but ask just about any doctor and they’ll tell you “there’s no such thing as a healthy tan.” Tanning causes damage as well, and as noted in the CDC link above, does not help prevent additional damage from further UV exposure.
However much some among us rail against organized medicine and big pharma, my visit to the dermatologist reminded me most practicing physicians are trying to bring us as much preventive medicine and medical guidance as possible. Because some UV can even penetrate on overcast days, the position of my doctor and the American Academy of Dermatology is to avoid exposure as much as possible and to wear sun protection lotion every day. That’s not exactly a way to drum up more business, nor is all the good advice we get from our primary care MDs and dentists, the latter on flossing and proper brushing.
As for good sun lotions, there are many to choose from. I’ll give you a free cost-saving tip, courtesy of Consumer Reports. In the July issue, the magazine noted after careful testing quite a few products failed to live up to their SPF number (a minimum of 30 is recommended), some by a considerable margin. It happens the #1 tested product out of around 50 cost $7.20 per ounce. The #2 product is Equate Sport Lotion, SPF 50. Yes, it’s sold at Walmart or you can order it from Amazon. It costs 63 cents per ounce. Guess who picked some up coming home from the dermatologist. It offers the highest level of protection from UVA and UVB, and adherence to its listed SPF value, essentially tied with the $7.20/oz stuff. That was an easy call for this cheapskate. Your doctor or pharmacist can assist with advice as well. Whichever one you choose, reapplication after being in the water is always recommended, regardless of labeling claims.
As for me, there is no melanoma. Self-diagnosis can be risky business, but this time it got me in for an overdue skin exam. I had a few precancerous lesions on the left side of my forehead frozen, which was truly a snap. And I’ve got a rejuvenated respect for following the advice I’ve been doling out so freely. I suppose this is one step shy of “physician, heal thyself!” How about “practice what you preach?”