The most important cause of all forms of
skin cancer is from UV Radiation from the sun. There are three
bandwidths of UV Radiation: UVA, UVB and UVC. The Ozone Layer
blocks out UVC and part of the UVB band. UVB is the bandwidth is the
primary cause of sunburn. However, both UVA and UVB cause skin aging
(dry, leathery skin) and skin cancer. Sun exposure for as little as 15
minutes can cause a sunburn. Other risks include photokeratitis,
cataracts, and immune system suppression.
Avoid the sun between the hours
of 10 am to 2 pm. An hour of exposure at 9 am equals 15 minutes of exposure
at 1:00 pm. Water, sand, snow can reflect the sun and amplify, even double, the UV exposure.
The three most common skin cancers are basal cell carcinoma, squamous cell
carcinoma and melanoma. The vast majority of basal cell carcinomas and
squamous cell carcinomas are related to sun exposure. A significant
number of melanomas are also caused by the sun.
See Slide Show of Using a Bilobed Skin Flap to Reconstruct the Nose from
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Staging of Skin Cancer:
Anyone can get skin cancer, even minorities. Each year
there are over two million cases of skin cancer with over 123,000 cases of
melanoma. Squamous Cell Carcinoma and Basal Cell Carcinoma are staged
the same way. The stages are related to the size of the tumor and
spread to adjacent structures. Melanomas are staged differently, these
tumors are staged by the thickness of the tumor.
Melanoma: This is viewed as a serious and often deadly from of
skin cancer. The treatment of these tumors is often with surgery.
Radiation therapy is often ineffective. New research and treatment
protocols using immunotherapy appear to hold great promise.
Sentinel lymphnode biopsy has a high false negative rate, when positive it
is highly predictive of recurrence.
sunscreens just protect against UVB and sunburn. These
products will not protect against UVA and skin cancer. Broad
Spectrum products that protect against UVA and UVB should be used.
SPF (Sun Protection Factor) is a relative scale. It does not
relate to hours of allowed exposure. The SPF, prior to the summer
of 2012, only applies to UVB or the sunburn band. After the
summer of 2012, a broadband SPF may be specified on products which will
apply to both UVA and UVB.
Products with an SPF less than 15 will help to reduce sunburn.
Products with an SPF of 15 or higher can reduce the risk of skin cancer
and early aging of the skin. SPF of 50 or greater will be
labeled after 2012 as "50+" since there is little evidence of any
difference between these products.
Sunscreen should be applied
30 minutes before exposure then every two hours.
Sunscreens are not waterproof but may be water resistant. These
products will have to be applied more frequently as specified by the
brim hats and sunglasses are a must. A tee shirt provides an SPF
protection of approximately 15. A wet tee shirt reduces
protection. A dark tee shirt offers more protection. Fabrics
which are thicker and more densely woven will offer more protection
against the sun. Sunglasses should offer UV
protection. A UV coating is also available for regular glasses.
One of the beneficial
effects of the sun is the production of Vitamin D. Use of
sunscreens and avoidance of the sun, helps prevent skin cancer and
premature skin aging. However, this may also cause Vitamin D
deficiency. Thus, one should always take a Vitamin D supplement.
This is very important during the winter months.
Vitamin D deficiency in
children can cause rickets, a bone disease in children. In adults,
deficiency can cause osteoporosis and brittle bone. There is also
some evidence that Vitamin D deficiency can cause heart disease. High
levels of Vitamin D can help prevent cancer and lower the risk of
Too much Vitamin D is toxic
and can be even life threatening due to increase in blood calcium
Sun Beds and Tanning
Sun beds are not any safer
than the sun. 39% of teenagers believe they are safer but they are
wrong. Pills are also used to darken the skin, however, they
are not FDA approved and some may be dangerous. A spray on tan may
be the safest, but one needs to be careful not to get the chemical into
the eyes, mouth and nose, and not to inhale the spray.
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