By being outside, for work or play, you are subjecting yourself to the sun’s rays, and that can lead to skin cancer. But if you knew there was something you could do to decrease your chances of getting this type of cancer — much like you would wear a harness when working at heights or a respirator when working with certain equipment or materials — would you do it?

What to Look For
The big picture of how we develop cancer is this: there is something that causes a change in our DNA, or the building blocks of our cells. Our body fixes a lot of this damage on its own, but when it can’t repair the damage caused to our DNA, a cancer cell is formed. Skin cancer is no exception.

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. They are all most commonly caused by cumulative ultraviolet (UV) radiation from sun exposure.

Basal cell carcinoma is the most common type of skin cancer that you can get. It can present as a dry patch of skin that does not go away or a pearly, pink bump that appears all of a sudden and also does not go away. Patients often state, “I thought it was a pimple, but it’s been there for several months or longer.”

Squamous cell carcinoma is the second most common type of skin cancer. Squamous cell carcinoma can present as a dry patch of skin that won’t go away or a red, rough bump that also doesn’t go away.

Melanoma is the third most common type of skin cancer and is on the rise, especially in the younger population. It also accounts for 75 percent of skin cancer deaths. For melanoma, there are guidelines to follow to help you decided if you should have your dermatologist take a look at a spot sooner than your usual skin check. They are called the “ABCDs”: 

Asymmetry. Does one side of your mole look like the other?
Border. Is the border uniform and smooth or jagged and blending into the surrounding skin?
Color. Is there more than one color brown?  Are there any blacks, reds, or purples?
Diameter. Is it greater than a pencil eraser head?
Evolution. Are any of your moles new or changing? 

Keep in mind these are just guidelines. If you do notice any of your spots presenting with one or more of the above symptoms, you should have a professional take a look at them. If any spot is bleeding just from washing or from no trauma at all, have your dermatologist evaluate it as this can be a sign of any of the three skin cancers discussed above.   

What You Can Do to Prevent
Skin cancer is one of those cancers that you can still have an impact on. The biggest contributor to getting skin cancer is UV radiation. There are three main types of UV radiation: UVA, UVB, and UVC. UVC gets filtered out by the Earth’s ozone layer (when it’s there). UVA and UVB are where we get most of our damage from. There are several ways you can decrease your UVA and UVB exposure: 

• Wear a daily sunblock of SPF 30 or greater and reapply every 2 hours. If you are going to be outside longer than that, wear sun protective clothing and a wide-brimmed hat and stay in the shade when you can. 

• Avoid sun exposure during the times of day when the sun is the strongest. This is usually between 10 a.m. and 2 p.m., but it depends on where you live.

• Check your skin on a monthly basis for changes in your current or new spots. Although it is most common to have skin cancer develop in sun-exposed areas, they can develop anywhere on your skin. Because of this, you should be looking over all of your skin on a monthly basis to keep track of both areas that are and are not exposed to the sun.

• Get a yearly skin check from a board-certified dermatologist. You can find a dermatologist in your area by going to www.AOCD.org or www.AAD.org 

Understanding some common misconceptions may also help you avoid getting skin cancer:

• There is a “good” kind of tan. The truth: A tan occurs mostly from UVB radiation and is your body’s way of protecting itself from further DNA damage. Although this can be slightly protective (equivalent to about an SPF of 3–10), it is at the cost of damage to your DNA. 

• Going to a tanning bed prior to going on vacation will help prevent you from getting sun burned on vacation. This couldn’t be farther from the truth. Most tanning beds use UVA radiation and do absolutely nothing to protect your skin from further damage. It is a concentrated dose of UV radiation that drastically increases your chance of developing skin cancer in the future.

• As long as you don’t get sunburned, you are ok. As stated above, even when your skin gets tan, it is a sign of DNA damage.

• Skin cancer is always raised. The truth: Most skin cancers start out flat and don’t become raised until they start growing deeper. Don’t let a spot that is flat but changing deter you from getting it checked by your dermatologist.

Sunblock and Other Suggestions 
Always check the active ingredients on the sunblock you are choosing. Stick with zinc oxide and titanium dioxide. These are true sunblocks and reflect the sun’s UV rays. Other active ingredients are chemical sunscreens and interact with your skin to protect you. You are more likely to be sensitive to sunscreens vs. sunblocks, and they can also sting your eyes, especially if you sweat.

You also want to make sure you are using an SPF of 30 or greater. Don’t forget to reapply every 2 hours regardless of the SPF number you are using or it’s as if you have never put it on!

About the Author
Dr. Vienna Gibson is a Board Certified Dermatologist, specializing in medical, surgical, and cosmetic dermatology. She is currently practicing and is the proprietor of Seaside Dermatology in Murrells Inlet, S.C. She completed her residency training through Michigan State University at Genesys Regional Medical Center where she served as chief resident. Dr. Gibson attended medical school at A.T. Still University in Kirksville, Mo., the country’s founding school for osteopathic medicine. She obtained a Bachelor of Science in Biology at Loyola University in Baltimore, Md. Dr. Gibson specializes in treating skin cancers and has performed over 500 successful Mohs surgeries, a unique procedure used to treat skin cancer. For more information, contact: Dr. Gibson, www.seaside-dermatology.com