As the largest organ in our body, the skin takes quite a beating. While one of its chief jobs is to regulate temperature and fluids, the skin is also our body’s shield against the elements – particularly, the sun – and bears the marks of years of sun exposure.
But the resulting unsightly sun spots and leathery texture take a back seat to the dangers of skin cancer.
"The UV radiation in sun is a carcinogen," Dr. Natasha Mesinkovska, UC Irvine Health dermatologist, states simply. "We need to treat it as such."
As residents of the Golden State, we need to take precautions, she says.
"I can almost always tell when a patient is from this area or is a transplant, by the condition of their skin. There is just no escaping the sun here. While it's the very reason many move out here to begin with, it also brings with it higher risks."
Three predominant types of skin cancer
What distinguishes one type of skin cancer from another?
- Melanoma, a highly metastatic form of skin cancer, is on the rise in the U.S. and globally. While there are genetic predispositions to melanoma, it develops mostly from overexposure to the sun.
- Squamous cell carcinoma, which develops within the epidermis, is another form of skin cancer and is dangerous as well, though it does not metastasize as readily as melanoma.
- Basal cell carcinoma is the most superficial and most common type of skin cancer. While considered less dangerous, it does grow if left unattended, and should be surgically excised. Are all skin cancer types deadly? ›
So what's a Southern Californian to do? "There are answers," Mesinkovska says. And they don't include burrowing indoors.
"We want to enjoy the beauty of California, including surfing, swimming and playing outdoors. The key is to avoid the sun during peak hours and come into the sun with the right gear."
Here are her dos and don’ts for residents of the Golden State:
- Shield yourself. It may not be what people want to hear, but particularly if you have fair skin and fair eyes, wearing clothing that covers the skin — long sleeves, long loose pants, a brimmed hat and sunglasses that filter UVA and UVB rays — is the single best thing you can do.
- How to find the right fabric. Mesinkovska says the special fabrics made for filtering out UVA rays are best, but can be expensive. One solution is to choose garments with UPF labels. UPF, a concept originally standardized in Australia in 1996, stands for ultraviolet protection factor, which assesses factors such as fabric weave (tighter is better) to rate how effectively a piece of clothing shields against the sun.
- Consider covering up even more. Parasol, anyone? "We see an extension of the Asian custom of protecting fair skin from spotting, as many Asian American women today use parasols, visors, shields and even cotton gloves. Their complexions are lovely and the rate of melanoma in countries like China is half of what ours is," Mesinkovska notes.
- Use sunscreen. Apply and reapply a quality sunscreen frequently, particularly during the peak hours of intense sunshine.
- Look for the seal. Mesinkovska recommends sunscreens (and cosmetics) that bear the American Academy of Dermatology seal to ensure the SPF and other claims are valid. Baby formulations are often a good choice because they tend to be PABA-free and less irritating to sensitive skin. Avoid oily or scented lotions, which can also irritate the skin. If swimming or exercising, be sure to use a water-resistant type and reapply after toweling off.
- Use the right SPF. She urges Southern Californians to use an SPF of 30 or higher.
- Protect yourself whether you see the sun or not. Can’t see the sun? Contrary to many people's assumptions, overcast skies and car windows don't protect you from UVA rays. Cover your face and hands with sunscreen when you dress in the morning. Ideally, reapply to your hands after washing them.
Check yourself and your family members
- Do it regularly. "I often say 'wives save lives.' In my experience your partner is most likely to notice skin lesions. We should listen when they insist we should have spots checked out." Particularly in the sunny Southern California climate, family members should run periodic inspections on themselves and each other.
- Follow the guidelines. Use the American Academy of Dermatology guidelines to help identify dangerous spots.
See a dermatologist regularly for a top-to-toe inspection
A yearly check-up with the dermatologist is a routine that should be as commonplace as the mammogram, prostate exam or pap smear.
Don't hesitate to have a spot looked at when it:
- Doesn't heal
- Bleeds for no reason
- Has irregular borders
- Is growing
- Has multiple colors
"Changing skin spots warrant a closer look," Mesinkovska says. Some people who come in are almost apologetic.
"To them, I say, 'There is no such thing as a silly question about a changing spot.' I can't tell you how many lives are saved because people come in for a 'silly' reason."
Don’t assume a little bare-time sun is safe
Any unprotected exposure adds risk.
Don’t use tanning beds
The World Health Organization found that those whose first exposure to artificial UV rays in a tanning bed occurred before age 35 have a dramatic 59 percent greater chance of developing melanoma. Young women who use tanning beds might be at higher risk than others for developing skin cancer.
Don’t assume because you have dark skin you are immune from the dangers
"We classify skin types into six categories, from the freckled complexion of redheaded people with light eyes, to the deepest dark skin tones," Mesinkovska explains. “We see the most skin cancers in type 1 and 2, but the risk is still there across the board. Even in darker skin groups, melanomas can appear on the bottom of the foot or other places where skin pigment and sun exposure are low."
Don’t wait if you have a suspicious lesion
Time is of the essence with certain kinds of cancers, so see a dermatologist right away. If appointment scheduler gives you an appointment weeks or months away, explain that you have a suspicious lesion and you need to be on the cancellation list or squeezed in sooner.
With the right equipment, a game attitude and good habits, you can still enjoy a sizzling summer in the sunshine.