Skin & Sun
Skin Cancer Facts & Figures
- According to the American Cancer Society, there will be more than 1 million new cases of skin cancer diagnosed in the United States this year.1
- It is currently estimated that 1 in 5 Americans will develop skin cancer during their lifetime.2
- According to the World Health Organization, over 65,000 people will die from too much exposure to the sun, primarily from malignant skin cancer.5
- The two most common forms of skin cancer are basal cell carcinoma and squamous cell carcinoma. If detected early, they are the most easily treated.1
- $1.5 billion was spent on treatment of non-melanoma skin cancer in 2004.6
- Melanoma causes more than 75 percent of deaths from skin cancer.1
- For 2008, projections estimate 116,500 new cases of melanoma.1
- Every 62 minutes, one American dies of melanoma (one person almost every hour). 8,420 people are expected to die from melanoma in 2008 – 5,400 men and 3,020 women.1
- 1 out of every 58 individuals will be diagnosed with melanoma. Men over the age of 50 and Caucasians are higher risk candidates than the general population.4
- In young adults between 25 and 29 years old, melanoma is the most common form of cancer. For adolescents and young adults between 15 and 29 years old, melanoma is the second most common form of cancer.
- The occurrence of melanoma in females between 15 and 29 years old is increasing over that of males in the same age group. The most common location of melanoma in this group of females is the torso and may be attributed to high risk tanning behaviors.3
- The five year survival rate for men and women ages 10-39 years old with melanoma exceeds 90 percent.3
- When detected and treated before it spreads to the lymph nodes, the five year survival rate for individuals with melanoma is 99 percent.1
American Cancer Society. (2008). Cancer Facts and Figures 2008.
Atlanta: American Cancer Society: 2008. (http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf).
Robinson MD, JK. (2005). Sun Exposure, Sun Protection, and Vitamin D.
JAMA 2005; 294: 1541-43. (http://jama.ama-assn.org).
Bleyer A, O’Leary M, Barr R, Ries LAG (eds). (2007). Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age, Including SEER Incidence and Survival:
1975-2000. Chapter 5: Malignant Melanoma. (pp. 53-57). National Cancer Institute, NIH Pub. No. 06-5767. Bethesda, MD 2006. (http://seer.cancer.gov/publications/aya).
SEER Stat Fact Sheets.(2007). Melanoma of the Skin.
National Cancer Institute. Bethesda, MD 2006. (http://seer.cancer.gov/statfacts/html/melan.html).
Lucas R, McMichael T, Smith W, Armstrong B, World Health Organization. (2006). Solar ultraviolet radiation: Global burden of disease from solar ultraviolet radiation.
World Health Organization Environmental Burden of Disease Series. (Vol. 13) (http://www.who.int/uv/publications/solaradgbd/en/index.html).
Bickers DR, Lim HW, Margolis D et al. (2004). The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology.
The Society for Investigative Dermatology. (http://www.sidnet.org/pdfs/Burden%20of%20Skin%20Diseases%202004.pdf).
Berg MD, A. AAFP. (2002, April). Screening for Skin Cancer: Recommendations and Rationale.
US Preventive Services Task Force 2002. (http://www.aafp.org/afp/20020415/usx.pdf).
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Skin Cancer Prevention
How to protect your family and self from UV
These tips, taken from the American Cancer Society’s brochure How Do I Protect Myself from UV, complement each other. Utilized together, they provide a comprehensive plan for protecting you and your family from UV.
When you are out in the sun, wear clothing to protect as much skin as possible.
If you can see light through a fabric, UV rays can get through too. Be aware that covering up doesn't block out all UV rays. A typical light T-shirt worn in the summer usually protects you less than sunscreen with a sun protection factor (SPF) of 15 or higher.
The ideal sun-protective fabrics are lightweight, comfortable, and protect against exposure even when wet. A few companies in the United States now make sun-protective clothing. They tend to be more tightly woven, and some have special coatings to help absorb UV rays. Some sun-protective clothes have a label listing the ultraviolet protection factor (UPF) value -- the level of protection the garment provides from the sun's UV rays (on a scale from 15 to 50+). The higher the UPF, the higher the protection from UV rays.
Children's swimsuits made from sun-protective fabric and designed to cover the child from the neck to the knees are popular in Australia. They are now available in some areas of the United States.
Newer products are now available to increase the UPF value of clothes you already own. Used like laundry detergents, they add a layer of UV protection to your clothes without changing the color or texture.
- Use a sunscreen with a sun protection factor (SPF) of 15 or higher
Some cosmetics, such as lipsticks and foundations, also are considered sunscreen products if they contain sunscreen. Some makeup contains sunscreen, but only the label can tell you. Makeup, including lipstick, without sunscreen does not provide sun protection. Check the labels to find out.
Read the labels: When selecting a sunscreen product, be sure to read the label before you buy. Experts recommend products with a sun protection factor (SPF) of at least 15. The SPF number represents the level of protection against UVB rays provided by the sunscreen -- a higher number means more protection.
The SPF number indicates protection against UVB rays only. Sunscreen products labeled "broad-spectrum" protect against UVA and UVB radiation, but at this time there is no standard system for measuring protection from UVA rays. Products with an SPF of 15 or higher that also contain avobenzone (Parsol 1789), ecamsule, zinc oxide, or titanium dioxide are likely to be effective against UVB and most UVA rays.
The Food and Drug Administration (FDA), which regulates sunscreens in the United States, has proposed a new set of rules for sunscreen labels. Part of this includes a rating system for UVA protection. Under the new system, sunscreens would be rated from 1 to 4 stars, with 1 star being a low level of UVA protection and 4 stars being the highest. It is not yet clear when this new rule might go into effect.
- Be sure to apply the sunscreen properly and allow for recommended set up time (20-30 minutes).
Be generous and reapply. About 1 ounce of sunscreen (a "palmful") should be used to cover the arms, legs, neck, and face of the average adult. For best results, most sunscreens must be reapplied at least every 2 hours and even more often if you are swimming or sweating. Products labeled "water resistant" may provide protection for at least 40 minutes even when you are swimming or sweating. Remember that sunscreen usually rubs off when you towel yourself dry, so you will need to reapply.
Sunless tanning products, such as bronzers and extenders (described below), give skin a golden color. But unlike sunscreens, these products provide very little protection from UV damage.
- Wear a hat
- Wear sunglasses that block UV rays
- Limit direct sun exposure during midday
Another way to limit exposure to UV light is to avoid being outdoors in sunlight too long. UV rays are most intense during the middle of the day, usually between the hours of 10 am and 4 pm. If you are unsure about the sun's intensity, take the shadow test: If your shadow is shorter than you, the sun's rays are the strongest. Plan activities out of the sun during these times. If you must be outdoors, protect your skin.
UV rays reach the ground throughout the year, even on cloudy days. UV rays can also pass through water, so don't think you're safe if you're in the water and feeling cool. Be especially careful on the beach and in the snow because sand and snow reflect sunlight, increasing the amount of UV radiation you receive.
Some UV rays can also pass through windows. Typical car, home, and office windows block most of the UVB rays but a smaller portion of UVA rays, so even if you don't feel you're getting burned your skin may still get some long-term damage. Tinted windows help block more UVA rays, although this depends on the type of tinting. UV radiation that comes through windows probably doesn't pose a great risk to most people unless they spend extended periods of time close to a window that receives direct sunlight.
If you plan to be outdoors, you may want to check the UV Index for your area. The UV Index usually can be found in the local newspaper or on TV and radio news broadcasts or on the EPA's UV resources website.
- Avoid tanning beds and sunlamps
Many people believe the UV rays of tanning beds are harmless. This is not true. Tanning lamps give out UVA and frequently UVB rays as well. Both UVA and UVB rays can cause serious long-term skin damage, and both contribute to skin cancer. Because of these dangers, many health experts advise people to avoid sunlamps and tanning beds.
- Protect children from the sun
Children require special attention, since they tend to spend more time outdoors and can burn more easily. Parents and other caregivers should protect children from excess sun exposure by using the measures described above. Older children need to be cautioned about sun exposure as they become more independent. It is important, particularly in parts of the world where it is sunnier, to cover your children as fully as is reasonable. You should develop the habit of using sunscreen on exposed skin for yourself and your children whenever you go outdoors and may be exposed to large amounts of sunlight. If you or your child burns easily, be extra careful to cover up, limit exposure, and apply sunscreen.
Although sunscreen can be applied to babies younger than 6 months, it is preferred that they are kept out of direct sunlight and protected from the sun using hats and protective clothing.
For the complete version of How Do I Protect Myself from UV
, please visit The American Cancer Society at www.cancer.org
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Ten Sun Safety Rules to Save your Skin
- AVOID INTENSE SUN, ESPECIALLY BETWEEN 10:00AM AND 4:00PM.
Don’t think that sunscreen allows you to bake in the sun. Wear long sleeves,
preferably a tight weave. Stay in the shade when you can. If you’re at the
beach, get a beach umbrella. Find the UV Index for your location at the EPA's
- LOOK FOR BROAD-SPECTRUM PRODUCTS RATED AT SPF15 OR HIGHER.
The slightly greater protection offered by higher SPF ratings may be needed for children when a) exposure times are
long, b) in extreme climates (e.g., high altitude, tropical latitudes, etc…), or c) for children who are very fair skinned.
Stronger SPFs are also recommended for those who tend to scrimp on the amount of sunscreen they apply.
- APPLY SUNSCREEN AT LEAST 30 MINUTES BEFORE SUN EXPOSURE.
This will allow bonding-based formulas to bond to the skin. For added protection, you may also wish to consider
products with titanium dioxide.
- USE A GENEROUS AMOUNT OF SUNSCREEN AND RE-APPLY IT OFTEN.
One-eighth (1/8) of an ounce is about right to cover all exposed skin for
an average-sized child in short sleeves and shorts. Your coverage may vary.
Sunscreen should be re-applied AT LEAST once during the day.
- DON’T THINK THAT SUNSCREENS MAKE YOU IMMUNE TO THE SUN.
To the contrary, even if you wear sunscreen and don’t burn, sun exposure can depress the immune system.
- WEAR A WIDE-BRIMMED HAT AND UV-BLOCKING SUNGLASSES.
Your eyes need protection as much as your skin does.
- USE A LIP BALM RATED SPF 15 OR HIGHER.
Lips need protection too!!
- AVOID SUNBURN LIKE THE PLAGUE.
Ditto for sunlamps and tanning parlors.
- EXAMINE YOUR SKIN ON A REGULAR BASIS.
Any mole that changes shape/color/size, any sore that doesn’t heal, or any persistent patch of irritated skin or small
growth may be a sign of cancer and needs to be professionally evaluated.
- SUNBURN BLISTERS ARE SECOND DEGREE BURNS- SEE A DOCTOR.
Remember that sunburns can look mild at first, but over a period of time, they can progress to the blister stage.
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Skin Cancer Detection
How to Examine Your Skin
Get familiar with your skin and your own pattern of moles, freckles, blemishes, and birthmarks. Check your skin monthly, and
be alert to changes in the number, size, shape, or color of spots on your skin or sores that do not heal.
The best time to do this simple exam is after a bath or shower. Use a full-length and a hand mirror so you can check your
skin from head to toe, noting anything new.
Face the mirror:
- Check your face, ears, neck, chest, and belly.
- Check both sides of your arms and the tops and palms of your hands.
- Check the front of your thighs, shins, tops of your feet, and in between your toes.
- Now look at the bottom of your feet, your calves, and the backs of your thighs – first one leg, then the other.
(You will need a hand mirror for the backs of your thighs.)
- Use the hand mirror to check the buttocks, lower back, upper back, and the back of the neck. (It may be helpful to
look at your back in a tall mirror rather than by using a hand mirror.)
If you do the exam regularly, you will know what is normal for you and can feel confident. Remember the warning signs and
check with your health care professional or dermatologist if you find something.
The most common skin cancers – basal cell and squamous cell – often take form of a pale, wax-like, pearly
nodule, a red scaly, sharply outlined patch, or a sore that does not heal. Another form of skin cancer – melanoma
– often starts as a small, mole-like growth.
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The ABCDE Rule for Early Detection of Melanoma
Most people have moles. The vast majorities of these moles are perfectly normal and pose no threat to your health. Any change in the way a mole looks, is a sign that you should call your doctor and schedule an appointment.
The ABCDE rule is a simple way to help you remember the important signs of
melanoma and other skin cancers:
- for ASYMMETRY: If one-half of a mole or birthmark does not match the other
- for BORDER: If the edges are irregular, ragged, notched, or blurred.
- for COLOR: If the color is not the same all over, but may have differing
shades of brown or black, sometimes with patches of red, white, or blue.
- for DIAMETER: If the area is larger than 6 millimeters (about ¼ inch – the
size of a pencil eraser) or is growing larger (can also be smaller than 6mm).
- for EVOLVING: Changes in size, shape, or color of a mole or skin lesion
or the appearance of a new spot.
Because some melanomas do not fit the ABCDE rule, it is vital that you stay
aware of any changes in skin lesions (changes, itches, or bleeds) or if you
develop a new skin lesion, you should make an appointment with a dermatologist.
Other warning signs may be:
- A sore that does not heal
- A new growth
- Spread of pigment from the border of a spot to surrounding skin
- Redness or a new swelling beyond the border
- Change in sensation -- itchiness, tenderness, or pain
- Change in the surface of a mole -- scaliness, oozing, bleeding, or the appearance of a bump or nodule
- A mole that looks very different from your other moles
American Cancer Society. (2008). Examining Your Skin. Atlanta: American
Cancer Society: 2008. Retrieved October 2008. (http://www.cancer.org/docroot/PED/content/PED_7_1x_Examining_your_skin_.asp?sitearea=&level=).
American Academy of Dermatology. Melanoma. American Academy of Dermatology.
Retrieved May 2011. (http://www.aad.org/media-resources/stats-and-facts/conditions/melanoma/melanoma).
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