Summer is here, and experts are sharing their tips to protect you and your kids from the sun’s harmful rays. Bahar Dasgeb, MD, a dermato-oncologist with Rutgers Cancer Institute; and Kelly Rose Kane, MD, FAAD, of Kane Dermatology in Somers Point, spoke with New Jersey Family about changes to look for on your skin, how to gauge the effectiveness of your sunscreen, how best to protect your skin outdoors and more.
Know the Risks for Skin Cancer
Understanding skin cancer risk starts with knowing your family history. Skin tone is also important. “Your risk is higher if your skin has less pigment, or if it burns or freckles easily,” says Dr. Dasgeb. Someone with a fair complexion who has blue or green eyes, as well as blonde or red hair, is also at a higher risk, says Dr. Kane.
If you have more melanin in your skin, (i.e. your skin is darker), there are less UV rays that can pass through the skin and reach your DNA, Dr. Dasgeb explains. People with darker skin tones are ar lower risk for skin cancer than people with light skin tone, but that doesn’t mean people with darker skin tones cannot get skin cancer Dr. Dasgeb says. In fact, due to the misconceptions that people with darker skin tones are not at risk, skin cancer in people of color tends to be diagnosed at a later stage, when it’s harder to treat, Dr. Kane says. Everyone, regardless of skin tone, should be using sun protection and doing regular skin checks.
Getting too much sun exposure without protection, suffering from a blistering sunburn or using a tanning bed (tanning beds are not calibrated which means UVA, B or C rays are not filtered and expose you to more harmful UV rays) all greatly increase your chances of getting skin cancer.
Things out of our control such as age, exposure to radiation, skin that scars easily and chronic infections also increase your risk.
It’s also important to be mindful of medications that can weaken your immune system, Dr. Dasgeb says. Organ transplant patients are 100 times more at risk of developing skin cancer in their lifetime due to immunosuppression. Skin is the largest immune organ, and if your immune system is low, the risk is higher. It’s also important to be aware of medicine that may make you more sensitive to sunburns, Dr. Kane says.
Skin cancer generally does not put you at risk for other types of cancers, unless you have a specific illness that increases your overall risk. For example, Gorlin syndrome is a genetic disorder that can lead to hundreds of basal cell carcinomas, and those patients also are prone to develop either benign or malignant brain tumors, Dr. Dasgeb says.
Light-skinned individuals who have had one melanoma have an increased risk of developing both subsequent melanomas and other non melanoma skin cancers, Dr. Kane says.
ScreenNJ is a statewide service that provides education about cancer prevention and detection to the community and professionals. ScreenNJ supports NJ residents to obtain cancer screening through navigation and mobile health services regardless of their ability to pay. For more information about ScreenNJ visit screennj.org.
Remember to Reapply Your Sunscreen Every Two Hours
How often you reapply your sunscreen is far more important than how high your SPF is, Dr. Dasgeb says. “If you put an SPF 90 on in the morning and don’t reapply, after two hours have no protection,” she adds. “It’s nowhere near as effective as putting on an SPF 15 that you are reapplying every two hours, which on its own filters more than 95% of UV light. Therefore, reapplication matters more than the SPF number!”
If you apply sunscreen once in the morning and once in the afternoon, but not in between, you’re not protected, Dr. Dasgeb says. This also applies to makeup foundation. Even if your face cream or makeup has an SPF of 15 or 20, you’ll need to reapply to be well protected if you are outdoors
Dr. Dasgeb says she uses a physical barrier sunscreen. Topically applied physical barriers like zinc oxide do not absorb sunlight but reflect sunlight. An example of a physical barrier sunscreen is a thick layer of zinc oxide paste, which resists sweat, and ocean water. Other examples include an SPF mask that covers your face and your hands or swimsuits or bodysuits made with SPF fabric. You can also use an SPF laundry detergent that infuses your clothes with a layer of SPF.
Using physical barrier sunscreens are smart for kids, too, especially if they’re at camp all day, says Dr. Dasgeb. That way, they don’t have to worry about reapplying.
Wear a Wide-Brimmed Hat and Know Which Sunglasses are Safest
Make sure your head is covered with a wide-brimmed hat, Dr. Dasgeb advises. She often sees patients come in with skin cancer in their scalp. The wide-brimmed hat also covers parts of your face, nose, ears neck, and some of your shoulders.
Look for sunglasses that are well-tinted and indicate UVA/UVB protection on the label. Avoid being outside from 10 am to 2 pm when the UV index is at its highest. Seek shade when possible. Remember that on cloudy days, the sun’s rays can still be harmful.
No matter the weather, the season, or even if it’s cloudy, make sure you’re well protected.
“UVB rays, the main cause of sunburn, are the strongest in the summer; however, UVB rays can burn and damage your skin year-round, especially at high altitudes and on reflective surfaces such as snow or ice,” says Dr. Kane. “Snow reflects up to 80 percent of the sun’s UV light, so the rays hit you twice, further increasing your risk of skin cancer and premature aging. A day on the slopes can do as much damage to you skin as a day on the beach. UVA rays remain constant throughout the year … and can penetrate glass, so it’s still possible to damage your skin while spending a bright winter day indoors.”
ScreenNJ is a statewide service that provides education about cancer prevention and detection to the community and professionals. ScreenNJ supports NJ residents to obtain cancer screening through navigation and mobile health services regardless of their ability to pay. For more information about ScreenNJ visit screennj.org.
Do Regular Skin Checks and See Your Dermatologist
Learn the ABCs – Ds and Es, too, of checking your skin for changes.
A stands for asymmetry. If a mole is not round, one part is a different shape, it has different colors, or has both flat and raised areas, it could be an area of concern.
B stands for border. If the borders are not smooth, keep an eye on this area.
C stands for color. If a mole is not a uniform color or if the color changes, it could be worrisome. Sometimes moles develop into a combination of brown, black and red.
D stands for diameter. If a mole is more than 5 millimeters in diameter it needs to be checked. A mole that is smaller could still be cancerous, but the larger it is, the more cause for concern. If a mole is large but has stayed that way for years, it probably isn’t cancer – any lesion that does not change in 9 to 12 months most likely is not melanoma (but should still be checked by a doctor because changes could occur years later), Dr. Dasgeb clarifies.
E stands for evolution. Any changes in skin should be evaluated. “A change means anything. Let’s say something is not itchy, and now it’s itchy. … It was not bleeding, and now it’s bleeding. It was not red, but it’s now red. It was not brown, but it’s now brown. It was not black, but now it’s black. It was small, but now it’s big. It was flat, and now it’s elevated. Any change,” Dr. Dasgeb says.
Besides obvious parts of your body, you also need to check the palms of the hands, soles of the feet, the scalp, ears, groin, the inside of the mouth and even your nails, Dr. Kane says, because these are all areas where melanoma can develop.
There is no official, medical recommendation on how often to see a dermatologist for those who don’t have a prior history of skin cancer, don’t have a genetic risk or family history, are immunocompetent, Dr. Dasgeb says. Immunosuppressed and organ transplant patients need to see a dermatologist for skin checks regularly.
Instead, Dr. Dasgeb advises everyone to see a dermatologist at least once a year, in addition to any time you see a noticeable change in your skin. You can also check yourself and your kids, she adds. People who have had skin cancer previously or who have an organ transplant should go as often as recommended.
You can look for dermatologists in your area on the American Academy of Dermatology website or at your local hospital.
ScreenNJ is a statewide service that provides education about cancer prevention and detection to the community and professionals. ScreenNJ supports NJ residents to obtain cancer screening through navigation and mobile health services regardless of their ability to pay. For more information about ScreenNJ visit screennj.org.
Educate Yourself About Skin Cancer
Skin cancer is the most common cancer in the United States. Five million new cases are diagnosed every year, compared to 2 million cases combined of all the other cancers, Dr. Dasgeb says.
Current estimates are that 1 in 5 Americans will develop skin cancer in their lifetime, according to The Skin Cancer Foundation.
Basal cell carcinoma is the most common form of skin cancer; an estimated 3.6 million cases are diagnosed in the U.S. each year. Squamous cell carcinoma is the second most common form; an estimated 1.8 million cases are diagnosed each year.
An estimated 200,340 cases of melanoma will be diagnosed in the U.S. in 2024. Of those cases, 99,700 of them will be noninvasive and confined to the top layer of skin, but 100,640 cases will get into the skin’s second layer. In the past decade, the number of new invasive melanoma cases diagnosed annually increased by 32 percent. An estimated 8,290 people will die of melanoma this year.
“We have something called regressing melanoma. Sometimes a melanoma leaves the skin completely and goes inside your blood,” Dr. Dasgeb says. “Then we suddenly see a patient coming with a lump that is melanoma. We look at the skin, there is nothing on the skin, … or there is a vague reminiscence of what once was a mole, and we biopsy there and you realize it’s something.” She advises everyone to take note of a mole that seems to be getting smaller, because it could be going underneath the skin.
There is also Merkel cell carcinoma and angiosarcoma of the skin, which are more dangerous than melanoma, but also more rare.
Understand Treatment Options and How They Vary
The good news: If skin cancer is caught early enough, it’s curable – which is why it’s so important to check your skin frequently.
If you have a superficial basal squamous cell lesion, which is usually pink or red and can possibly scab up, typically it can be removed surgically and then you’d use a topical immunotherapy cream. “Sometimes the bigger ones are surgically removed, or sometimes they’re so big that they’re no longer surgically treatable,” Dr. Dasgeb says. “In that case, you give them systemic treatment like you treat other cancer patients with chemotherapy, immunotherapy, etc.”
If you have thin melanoma, the mole is small and caught early, and can be cut out; it’s usually treatable. If it’s a thick melanoma, you have to figure out what stage of cancer it is and decide on treatment options from there.
In the end, it’s crucial to conduct regular self-screenings and talk to your dermatologist about skin checks. Be sure to make sun protection a priority, no matter what time of day or year it is. “There is no such thing as a healthy tan,” Kane says. Any change in skin pigment due to sun exposure is a sign of damage and can increase the risk of skin cancer. “I want everyone to enjoy being outside and to enjoy the beauty of New Jersey beaches and to be active, but we need to be smart in the sun.”
Bahar Dasgeb, MD, is a dermato-oncologist with Rutgers Cancer Institute, the state’s only National Cancer Institute-designated Comprehensive Cancer Center.
Kelly Rose Kane, MD, FAAD, owns Kane Dermatology in Somers Point.
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