When scheduling your doctor visits for the year, you might not think of seeing a dermatologist for a skin checkup, but healthy skin matters and is an important component in overall wellness.
“We do recommend skin cancer screening evaluations, also known as a full body skin check,” said Morgan McGuigan, PA-C with UPMC Dermatology-North Hills. The frequency can vary among patients, but those with a history of skin cancer should be seen in a dermatologist’s office more often.
Dr. Charles Mount with Pittsburgh Skin/Dermatology & Mohs Surgery based in Cranberry advised that patients should be screened annually from the age of about 40, but those with certain risk factors (family history, prior tanning bed use or having more than 50 moles) should get started earlier.
Similar to breast self-exams, McGuigan also advises patients to do monthly skin checks, making sure that there isn’t anything new that wasn’t there before or that a mole hasn’t changed shape or color.
“Something unique that UPMC offers is ‘eDermatology,’ which is part of the telemedicine team. You can upload photos online, and a provider will get back to you. If you have a concern, this is a good way to get it evaluated quickly,” she said.
Skin Cancer: Types, Risk Factors and Prevention
There are over 3,000 skin conditions for which people may turn to a dermatologist, from eczema to acne to warts to psoriasis to rashes. However, one that is high on the list of concerning issues is skin cancer. The three most common types of skin cancer are basal cell, squamous cell, and melanoma.
“By far and away, the most common skin cancer is basal cell carcinoma. It usually appears as a pink or slightly translucent bump that resembles a pimple that won’t go away for months. It is very unlikely to be life threatening but can be locally destructive: it can grow into nerves and muscles and bone if not treated and can grow into a much bigger problem,” said Mount.
Squamous cell carcinoma presents as pink or red and often appears as a scaly, tender bump, but it is also rarely life threatening.
The skin cancer that rings the most alarm bells is melanoma. Melanoma is highly curable if caught early while localized, but can be deadly if it spreads.
The American Cancer Society estimates that 97,610 new melanomas will be diagnosed in 2023, with the majority of cases seen in men, and almost 8,000 people are expected to die from the disease this year.
Melanomas often begin as moles that start changing in various ways. The ABCDEs of melanoma are: Asymmetry; uneven Borders; Colors such as brown, tan or black; approximately one-quarter inch in Diameter; and change in size, shape, color or elevation, otherwise defined as Evolution.
Risk factors for skin cancer include those with fair skin and light eyes; a long history of sun exposure; working outdoors; being immunocompromised or using immunosuppressant medication long-term; and genetics. Another major factor is a history of tanning bed use—even once.
“Lifetime ultraviolet radiation exposure is the biggest risk factor for overall skin cancer risk, and both ultraviolet A and B cause skin cancer,” said Dr. Mount, noting that UVA is not safer than UVB.
“If you have ever used a tanning bed, your lifetime melanoma risk has gone up at least 60 to 80 percent, and it never comes back to zero,” he continued, adding that there is no federal oversight of tanning beds, so they are best avoided. “That risk elevates and stays there.”
It is a myth that darker complected people do not get melanoma, but melanoma is 20 times more common in those with fairer skin tones. Age also increases the risk, with 65 being the average age of diagnosis.
Even though you may only be exposed to sun for a few minutes per day, those minutes can add up to significant exposure over a lifetime, which is why protection is key to prevention. If you’re going to be outdoors, both McGuigan and Dr. Mount highly recommend wearing sunscreen on a daily basis—even on cloudy days or in the winter.
“UVA rays can come through the clouds, which is why you can get burned on a cloudy day,” said McGuigan, adding that you can even get sun exposure in a car. She also recommended to use sunscreen 30 SPF (Sun Protection Factor) and above.
And though it is best to avoid the sun when its UV rays are strongest (generally between 10 a.m.-4 p.m.), if you must be exposed, then be sure to reapply sunscreen every 90 or so minutes.
Selecting the right sunscreen can be daunting with so many products on the market. Both Dr. Mount and McGuigan agree that mineral-based sunscreens (containing titanium or zinc) are usually well tolerated by most people. Proceed with caution when choosing products labeled ‘natural’ or ‘organic,’ or those that are overly fragrant, as some people have reactions to these ingredients.
“The general rule is that the stronger something smells, the more potentially irritating it can be to the skin,” said Dr. Mount, adding that it’s best to get advice from your dermatologist about which sunscreen brand to choose.
Both also recommend the use of protective clothing with built-in UPF protection, along with hats.
Healthy Skin Care Tips
Mitigating risks for skin cancer and being smart about sun exposure and protection is of paramount importance, but taking general care of your skin is also important, particularly as part of the aging process.
“The best thing you can do is keep your skin hydrated and the best way to do that is in the shower,” said McGuigan. “Make sure that it’s not a super-hot shower, as that can dry your skin out. Try to use products that are scent-free; scented products can strip moisture from your skin.”
She also recommended applying lotion or moisturizer to skin while it is still slightly damp as this can help lock in moisture. And drinking enough water keeps the skin hydrated as well. Wearing daily sunscreen is not only a skin cancer prevention method but can help with antiaging and give skin a healthy glow.