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Empire of the sun
According to Dr. Marie F. Mack, chronic exposure to sunlight is the cause of almost all melanomas, the most common form of skin cancer. Melanomas affect 800,000 Americans each year and most frequently occur on exposed parts of the body: the face, ears, neck, scalp, shoulders and upper back.

“We know that sun rays are a natural carcinogen, making anyone with a history of frequent sun exposure a candidate for melanoma,” said Mack, board-certified dermatologist at Kelsey-Seybold and listed as one of Texas Monthly magazine’s “Super Doctors.”

Skin consists of three layers: the epidermis, dermis and subcutis, explained Mack. The epidermis, the topmost layer, is as thin as a pencil line and contains cells which produce melanin, the pigment that gives skin its normal color. Sun exposure causes these cells to produce more melanin and create a darker skin color. A suntan is the body’s attempt to protect skin layers from the penetrating rays of the sun.

Melanoma develops in the same skin cells that produce the melanin.

“Exposure causes genetic alternations in cells, and if those cells continue to reproduce, they give rise to skin cancers,” Mack said.

People who work long hours outdoors or who spend excessive leisure time in the sun are in jeopardy, she said.

“We’re seeing more cases of skin cancers than ever before,” said Mack, who has diagnosed more than 100 cases of melanoma malignancies.

They tend to be baby-boomers who grew up at a time when a deep tan and bleached hair were deemed necessary to be more attractive.

It was the first generation with large amounts of leisure time for swimming, surfing, sailing and sunbathing. They used tanning potions, like baby oil spiked with iodine, formulated to enhance the effects of sunlight.

Popular songs of the ’60s advocating the sun-splashed lifestyle included the hits, “The Warmth of the Sun,” the Beach Boys; “Only Live for the Sun,” the Sunrays; and “California Sun” by the Rivieras.

But now they’re singing a different tune. The damage done years ago is manifesting itself today.

Texas ranks third in the nation for incidents of melanoma, and half of all newly diagnosed cancers in Texas are skin cancers.

Even today, with people more informed about the dangers of sunbathing, the old associations equating a dark tan to a healthier, sexier appearance still remain.

“We’ve tried to educate people about the dangers of overexposure, but you wouldn’t know it from watching folks at public beaches and parks,” said Mack. “What they don’t realize is that it’s burn now, pay later.”

And when it comes due, the debt is high. Skin cancer kills more than 10,000 Americans every year.

Signs and symptoms
A cancerous skin lesion can appear suddenly or develop slowly. Its appearance can vary. Everyone, regardless of age or race, should have their skin examined by a doctor at least once a year, Mack said. Perform self-exams in the interim.

“Examine your skin regularly, especially the face, neck, ears, scalp, upper chest and shoulders. Do so monthly if you have a family history of skin cancer or multiple moles,” Mack said. “Be sure to check for new skin growths or changes in existing moles, freckles, bumps or birthmarks. If you notice a sudden change, get to your doctor immediately.”

To properly diagnose skin cancer, your doctor or dermatologist will need to take a small sample of skin for laboratory analysis. This biopsy is usually done in a doctor’s office with a local anesthetic.

“I tell my patients to use the A-B-C-D skin examination guide recommended by the American Academy of Dermatology,” Mack said. (See The ABCs of moles.)

An ounce of prevention
“Your first line of defense is good sunscreen,” Mack said. “And don’t be skimpy with it.

“Spread a tablespoon spread over your face and another two ounces on your body. Be sure to reapply after swimming.”

If used properly, two adults could go through a bottle in a day. Use a sun protection factor of at least 15. Be sure to apply 20-30 minutes before exposure. It needs time to bind to the skin for maximum benefit. (See Sunscreen vs. sunblock)

“African-Americans can sunburn, too, Mack said. “Though melanomas are not as common, they suffer a disproportionately high death rate probably from delayed detection.

“It’s important for people of all races to take sunburn precautions and check their skin for evidence of changes.”

Because of the depleted ozone layer, the sun’s effect is stronger than ever. Limit exposure between the hours of 10 a.m. and 4 p.m. when ultraviolet rays are most penetrating.

Dress right. Wear a wide brim hat and loose fitting clothing if working outside. Add sunglasses.

Avoid tanning beds.

“If they were called by their rightful names, they’d be known as cancer beds,” Mack said.

Continued
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