Screen the rays: Skin damage from the sun

Although treatment hinges on finding skin cancer early, dermatologists say young adults are notoriously hard to persuade to take precautions against overexposure.
Aug. 11--Kevin Sklark noticed in March what he thought was a strange bug bite near his nose. So the 26-year-old Air Force sergeant visited a military doctor, who agreed it might be a bite.

Sklark later was diagnosed with basal cell carcinoma, one of three types of skin cancer.

Doctors twice surgically removed a patch of skin about the size of a thumbnail to treat the cancer, which he later discovered had been forming for about five years, he said.

"They cut a pretty decent-sized chunk out," he said.

Sklark is one of more than a million people nationally who will be diagnosed this year with skin cancer, the most common form of cancer in the United States.

The sun's dark side

Traditionally viewed as an "old-person's disease," skin cancer is becoming more prevalent in teenagers and young adults who ignore doctors' warnings that the ultraviolet light that creates a stylish summer tan also can lead to skin cancer.

Tips for skin health

  • Stay out of the sun when possible.
  • When outdoors wear a high-SPF sunscreen, hat and tightly knit clothing.
  • Avoid sun exposure between 10 a.m. and 3 p.m.
  • Check your entire body once a month for unusual growths or changes in moles, and report anything suspicious to a doctor.

And although treatment hinges on finding skin cancer early, dermatologists say young adults are notoriously hard to persuade to take precautions against overexposure.

"Not a month goes by that I don't see skin cancer in someone in their twenties," said Dr. James Spencer, a Florida dermatologist and associate professor of clinical dermatology at Mount Sinai School of Medicine in New York.

People typically accumulate most of their sun exposure during childhood and adolescence, but everyone can take steps to reduce their risk.

Some exposure to ultraviolet light allows the body to produce needed amounts of vitamin D, and it can be psychologically beneficial. In fact, the majority of adults of both genders who responded to a 2005 survey by the American Academy of Dermatology said people look healthier when they're tan.

Too much time baking outdoors or under artificial tanning lamps, however, allows rays of ultraviolet light to penetrate the skin, altering the DNA of cells.

"Really, when you get a tan, that's just an indication that you've had some cellular damage to the skin," said Dr. Joel Sears, a Spokane dermatologist.

UVB radiation affects the outer layers and causes sunburns, whereas deeper damage from UVA rays contributes to wrinkling and aging.

About 80 to 90 percent of the visual changes to the face and skin that people attribute to aging are caused by exposure, Sears said.

Cumulative damage often causes the common cancers, basal and squamous cell carcinomas. Sunburns have been linked to melanoma, Sears said.

A handful of sunburns can double your chances of skin cancer, he said.

Treatment and prevention

Like Sklark, most people with the common cancers can be treated. But melanoma, which can appear anywhere on the body, kills about one person per hour in the United States. It is becoming increasingly prevalent, and it is the most common cancer in women ages 20 to 29, Sears said.

Light-skinned people with blond or red hair and blue or green eyes who burn easily are most at risk for exposure-related skin cancer, whereas dark-skinned people have more natural protection against the sun.

Sklark, who's been deployed to the Middle East, spent a lot of time outside without sunscreen prior to his diagnosis, he said.

Sun worshippers can protect themselves by wearing sunscreen, hats and tightly knit clothing. However, they should remember that sunscreen is just that -- a screen. Newer sunscreens block against UVA and UVB, but older sunscreens may not. Sunscreen should be used quickly or replaced.

Sunless tanning

Although some people seeking a golden hue may think artificial or "sunless" tanning is a safer alternative, many skin doctors say it's not. While a little radiation from a tanning bed at a local salon probably won't be harmful, moderation is key.

About 30 million people tan indoors annually in the United States, 2.3 million of which are teens, according to the American Academy of Dermatology. About 70 percent of customers are women ages 20 to 35, said John Overstreet, executive director of the Indoor Tanning Association, an industry organization.

Spencer, the Florida dermatologist, attributed the increase in cancer in young adults partially to indoor tanning.

"We all want instant gratification," he said. "People want to be pretty this weekend, and they really don't care."

But Overstreet said indoor tanning has been the target of a "very well-financed and highly successful campaign to scare us from being in the sun," saying people have missed out on benefits of ultraviolet light exposure as a result. Indoor tanning is the only place where a knowledgeable person will advise you about how much to tan without burning, he said.

"The sun is the source of life for all of us," Overstreet said. "Without it, you'd die. The trick is moderation and figuring out what's best for yourself."

Deena Treperinas, owner of Sunny Buns tanning salon in south Spokane, said most clients tan for the healthful benefits.

"They're not here to get the color," she said. "That's an added bonus. But they are here for the vitamin D. It makes you feel good when the sun's not shining."

People also come to erase summer tan lines and to build "base tans" before going on vacation, she said.

Yet Sears, the Spokane doctor, said people get adequate amounts of vitamin D from daily living. Most dermatologists also dispute the idea of building a base tan, saying any tanning represents skin damage.

About half of states have regulations on indoor tanning for minors, but Washington does not. The World Health Organization and the American Academy of Dermatology recommend that minors be forbidden from indoor tanning.

Treperinas said she doesn't have many young girls come into her salon, and store personnel keep a close eye on those who do.

"I don't want anybody to get skin cancer because of us," she said.

Treperinas and other salon operators do offer an alternative to ultraviolet tanning. Once used for bodybuilders, airbrush tanning is gaining popularity, especially with pregnant mothers and people who have skin cancer, she said.

"All the movie stars and Victoria's Secret models, that's what they do," she said.

Airbrush tanning uses a dye that stains the outer layers of the skin. It does not protect against the sun. At Sunny Buns it costs about $35 for a 15-minute spraying process, which provides color that lasts about a week.

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The Spokesman-Review, Spokane, Wash.
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