Too much time in the sun can be dangerous if you’re not careful – and well beyond a sunburn. The National Cancer Institute says more than a million Americans are diagnosed with skin cancer every year. But dermatologist Dornechia Carter says skin cancer is often curable if it’s caught early. She talked with Sam Baker about skin cancer in this KERA Health Checkup.
Dr. Carter: It is kind of a Catch-22. We do need a little bit of sunlight, there’s the need for Vitamin D in order to maintain our bone health. However, we do know that sun exposure does cause damage to the skin and thus can lead to skin cancer. So there’s ways to balance it out, whether that’s eating Vitamin D-rich foods and getting a little bit of sun. But we don’t want to overdo it.
Baker: What is too much?
Dr. Carter: We don’t have a number to say, ‘Oh, you should be out in the sun for this number of minutes.’ However, we do know that you do get some transient exposure just by walking around and you don’t necessarily need to shelter yourself. But we don’t want you laying out in the sun, getting sunburns and to the point where you actually see a tan, that does represent some damage to the skin that’s your body’s response, saying you’ve gotten too much sun now. So it’s making you darker trying to protect yourself.
Baker: I was going to ask, how dangerous is outdoor tanning?
Dr. Carter: Outdoor tanning is one of the worst things that you can do. It’s akin to just laying out and asking for a sunburn. You get cumulative sun damage while you’re laying out in the sun. So I would not recommend sun tanning nor would I recommend a sun tanning booth.
Baker: How serious is skin cancer?
Dr. Carter: There are three main types that we see. Basal cell cancer: That one tends not to metastasize. But it can do a lot of local damage. If you get it on your nose, for instance, it can do a lot of damage to your nose and require quite a bit of repair to fix. Squamous cancer. Quite a bit more dangers, it can metastasize. Thankfully, if we remove these two cancers they are pretty much considered cured. So the earlier the better. With the third one, the most dangerous is melanoma. Melanoma is one that has a very high chance of metastasizing. Again, if we catch it early, we can take it out and keep close monitoring on you, make sure you don’t develop any more.
However, it is the most dangerous of the three, and it’s the one that we worry the absolute most about with getting suntans, getting blistering sunburns and the like.
Baker: What more can you do on your own to keep an eye out for this – how would you recognize it?
Dr. Carter: We try to make it simple and refer to our alphabet, so A B C D E.
A is for asymmetry. If you see a mole or a mark on you that is not symmetrical, it can’t be folded in half on itself, then that’s something to be worried about.
B is for borders. If the borders are kind of jagged, or they’re faded, they’re not very clear. Then that is something that should highlight your attention. C is for changes in color. And changes in color could mean the color is very different than anything else you see on your body or it’s really, really dark. Or it used to be all one color and now it has a gray spot or a light spot. Or it used to be a lighter color and has now a dark spot. So anything that is irregular about the pigmentation, the color of that spot.
D is for diameter: Larger than a pencil eraser. So everybody knows what a pencil eraser looks like. If it’s starting to get large, then that’s something to worry about.
E is for evolution, or I like to say, “Everything else.” If it’s bleeding, if it’s itching, if it hurts, if it just seems that it’s not normal, you have a bad feeling about it, don’t sit at home and worry about it. Get it checked out. Get a doctor to look at it. Get a dermatologist to look at it.
Baker: Anything that looks odd, you have a look-see.
Dr. Carter: Exactly. And more people are very familiar with what their bodies look like. And I suggest that you become very familiar yourself. If you’re not, just like we recommend that you do a breast exam for women every single month. I recommend at the same time, you look around and do a skin exam as well.
Baker: If you should find that you have skin cancer, how do you treat it?
Dr. Carter: Sure. So there are a number of ways to treat skin cancers once we do find them. Typically when you see a dermatologist, you’ll get a biopsy and that’s how you get your diagnosis. For treating it, we can do a number of things whether that’s surgically removing it, there are some medications that we can put on to remove it. And in more advanced cases, we have specialized types of surgery called Mohs surgery. We also can do radiation and some of these more advanced therapies. But the vast majority of cancer, we’re able to simply remove in the office.
Baker: I assume anyone is susceptible to skin cancer but are there certain groups who get it more than others?
Dr. Carter: Well at this point, we do see mostly lighter skin patients with skin cancer. However, that is not to say that our darker skin patients do not have a chance of having that same cancer. Absolutely everyone needs to get out there and get their sunscreen, protect themselves and check themselves out regularly. Cause we are seeing skin cancers in darker populations more frequently.
Baker: I do wonder, though: Do people of color tend to take skin cancer for granted?
Dr. Carter: I think that people of color tend to worry less about it. We tend not to get quite as frequent of sunburns but we do get sun damage and we do get sunburns. And we also do get skin cancer. So we are not exempt.
Baker: Best way to guard against skin cancer?
Dr. Carter: Best way to guard against skin cancer is sun protection, avoiding sunburns. Get a little bit of sun, have fun, but wear your hats, your protective clothing, your sunscreen and check yourself out once a month. You can see a dermatologist, especially if you have a family history, once a year, for a skin check as well.
Baker: Regarding sunscreen, what factors should you look for. A mean over the years, I’ve seen different numbers. So what’s currently recommended?
Dr. Carter: Yes. I understand that’s very confusing to people who are looking at these bottles and saying, “Which one do I pick?” And as a dermatologist, the thing that I consider the ost important is that you get sunscreen on your skin. So whatever it takes. It’s something that feels good and that you’re willing to apply every couple of hours.
Now as far as a number on the bottle, I would look for SPF 30 or higher. Once you get beyond 30, the additional protection that’s afforded is not that much more. So 30 is your magic number.
Dr. Dornechia Carter is with Dermatology Associates of Uptown and a consultant with Methodist Charlton Medical Center.
For more information: