Lying on a beach under sunny skies may be a major draw for tourists everywhere, but some dermatologists view this leisure activity as a leading cause of skin cancer.
Arthur Colsky, a Miami-based dermatologist, was in Grand Cayman recently explaining the health benefits of covering up rather than embracing the sun.
‘I would recommend that you protect yourself from the sun,’ he said.
Noting that the weather in Cayman is comparable to Miami, he explained how that related to ultraviolet radiation levels.
‘There is similar UV exposure here and so skin cancers are very common and will occur with a fair and concerning frequency,’ he said.
Three main types of skin cancer can strike and they vary in severity as well as appearance.
The most common form of this disease, as well as of all cancers, is basal cell carcinoma, which is also the least dangerous of the three types.
Squamous cell carcinoma is the second most-common skin cancer, and this can be very dangerous due to its potential to metastasise, or spread to other parts of the body.
The most dangerous and least-common skin cancer is malignant melanoma, which tends to spread.
Like the other two cancers, though, malignant melanoma is almost always curable when detected in its early stages.
If the disease is not caught early, it can be fatal.
‘At the first sign there may be something present, the individual should have it checked by a dermatologist,’ Dr. Colsky said.
‘It will then be removed and/or require further treatment such as a biopsy of the lymph node, or chemotherapy or other systemic treatments, if advanced,’ he added.
Regular checkups
To catch skin cancer early, the doctor stresses the importance of regular checkups and self-examinations.
Dr. Colsky points to the ABCD rule for detecting skin cancer.
When checking a mole, there are four warning signs to look for: Asymmetry, where one half of the mole doesn’t match the other; Border, if the outline of the mole is irregular or poorly defined; Colour, whether various shades of tan, brown and black are all present along with possibly white, red or blue; and Diameter, if the mole is larger than 6mm, about the size of a pencil eraser.
In general, changes in any mole or a mole that appears different from the rest should prompt a visit to the dermatologist.
At the very least, however, people should see a dermatologist once a year for a regular check-up, Dr. Colsky advises. If someone is at risk due to a previous problem, family history, past sunburns or greater sun exposure, the doctor suggests anywhere from two to four visits annually.
Dr. Colsky stressed that people need to take steps to prevent too much exposure to the sun.
‘We know UV radiation is carcinogenic and we know exposure to UV radiation is responsible for the vast majority of skin cancers,’ he said.
Everyone needs to take the proper precautions, he explained. ‘Once you go to the beach, you are at risk.
‘You should apply an SPF30 sun block every 30 minutes and in an amount to get adequate coverage, but sun block is no substitute for sun avoidance,’ Dr. Colsky said.
He added that when going to the beach, standard accessories should include an umbrella, a hat, sunglasses that provide UV protection and protective clothing. To limit the risk from exposure to the sun, he also recommends staying off the beach between the hours of 10am and 4pm.
Sonia Kapoor, a dermatologist who grew up in Grand Cayman, tempers this advice based on her experience locally. She agrees with Dr. Colsky about the importance of using sun block, but doesn’t recommend avoidance of the sun.
‘The sun is good for you and helpful for certain skin disorders such as psoriasis,’ she said.
Effects of the sun
At his practice, Dr. Colsky has seen older patients with mottled, weathered, wrinkled and discoloured skin. In comparison, on the areas of their bodies not exposed to the sun, such as beneath bathing suits, the skin looks normal, healthy and youthful, he explained.
‘I don’t leave my house without sun block on,’ he added.
Exposures to the sun build up and manifest themselves later in life, Dr. Colsky explained.
‘The skin is like a tape recorder – it never forgets,’ he said.
That analogy rings true for Dr. Kapoor as well, but she doesn’t believe that people who live in sunny climates like that found in the Cayman Islands are necessarily at greater risk of developing skin cancer.
‘Studies have proven that the higher risk is for people who come down here from areas which get little sunlight, like the northern US. They receive a sudden exposure and get burned.
‘These are the people who may get skin cancer 15 years down the line,’ she said.
She likened this sudden exposure to someone going to the gym for the first time.
‘If you go to the gym and start lifting a 20-lb. weight right away, you are going to pull a muscle,’ Dr. Kapoor said.
In the same way, people need to be careful about their exposure to the sun.
‘If you are out in the sun on a regular basis and get a little tan each time, that offers some protection,’ she said.
Dr. Kapoor wants people to take care when outdoors, while extolling the virtues of an active, healthy lifestyle.
‘Don’t deprive yourself of a good quality of life. But you should include sun block as part of your daily regimen – just like brushing your teeth,’ she said.
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