Ghosts of past tanning

The North

west of Scotland where I was brought up is one of the most beautiful places on Earth

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t is probably also one of the wettest. Skin-wise this has its advantages, being shrouded in mist and fine rain does wonders for the complexion as does the fact that the rare appearances the sun makes really can’t cause much damage.

Of course the advent of the package holiday and cheap flights abroad changed all that and thin skinned, delicate complexioned Celts were able to stake out their bodies on the beach along with their darker skinned European cousins.

The trouble is our skins, as well documented, do not cope with sun well and are prone to damage and skin cancer. I think back in horror now to the hours spent on foreign beaches inducing a tan. One student summer my sister and I spent three months living on the beaches of Greece, outside morning noon and night, tut tutting at those who did not use tanning oil (just olive oil) while we smothered ourselves in less than useless factor two.

The years rolled by and my predilection for going the deepest brown my, fair, Celtic skin would allow, continued. Then the damage started to show, firstly in lines (in contrast my red haired friends who could not go in the sun at all still look like girls) then a few years ago, in more and more brown spots, over pigmentation in some places and loss of pigmentation in others. Much too late I switched to a sun factor 15 and now since living here, factor 50.

Nevertheless the years have taken their toll on a skin more suited to mist and rain and I began to worry whether this or that freckle is getting darker and even if certain brown marks are not freckles at all but something more sinister. Pictures on the Internet confuse me as they always seem to be of magnified extreme cases and I can’t seem to find anything similar to my marks.

This month is skin cancer awareness month so I finally decide to stop avoiding the issue and visit my doctor, Else Christoffersen at Cayman doctors to have her take a look. We talked a bit about the types of skin changes she will be looking for before she asks me to don a paper gown and then proceeds to examines me. I think she is just going to look at the brown spots on my calf that I am worried about, but she examines me literally from head to toe, even between the toes. I am rather surprised by this but she says lesions can appear in places that are not even exposed to the sun; in fact Bob Marley’s cancer was caused by an undetected mole under his big toenail that got traumatised by playing football. He neglected it and over time it became cancerous.

As she looks at my skin through a large magnifying glass and light, Christoffersen draws a ring around anything she thinks is suspicious. By the time she finishes looking at my front half I have a disturbing amount of rings. I turn over on my stomach and the procedure is repeated. She then takes out a red light to look more closely at the outlined marks, she says that any suspicious cells will show up as red under the light. She shows me one, particular brown mark on my leg and I can see that it is showing up slightly red compared to others around it. The light also shows up other damage such as lack of pigmentation on parts of my legs. She finds nothing else to worry about on my body but a small mark on my lip also shows up red.

Christoffersen says that the normal procedure is to take a punch biopsy and send them away to be tested but because the one on my lip is so small she would prefer if I had that done by a dermatologist. After a biopsy is confirmed treatment is based on the doctors assessment of what method is most appropriate depending on the size and location.

Christoffersen uses Photo Dynamic Therapy, a combination treatment using cream and red light. The light activated cream, which is left on for about three hours, targets the abnormal cells but leaves the healthy cells alone. After three hours the area is exposed to a special red light for about nine minutes.

The skin will appear red for about ten days then the superficial layers of skin dry and peel similarly to that of a sun-burn. The advantages of this type of treatment is that there is no cutting and no scarring.

Before we finish up, Christoffersen uses a laser camera to take pictures of the couple of marks on my legs. The camera, developed in Australia, gives exact measurements of spots so that they can be kept track off and the patient and the doctor have a record for future reference. She says that the main thing is to have these things caught and treated in time; so although I am concerned that I have suspicious marks, if I had kept procrastinating it might have gotten worse and it does point out that health awareness months do push people into getting themselves examined.

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