May is Melanoma Awareness Month. Melanoma is the deadliest form of skin cancer and anyone is susceptible to developing it. It is our duty to help increase awareness of the importance of the prevention, early detection and treatment of skin cancer.

Each year, approximately two million people in the United States are diagnosed with non-melanoma skin cancer, with the majority being either basal cell or squamous cell carcinomas. In addition, melanoma has tripled over the past three decades and is currently one of the top 10 causes of new cancer cases.

We encourage everyone to be aware of the four warning signs for keeping skin healthy:

• A for Asymmetry – if one half of a mole is different than the other half
• B for Border Irregularity – if the mole’s edges are uneven, blurred or notched
• C for Color – if the mole’s color is uneven and has shades of black or brown
• D for Diameter – if the mole’s diameter is greater than 6 milimeters

“It is important to pay attention to your skin so it’s easier to recognize changes that may need to be examined,” said George Keough, MD. “A sudden or continuous change (including any of the ABCD’s) in the appearance of a mole is a sign to contact a dermatologist immediately.”

During the upcoming summer months, stay in the shade and do not go in the sun without SPF 30 or higher, with both UVA and UVB protection. Please feel free to contact us if you have any questions regarding skin cancer or protection.

Melanoma is an ugly word, but even uglier are its effects on your body. The most serious cancer of the skin, melanoma begins in the melanocytes (pigment-producing cells) and shows up in the skin because that is where these cells are mostly found. While one in 50 Americans is at risk for developing melanoma at some point in his or her lifetime, you might be surprised to hear that the demographic being most affected by this type of cancer is actually younger adults and teens.

In fact, melanoma is the number one cancer in young adults ages 25 to 29 years old and the second most common cancer in adolescents and young adults ages 15 to 29. About 65% of melanoma cases can be traced to overexposure to ultraviolet or UV rays from natural or artificial sources. This means sunlight and indoor tanning beds are partly to blame. Other factors that can play a part are family history, genetics and environment. Even if you don’t actively tan, it’s still important to realize that melanoma can pop up in melanocytes all throughout the body, even ones which have never been exposed to the sun.

So what does all of this mean for you, especially if you or someone you love is a young adult/teen with a greater risk? It is first important to learn preventative measures and then adhere to them as much as you can.

Practice Safe Sun
• Apply sunscreen generously to all skin that is exposed.
You might think this is only something you do while on vacation or lounging at the pool during summer months, but actually, this should be a daily ritual year-round, even on cloudy or overcast days. Make sure the sunscreen you use offers broad-spectrum protection from both UVA and UVB rays. Also, choose a sunscreen with a sun protection factor (SPF) of 30 or higher. Read ingredients and select products which contain titanium dioxide and mexoryl. These block UVA rays better.

When we say apply generously, it means generously! In order to protect your entire body, use about an ounce of sunscreen (picture a full shot glass) and make sure to apply it at least 20 minutes before exposing your skin to the sun. When swimming or sweating under the sun’s rays, reapply sunscreen every couple of hours. Even if your bottle says waterproof, it will need to be reapplied throughout the day.

• Wear clothing that protects your skin
This could be a long-sleeved shirt, pants and a wide-brimmed hat if possible. Lighter colors will help you keep cooler even on the hottest days.

• Be aware of the sun’s intensity
The sun’s rays are most intense during the hours of 10 a.m. and 4 p.m. so try to be most careful during these times.

• Pay special attention when near water, snow and sand
These elements can reflect the sun’s damaging rays and this has the potential to increase your chances of a sunburn.

• Speaking of sunburns…
Avoid them at all cost! Severe sunburns, especially the ones you might have gotten as a child, can increase your risk of developing melanoma and other types of skin cancer. Even one sunburn which included blisters can double your chances of melanoma later in life.

• Don’t be fooled into thinking tanning is better than burning
We understand that everyone would like to be a bronzed goddess, but there are just too many other ways to achieve this look besides tanning. Current research shows that there is no way to get a tan through UV exposure without increasing the risk for skin cancer. Spray tans, self-tanning creams and bronzers can help you achieve the same results without the risk factors.

• Vitamin D comes in supplement form
We’ve heard so many people say they need to be in the sun to get that necessary vitamin D, but in reality, you can get a daily dose of this important vitamin in the form of supplements, all the while sparing your skin.

• Don’t let your medicine chest put you at greater risk
Some prescription and over-the-counter drugs have the potential to increase your skin’s sensitivity to the sun. Be aware of what medicines you are taking and their side-effects. Watch your time in the sun depending on when you are taking them.
Early Detection

In addition to these preventative measures, it is also important to check your skin for anything that doesn’t seem right. Research has shown that patients are more likely to spot a melanoma on their own bodies. Skin cancer is one of the easiest cancers to detect in its early stages because the signs are visible on the skin.

Monthly self-exams should consist of looking over the entire body, including the back, scalp, soles of feet and palms of hands. Any changes in size, color, shape or texture of moles should always be noted and shared with a dermatologist. Annual check-ups with a dermatologist are also necessary to keep track of everything going on with your skin.

While the statistics might sound scary, there’s no need to live in fear about melanoma. Through education, awareness, prevention and early-detection, it is possible to have healthy glowing skin and the team here at Knoxville Dermatology Group is here answer your questions and give you peace of mind.

Schedule an appointment today with one of our board certified physicians to get your skin on the road to better health!

Contact Knoxville Dermatology Group at 865.690.9467.

Since May is “Melanoma/Skin Cancer Detection and Prevention Month,” our Skin School will be posting a series of articles to explore this topic in-depth.  The first line of defense against skin cancer is prevention and our team of physicians at Knoxville Dermatology Group find knowledge is our most powerful weapon.  Therefore, our goal is to provide our clients (current and potential) with resources to answer dermatologic questions as well as increase awareness about skin diseases such as melanoma and skin cancer.

Skin cancer is the most common form of cancer in the United States. The two most common types, called basal cell and squamous cell carcinomas, are highly curable. But melanoma, the third most common skin cancer, is more dangerous.

Who Can Get Skin Cancer?
Anyone can get skin cancer, but some things put you at higher risk, like having—

• A lighter natural skin color.
• A personal history of skin cancer.
• A family history of melanoma.
• Exposure to the sun through work and play.
• A history of sunburns early in life.
• Skin that burns, freckles, reddens easily, or becomes painful in the sun.
• Blue or green eyes.
• Naturally blond or red hair.

RISK FACTORS
Ultraviolet (UV) Light

Ultraviolet (UV) rays are an invisible kind of radiation that comes from the sun, tanning beds, and sunlamps. UV rays can penetrate and change skin cells.

As found on the Skin Cancer Foundation website, the three types of UV rays are ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC)—

• UVA is the most common kind of sunlight at the earth’s surface, and reaches beyond the top layer of human skin. Scientists believe that UVA rays can damage connective tissue and increase a person’s risk of skin cancer.
• Most UVB rays are absorbed by the ozone layer, so they are less common at the earth’s surface than UVA rays. UVB rays don’t reach as far into the skin as UVA rays, but they can still be damaging.
• UVC rays are very dangerous, but they are absorbed by the ozone layer and do not reach the ground.

Too much exposure to UV rays can change skin texture, cause the skin to age prematurely, and can lead to skin cancer. UV rays also have been linked to eye conditions such as cataracts.

UV Index

Developed by The National Weather Service and the Environmental Protection Agency, the UV Index lets you know how much caution you should take when working, playing, or exercising outdoors.

The UV Index predicts exposure levels on a 1–15 scale; higher levels indicate a higher risk of overexposure. Calculated on a next-day basis for dozens of cities across the United States, the UV Index takes into account clouds and other local conditions that affect the amount of UV rays reaching the ground.

Tanning and Burning
When ultraviolet (UV) rays reach the skin’s inner layer, the skin makes more melanin. Melanin is the pigment that colors the skin. It moves toward the outer layers of the skin and becomes visible as a tan.

A tan does not indicate good health. A tan is a response to injury, because skin cells signal that they have been hurt by the sun’s UV rays by producing more pigment.

People burn or tan depending on their skin type, the time of year, and the amount of time they have spent in the sun. According to the American Academy of Dermatology, the six types of skin, based on how likely it is to tan or burn, are—

• I: Always burns, never tans, sensitive to sun exposure.
• II: Burns easily, tans minimally.
• III: Burns moderately, tans gradually to light brown.
• IV: Burns minimally, always tans well to moderately brown.
• V: Rarely burns, tans profusely to dark.
• VI: Never burns, deeply pigmented, least sensitive.

Although everyone’s skin can be damaged by too much sunlight, people with skin types I and II are at the highest risk.

SIGNS & SYMPTOMS

Warning Signs: The ABCDEs of Melanoma

Moles, brown spots and growths on the skin are not always harmless. Anyone who has more than 100 moles is at greater risk for melanoma. The first signs can appear in one or more atypical moles. That’s why it’s so important to get to know your skin and to recognize any changes in the moles on your body. Look for the ABCDE signs of melanoma, and if you see one or more, make an appointment with a physician immediately.

Asymmetry: The mole is asymmetrical.
Border: The borders of an early melanoma are uneven and edges may be scalloped.
Color: A variety of colors is a strong warning. Different shades of brown, tan or black
could appear; Melanoma may also become red, blue or another color.

Diameter: Melanomas usually are larger in diameter than the size of an eraser on your pencil (1/4 inch or 6 mm), but they may sometimes be smaller when first detected.

Evolving: Any change — in size, shape, color, elevation, or another trait, or any new symptom such as bleeding, itching or crusting — points to danger.

According to the Skin Cancer Foundation, the ABCDE rule helps detect many melanomas but some melanomas do not exhibit the ABCDE features. Recently, several melanoma specialists developed a new method of sight detection for skin lesions that could prove to be melanomas. This method is based on the concept that these melanomas look different – they are “ugly ducklings” – compared to surrounding moles. The premise is that the patient’s “normal” moles resemble each other, like siblings, while the potential melanoma is an “outlier,” a lesion that, at a given moment in time, looks or feels different than the patient’s other moles, or that over time, changes differently than the patient’s other moles. The “ugly duckling” methodology may be especially useful in the detection of nodular melanoma, a dangerous type of melanoma, which notoriously lacks the classic ABCDE signs.

Thus, during skin self-examination and professional examination, patients and physicians should be looking for lesions that manifest the ABCDE’s, AND for lesions that look different compared to surrounding moles. An approach combining the ABCDEs and the “Ugly Duckling” technique should improve the chances of early detection of all types of melanoma.

TREATMENT

MOHS Surgery

Mohs Surgery is used for most common types of skin cancers, namely basal and squamous cell cancers.

Since 1971, Knoxville Dermatology Group prides itself in the quality and variety of services its Board Certified dermatologists provide to their patients. In particular, the MOHS procedure is performed in our state-of-the-art MOHS Surgery Center.

The American Society of Mohs Surgery describes Mohs Surgery as the “surgical procedure of removing skin cancer and other malignancies followed by a microscopic examination of excised tissue to ensure the malignant tissue has been completely removed.”  After the first layer of cancerous tissue is removed by the physician, a corresponding diagram is drawn to “ensure proper orientation on the patient,” and the technician “sections and stains the tissue to prepare a microscope slide.” Afterward, the physician studies the slide to determine which sections are still cancerous.  Once the lesion and all cancerous roots have been removed, the physician closes the “surgical defect.”

In other words, the main goal is to remove the skin cancer without leaving a noticeable scar and preserve healthy tissue.

According to the American College of Mohs Surgery, there is a very low chance that skin cancer will recur following the procedure. Cure rates have been reported as high as 96%-99%.

Prompt action is your best protection.

Preventing Skin Cancer
Take precautions against sun exposure every day of the year, especially during midday hours (10:00 a.m.–4:00 p.m.), when UV rays are strongest and do the most damage. UV rays can reach you on overcast days as well as reflect off of surfaces like water, cement, sand, and snow.

• Seek shade, especially during midday hours.
• Cover up with clothing to protect exposed skin.
• Wear a hat with a wide brim to shade the face, head, ears, and neck.
• Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.
• Put on sunscreen with sun protective factor (SPF) 15 or higher, and both UVA and UVB protection.
• Avoid tanning beds and sunlamps. The UV rays from them are as dangerous as the UV rays from the sun.

Schedule an appointment today with one of our board certified physicians to gain more knowledge about your skin so it can reach its fullest, healthiest potential!

Contact Knoxville Dermatology Group at 865.690.9467.