5 Steps to Prevent Skin Cancer
Using these sun smarts today can help stave off skin cancer tomorrow.
The ozone layer is shrinking, the rates of skin cancer are rising and you can still recall the blistering sunburns you had as a kid or those deep dark tans you (regrettably) worked so hard on as a teen. But does that mean you're doomed to get skin cancer? Absolutely not. "Careful sun avoidance and safe sun practices at any age can greatly reduce your risk," says Barbara Gilchrest, M.D., professor of dermatology at Boston University School of Medicine. Nearly 80% of your lifetime sun exposure happens after the age of 18, so it's still vitally important to protect yourself from the sun—and the havoc it wreaks on your skin. What's more, new research shows that what you consume and how you treat the damage can help further safeguard your body's largest organ. The bonus: The steps you take to ward off skin cancer also fight wrinkles and other signs of aging. Take action today.
Use Sunscreen (Correctly)
Avoiding the sun as much as possible is unquestionably the most effective way to prevent both potentially fatal melanomas and other less dangerous, but still serious, skin cancers. Ultraviolet light generates free radicals, highly charged molecules that damage cells and DNA, and suppress the cancer-fighting immune system. Experts recommend seeking the shade, heading to the pool or beach in the late afternoon (rather than midday when the sun is strongest), sporting a broad brim hat and long sleeves and wearing sunscreen—a lot of it! A recent study from Australia found that adults who were told exactly how to apply sunscreen and maintained a strict daily regimen were 50% less likely to develop melanoma than those who were told to wear sunscreen as they always had. Here's what you need to do.
Slather It On: Most people use way too little sunscreen. "If you're applying it to your face, neck and arms, you need 2 teaspoons," says Melody Eide, M.D., a dermatologist with the Henry Ford Health System in Detroit. For your entire body, use at least a shot glass full (about 1 ounce). That means a family of four should go through nearly an entire 8-ounce bottle of sunblock in just one visit to the beach—even more if you're there longer than two hours and reapplying after swimming and sweating. Studies show people tend to use one-quarter to one-half of the recommended amount, turning that SPF 30 into a 10.
Read the Labels: Buy a sunscreen with at least SPF 30 and broad-spectrum coverage, and check for these ingredients: avobenzone, mexoryl, oxybenzone, titanium dioxide and zinc oxide. Or just look for the Skin Cancer Foundation's new "Active" seal of recommendation, which is found on many brands, including Anthelios, Banana Boat Ultra Sunblock Lotion, Coppertone Sport Sunscreen and store-brand offerings from Rite Aid and Walgreens.
For Everyday Use: When you're not planning to be out for extended periods, you still should wear an all-day moisturizer with a sunscreen. Seek out the Skin Cancer Foundation's "Daily Use" seal for products that have SPF 15 and some UVA protection but are less protective than those with the "Active" seal.
A Layer of Protection: While you always need sunscreen on exposed skin, ultraviolet protection factor (UPF) clothing can protect the rest of your body. "There's no chance you'll miss a spot," says Deborah S. Sarnoff, M.D., senior vice president of the Skin Cancer Foundation. Look for UPF clothing with a rating of at least 30—a typical cotton T-shirt has a UPF of 5.
According to the latest research, diets rich in certain nutrients may reduce your risk of skin cancer and pre-cancers, says Jane Grant-Kels, M.D., director of the cutaneous oncology and melanoma program at University of Connecticut Health Center in Farmington. Certain foods help the body develop its own protective barrier from the sun, fight free radical damage and boost your immune system.
Omega Fatty Acids: Animal testing and epidemiologic studies have found that a diet rich in omega-3 and omega-6 fatty acids lowers the risk of non-melanoma skin cancers, says Dr. Grant-Kels. Two fatty acids stand out: linoleic acid (LA), an omega-6; and alpha linolenic acid (ALA), an omega-3. "LA has a positive impact on the barrier function of the top layer of skin," says Dr. Grant-Kels. "And ALA improves the function of your immune system." LA is found in many oils, including safflower, grape seed, sunflower and corn. ALA comes from green leafy vegetables, flaxseed and walnuts, as well as soybean and canola oils. Cold-water fish, such as salmon, mackerel, sardines, herring and rainbow trout, are rich in other beneficial omegas.
Green Tea: Polyphenols, the potent antioxidants in green tea, are thought to repair damaged DNA and stimulate the immune system, says Santosh Katiyar, Ph.D., senior scientist at the Comprehensive Cancer Center, University of Alabama at Birmingham. In one study Katiyar exposed mice to UV, while spiking their water with green tea polyphenols. The tea-guzzling mice had 60% to 75% fewer skin cancers than controls. "People should drink about four cups of green tea every day for the same level of prevention," says Katiyar.
Catching skin cancers early can save your skin, if not your life. The five-year survival rate for melanoma when detected before it has started to spread is 99%, but it plummets to 15% when found at an advanced stage. When non-melanoma cancers such as squamous cell and basal cell carcinomas are small, they can typically be removed with minimal damage to your skin. When they are larger, the surgery can be disfiguring, and some rare cases can even be fatal. Despite the benefits of early detection, most Americans don't do monthly skin exams or get their skin checked by a doctor. The Skin Cancer Foundation recommends that most people check their entire body (with the help of a mirror) every month. Those with a personal or family history of melanoma or dysplastic nevi (moles that are not round and uniform), or who have more than 50 moles need to see a dermatologist at least annually, says Steven Wang, M.D., director of dermatological surgery and dermatology at Memorial Sloan-Kettering Cancer Center in Basking Ridge, New Jersey, and author of Beating Melanoma (Johns Hopkins Press). Even if you have no risk factors, make an appointment with a dermatologist and discuss when to return for follow-up checkups.
Using a hand mirror, examine your skin every month for any irregular spots, freckles or moles.
Melanomas: Looking for the ABCD's (asymmetry, uneven borders, variegated color or large diameter) in moles is standard, but now experts want you to also focus on E for evolving. "We're picking up melanomas much earlier, when they're so small you can't really see borders and colors," says Dr. Wang. Any change in a mole needs to be checked by a dermatologist.
Basal and Squamous Cell Carcinomas: Non-melanomas come in many shapes and sizes. Look for an open sore that never quite heals, a reddish patch, a shiny pink or pearly bump, a pink growth with an indented center, a waxy white or yellow scar-like area, or thick, rough, scaly patches.
Actinic Keratosis (also called Solar Keratosis): You may feel these scaly or crusty sandpaper-like growths before you see them. They are believed to be precancerous versions of squamous cell carcinomas, so you'll probably want to have them treated.
Dysplastic Nevi (Atypical Moles): While they clinically look similar to melanomas, these moles are benign. But the more of them you have, the greater your risk of developing melanoma, so see your dermatologist regularly.
Age Spots (Solar Lentigines or Liver Spots): These flat or slightly raised gray, tan or brown spots sometimes resemble a cluster of freckles and are benign. "People with numerous age spots might have a lot of skin damage from the sun, but there are no studies showing that they increase a person's risk of skin cancer," says Dr. Wang.
Reversing the Damage
If your skin is freckled, sallow or wrinkled from too much sun exposure, you can remove the damage and possibly also lower your risk of cancer.
Tretinoin Topical (Brand Names Retin-A, Renova and Others): Approved for treating various skin conditions including acne and fine facial wrinkles, this prescription retinoid cream may also have an added benefit. Some dermatologists believe retinoids (the acidified form of vitamin A) could prevent skin cancer when paired with a broader regimen of sun protection and avoidance.
Chemical Peels: In addition to rejuvenating sun-damaged skin, peels can eliminate actinic keratosis, says Chad Prather, M.D., surgical director of the Louisiana State University department of dermatology. Treatment with trichloroacetic acid has been shown to significantly reduce these rough, dry patches and lower the incidence of non-melanoma skin cancers. "The chemicals strip away the sun-damaged epidermal layers and precancerous lesions," says Dr. Prather. Superficial at-home peels or light ones done in a spa setting are not deep enough to slow the progression of actinic keratosis.
Originally published in the June 2011 issue of Family Circle magazine.