The Catalyst Issue 3 | Spring 2009 | Page 26

> Skin Care continued
“ The incidence of melanoma has gone up dramatically over the past several decades . But the death rate has been fairly stable because we ’ ve been able to detect it and remove it early .”
— Dr . Butler
directly to sun exposure . Dr . Butler says that melanoma can occur inside the mouth , on the palms of hands and soles of feet — places that seldom receive direct sunlight . “ There seems to be some link between sun exposure and the development of melanoma ; we ’ re just not sure exactly what the link is ,” he says . “ We think melanoma may be more related to the development of sunburns than to chronic sun exposure .” Individuals who had severe sunburns as children have an increased risk of developing melanoma as adults .
Melanoma most often appears as a mole , and Dr . Butler says the best defense is to watch for new moles on your body and look for changes in existing ones ( see sidebar , page 27 ).
Protecting your skin All types of skin cancer can be recurring . It ’ s vitally important to do what you can to prevent them , even if you ’ ve already been diagnosed with skin cancer . Dr . Butler says fewer skin cancer cases would occur if people spent less time in the sun , particularly during midday . “ The worst rays , the most potent rays that affect the skin , are present in the middle part of the day , between 10 a . m . and 3 p . m .,” he says .
“ We dermatologists feel very strongly that avoiding the sun is important ,” says Dr . Butler . While that may seem virtually impossible in a place like Texas , there are important facts people should know and steps to take to minimize risk .
People with fair or freckled skin , and blonde or red hair , who burn rather than tan in the sun , are at greater risk for skin cancer , says Dr . Butler . However , even people who tan should , like their fairer counterparts , take precautions in the sun . “ If you ’ re planning to be outdoors , especially if you ’ re enjoying some sort of sport like fishing or golfing , you need to plan to protect your skin from the sun ,” he says .
The most basic forms of protection are clothing and sunscreen . Dr . Butler believes the number of skin cancer cases has jumped in recent decades in part because people spend more time in the sun wearing fewer clothes . “ A hundred years ago , when people went to the beach they actually covered up ,” he says . “ Nowadays , swim suits are almost nonexistent .” Also wear a hat to cover the face and neck — areas most exposed to the sun and where most skin cancers appear .
Use a sunscreen with a sun protection factor ( SPF ) of 30 or more . “ Apply it liberally before sun exposure , and reapply it every two hours you ’ re outside ,” says Dr . Butler . Sunscreen lotion protects against the ultraviolet radiation in sunlight that damages the skin . Ultraviolet B ( UVB ) rays penetrate less deeply than Ultraviolet A ( UVA ) rays , but still damage the DNA in skin cells . “ Over time , this increases the risk of skin cancer ,” he says . UVA rays accelerate the skin ’ s aging and may contribute to the development of skin cancer .
All people — especially those at high risk — should undergo an annual skin cancer screening from their dermatologist .
A team approach to treating skin cancer
Surgery is the preferred treatment for all skin cancers . Dr . Butler says dermatologists can remove most skin cancers in their clinic , often using an advanced procedure called Mohs surgery , a targeted outpatient procedure that is most effective for treating recurring basal cell and squamous carcinomas that haven ’ t spread to other parts of the body . The precise procedure spares as much healthy tissue as possible and uses microscopic analysis to ensure complete removal of the cancer , some of which may not be immediately visible to the eye .
Treatment for melanoma may involve surgery , radiation therapy and even chemotherapy . Larger moles or lesions on sensitive places such as eyelids get referred to the Division of Plastic Surgery . Plastic
26 THE CATALYST Spring 09