Dermatologists see ultraviolet radiation as the primary cause of skin cancer. The sun’s damaging rays also contribute to signs of aging, such as wrinkles, sagging, pigmentary changes and sallowness in sun-exposed skin.

Solar radiation and exposure to sunlamps and sun beds are now listed as known human carcinogens, and dermatologists express concern about the lack of regulation in the industry. The lamps in tanning units can emit 25 times more damaging ultraviolet light than the equivalent amount of sunlight.

Skin cancer

Due in large part to overexposure to harmful rays, more than one million new cases of skin cancer are diagnosed each year in the United States, a 15-20 percent increase over the last decade. Most of these cancers are basal cell carcinoma, followed by squamous cell carcinoma and melanoma. Basal cell carcinoma is by far the most common type of skin cancer, and is usually easily curable.

Malignant melanoma is the least common, but potentially the most serious type of skin cancer. It can develop the capability to metastasize early in its course and become life-threatening. Melanomas usually show some or all of the “ABCDs”: Asymmetry, Border irregularity, Color irregularity, and Diameter greater than 6mm - about the size of a pencil eraser. Any mole which shows a change in size or color, rapid growth, or a tendency to itch, burn, bleed, crust, or hurt should cause concern. It should be noted, however, that most melanomas cause no discomfort.

Among the risk factors for melanoma are fair skin, prolonged sun exposure, blistering sunburns in childhood, a family history of melanoma, and the presence of irregular moles or large numbers of normal-appearing moles. More specifically, fair skin, an inability to tan, blond or red hair, blue or green eyes, and freckles are all associated with a greater risk.

Mohs’ surgery

One of the most advanced treatments for non-melanoma skin cancer is Mohs’ micrographic surgery. According to Dr. Peter Simoneaux, who specializes in dermatologic surgery and the Mohs’ technique, the cure rates can be as high as 99 percent.

Mohs’ micrographic surgery is a highly specialized treatment developed by Dr. Fredric Mohs for the total removal of skin cancers using microscopically controlled excision. Because skin cancers can spread beyond their apparent borders on the skin surface, this specialized surgical technique uses precise orientation and careful microscopic examination and mapping of the entire periphery of specimens to locate any residual cancer, which permits the removal of just those areas and avoids the unneeded removal of normal skin.

“Hospitalization is rarely needed with Mohs’ surgery,” says Dr. Simoneaux who performs the procedure entirely in his Covington office. High cure rates mean fewer additional treatments and, since the surgery can be performed under a local anesthetic, the risks of sedation and time lost in recovery can be avoided.

Protection

Education and prevention are essential to reducing the risk of skin cancer. The Environmental Protection Agency has created the Sunwise School Program to help educate children about the dangers of excessive sun exposure.

Sun-protective topical medications include sun blocks and sunscreens. A sun block contains a compound, such as titanium dioxide, which physically blocks ultraviolet light from the skin. Sun blocks can be less irritating than PABA-containing sunscreens, which act to absorb the ultraviolet light and prevent it from reaching the skin.

The Sun Protection Factor of a product measures its effectiveness. The SPF is a ratio of the time one can spend in the sun before burning compared with the time without the product. Thus, an SPF of 4 allows someone to spend four times longer in the sun before burning, an SPF 15 would allow one to spend 15 times as long in the sun before burning. An SPF of 15 theoretically blocks about 93 percent of the ultraviolet light reaching the skin.

For those with sensitive skin, and for infants, a sun block containing titanium dioxide may be preferable to a sunscreen. Burning around the eyes is common with all sunscreens, and can be avoided by using UV-protective sunglasses and a hat to cover the forehead, thus avoiding application of sunscreen to these areas. Lip balms with sunscreens can protect the lips.

Clothing is another helpful adjunct to the use of sunscreens. A broad-brimmed hat, long-sleeved shirts and long pants offer sun protection without the inconvenience and cost of sunscreen application, but may be impractical in hot, humid climates like Louisiana.

For more information on Mohs’ micrographic surgery call Dr. Simoneaux at 892-4551.

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