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May is Skin Cancer Awareness Month. With summer on the horizon, it's a good time to learn about protecting our skin while we're outdoors.
Exposure to the sun’s harmful rays can damage your skin and your eyes, as well as cause skin cancer, including melanoma.
Swedish physicians provide advice for protecting your skin to help you and your family lower your risk of sun damage and skin cancer.
Summer is around the corner. For many of us, that means we’re getting ready to enjoy the warmer weather, brighter skies, and as many outdoor adventures as we can. These days are often called the carefree days of summer, but it's important to remember that your skin is among the things that definitely need care during those warm sunny days.
As wonderful as it can be to feel the warm sun on your skin, those same rays of sunlight — and their ultraviolet (UV) radiation — can cause skin damage from the moment you step outside. Over time, this can increase your risk of skin cancer, including melanoma. May is Skin Cancer Awareness Month, so we asked some Swedish experts to share information about ways to protect ourselves and our loved ones.
Melanoma is a serious form of skin cancer that begins in cells known as melanocytes (which produce melanin to give skin its pigmentation). It’s less common than other types of skin cancer — it’s responsible for only 1% of cases. Still, it’s more dangerous because it is a type of skin cancer that is more likely to spread to other organs if not treated early. Sun damage accounts for about 90% of all skin cancers, including melanoma. Family genetics may play a role, but only for a small number of people.
“Exposure to ultraviolet radiation from the sun increases your risk of getting melanoma, especially if you had sunburns during childhood,” says Kelly Paulson, M.D., an expert in melanoma and a medical oncologist with Swedish Cancer Institute. “The UV light hits the melanocytes and damages them. As a result, the cells forget their genetic programming and start to grow out of control and spread.”
You’re exposed to two types of UV rays daily, she says. Ultraviolet A rays have a shorter wavelength. Although they’re slightly less dangerous, more of these rays break through the atmosphere to impact your skin. Ultraviolet B rays have longer wavelengths, making them stronger and more damaging. Fortunately, the ozone layer absorbs most of them.
Keep in mind, that the sun isn’t the only source of UV radiation.
“Tanning beds are more dangerous than the sun because they use more UV radiation and the UVA rays penetrate the skin deeper,” says Dr. Paulson.
The importance of sunscreen?
Everyone should wear sunscreen year-round, even if it’s cloudy and cold outside. But sunscreen is vital in the summer months since that’s when UV rays are strongest. It’s also when your skin is the most exposed.
Two different types of sunscreens are manufactured in the United States, and both provide good protection. These types include:
- Mineral-based. These contain a metal such as zinc or titanium that reflects the sun’s light away from your skin.
- Organic (chemical) based. These contain organic compounds that cause a chemical reaction when exposed to the sun. The reaction transforms UV rays into heat, which is released from the skin.
These sunscreens protect all skin tones, Dr. Paulson says.
“Melanoma is most common in non-Hispanic whites,” she explains. “But even people with very dark skin can get melanoma. Since skin with more pigmentation makes melanoma harder to spot, they can often have a later diagnosis and worse outcomes.”
The right sunscreen for you
The best sunscreen for you is the one you will use. If you don’t like applying sunscreen with your hands, buy one with a spray applicator. If it just doesn’t feel like summer without a coconut-scented sunscreen, by all means, stock up.
Select a sunscreen labeled “broad-spectrum,” says Michael Baze, D.O., a dermatologist at Swedish Dermatology – Bellevue, because it protects against the UVA and UVB rays that can damage skin. Whatever brand or application method you choose, be sure the sunscreen has a sun protection factor of at least 30. Ones with higher SPF are available, but the added level of protection is minimal.
“Between an SPF 30 and SPF 50 sunscreen, you may get 1% additional UV protection — going from 97% to 98%,” he says. “The recommendation is SPF 30 and do your best to reapply it every two hours while you’re outdoors.”
“Applying sunscreen to every area that’s exposed can help you avoid cancers that lead to surgery and radiation,” she says. “These treatments can lead to quality-of-life issues, such as significant scarring and even tissue removal.”
Sunscreen application tips
Dr. Paulson notes that applying sunscreen isn’t necessarily a one-and-done operation. She encourages people to:
Apply sunscreen before going outside — about two tablespoons should be enough for your entire body.
Reapply every two hours if you are sweating or swimming.
- Get good coverage across all exposed areas of your body. Find a sunscreen buddy who can make sure your back and scalp are covered.
- Keep sunscreen handy — at home, in the car, in your pool bag, etc.
- If you’re driving, be sure to apply sunscreen to the left side of your body — you’ll get more exposure in the driver’s seat.
- If you expect to spend time in the water or sweat excessively, use a sport or water-resistant sunscreen (you’ll still need to reapply it every two hours to ensure good coverage).
- Avoid peak sunlight hours between 10 a.m. and 4 p.m. when possible — that’s when the sun is highest and can do the most damage to your skin. In fact, Dr. Baze says, the intensity of the sun’s rays nearly quadruples during those hours.
“Someone that is outside at 9 a.m. could be out for an hour and get the same amount of UV radiation as someone who is outdoors at 1 p.m. for 15 minutes,” he says. “So, be sure you limit your outdoor activities during those peak hours.”
Dress for success
Sun-reflective or UPF (ultraviolet protective factor) clothing. This can protect you from the sun’s harmful rays, as well. When dressing for the outdoors, choose clothing with:
- Vivid colors. These absorb more UV light than light-colored clothing, so UV rays are less likely to reach your skin.
- Dense fabric. A tighter knit blocks the rays from getting through.
- Synthetic materials, such as polyester and nylon. These are more protective than cotton or rayon.
Dr. Paulson recommends sun-reflective clothing, which blocks ultraviolet light and protects against melanoma and other skin cancers.
“There are so many varieties now — long-sleeve shirts, shorts and pants, neck gaiters, even gloves,” she says. “I like rash guard swim shirts, which can protect your skin from the sun in places where sunscreen is likely to wash off.”
Protect your head, neck and eyes
Don’t forget to top off your outfit with something that protects your head. But remember, not all hats are created equal. For example, baseball caps cover your head and shield your face, but leave your ears and neck exposed. Consider a broad-brimmed hat, which will protect your skin from the neck up.
Melanoma can develop in the eyes, too, so be sure to wear sunglasses with UV protection. Wear them whenever you’re outside because reflected sun rays can also hit your eyes.
"You don’t have to look into the sun. The rays bounce off the car that’s in front of you, the pavement, as well as the water,” Dr. Baze says. “Even when you’re looking away from the sun, you’re still going to have ultraviolet radiation sent in your direction.”
That’s a problem, he says. The more exposure you have, the greater your risk of developing cataracts and skin cancer of the eyelid or skin around your eye.
Not all sunglasses do a great job of protecting your eyes, though. Look for ones that specifically say the lenses offer UV protection.
“It’s not enough to have tinted lenses. When our eyes are in the shade, our pupils dilate and let more ultraviolet radiation through,” he says. “So, you must find sunglasses that block UV rays.”
In addition, choose ones that offer wrap-around coverage. Frames that are large enough to cover your eyes and the surrounding skin can reduce your skin cancer risk.
Remember to protect your children, too
The more sunburns a person gets at a young age, the higher their risk for melanoma. That’s why it’s so important for parents to protect their young children from the sun and educate them about skin cancer prevention.
- Keep babies younger than 6 months out of direct sunlight.
- Older infants and children should wear brimmed hats, UV protection sunglasses and tightly woven clothing while in the sun.
- Discourage children from tanning.
- Set a good example by protecting your own skin from the sun!
- Help kids apply sunscreen, even if they insist, they can do it on their own.
For more ways to protect your kids’ skin from the sun, check out this advice from the American Academy of Pediatrics.
How to spot melanoma
An annual check-up by a dermatologist can help detect any signs of skin cancer in the early stages. It’s important to perform regular self-exams, too. When melanoma is detected early, the estimated survival rate is 99%.
When checking your skin for suspicious spots, remember your ABCs. Look for these typical characteristics:
Asymmetry: An irregular shape, such as one that has a smaller or bigger half.
Border: A border that isn’t smooth — it can be notched or wavy.
Color: More than one color or uneven color distribution throughout the spot.
Diameter: A size equal to a pencil eraser — approximately one-fourth of an inch.
Evolution: Changes in size, color, or shape over time, as well as new symptoms, such as bleeding.
Advances in treating melanoma
Your treatment choices are determined both by the size and stage of your cancer and whether it’s spread. Typically, surgery works well for most early-stage cancers, but the advanced disease may require radiation and chemotherapy.
Within the last two years, however, the U.S. Food & Drug Administration has approved new leading-edge therapies:
Immune checkpoint inhibitors: These drugs target proteins in your immune cells that must be turned on or off to respond to melanoma cells. When these medications are paired with surgery, they reduce the likelihood that melanoma cells will return by half and extend life.
Tebentafusp: This medication, also known as KIMMTRAK®, is designed to treat ocular melanoma, melanoma that affects your eyes. The drug activates your immune cells and pushes them to recognize melanoma cells as a threat and attack cancer.
Combination immunotherapies: This group of new combination immunotherapies can treat various cancers based on the features of the exact melanoma you have, your goals and wishes, and the level of aggressiveness needed.
“These immunotherapies can be effective even for patients with stage 4 melanoma where the cancer has spread to the brain,” she says. “Many times, we can get their melanoma in remission and have it stay that way for many years.”
In addition to caring for patients with skin cancer, Dr. Paulson conducts melanoma research. In 2019, she co-authored a research study showing that from 2006 to 2015 in the United States, melanoma incidence decreased overall among people ages 10 to 29.
“Young people seem to be getting the message about protecting their skin from the sun,” she says. “Unfortunately, melanoma rates are rising in older adults. We need to continue to spread the word about sun protection so that people of all ages can avoid skin cancer.”
Find a doctor
If you have questions about melanoma or protecting yourself from the sun’s rays, contact the dermatology department at Swedish. We can accommodate both in-person and virtual visits.
Learn more about Swedish Cancer Institute's medical-oncology team.
Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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