A screen to protect against skin cancer

Thailand is the land of sun, sand and smiles, making it popular with holidaymakers. But too much of that golden sunlight can be bad too. How much exactly is too much? That’s a question that has yet to be answered but we do know the amount of sunlight you can safely soak up depends on your genes and your lifestyle. We also know that the only weapons to fight llife-threatening skin cancer are knowledge, prevention, early detection and treatment.
    The sun’s UV rays penetrate the skin and cause melanocytes to reproduce abnormally. This leads to melanoma. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common.
    Melanin is responsible for the colour of our skin. Thus, lighter-skinned individuals, that is, those with lesser melanin to begin with, are at greater risk of contracting the rather aggressive malignant melanoma.
    However, those with darker skin could also be affected, especially on the palms and feet. Men are slightly more likely to contract malignant melanoma than women. Such risks are exacerbated by many factors including exposure to ultraviolet (UV) rays and to radiation, which includes X-rays and hydrocarbons. Smoking, drugs and infections tend to suppress the body’s immune system and increase the risks. Exposure to chemical toxins such as arsenic found in herbal remedies, repeated sunburn, and a family history of melanoma are also considered risk factors.
    Genes have been found to play a vital role in determining whether you contract skin cancer. A person with a close relative, such as parents and siblings, with melanoma is 2-3 times more likely to contract skin cancer than the rest of the population. This risk increases by 30-70 times if there are multiple close relatives with melanoma.
    However, skin cancer is highly preventable and largely curable, especially if it is detected and treated early. Experts recommend that from the age of 10, people who belong to high risk groups should visit a specialist for a professional skin examination at least annually. Other high risk groups such as light-skinned males aged 50 and above and those with multiple or atypical moles should also undergo such an examination.
    The Australian Cancer Network and the Skin Cancer Foundation recommends a bi-annual full body skin examination for high-risk individuals and monthly head-to-toe skin self-examination for the general public so that they can identify any new or changing lesions that might be cancerous. The monthly head-to-toe skin self-examination must be thorough and cover every inch of skin, not just those limited to areas exposed to the sun. The front and back of the ears, the scalp, between fingers and under fingernails, armpits, (for women: under the breasts), palms and soles, even the genitalia should be examined carefully.
    While the examination aims to identify any skin abnormality, particular attention should be paid to moles, if any. New moles or changes in existing ones should be brought to a doctor’s attention. In this context, it is helpful to remember the ABCDE rule. Asymmetry of moles should be considered a sign that medical attention is needed. Border irregularity in moles is another indicator of trouble, so watch for jagged borders. Colour variation is also troubling; a harmless mole will be uniform in colour. Diameter is also critical; if your mole is larger than 6 mm in diameter, it should be brought to your doctor’s attention. Enlargement is another red flag; if a mole on your body has increased in size it should be medically examined.
    Experts suggest that anyone who notices changes in their skin or in the appearance of moles or changes in the character of existing moles should schedule a medical screening to determine if any of this could be an indication of skin cancer. Screening techniques such as FotoFinder are continuously being developed for an approved accuracy of diagnosis.
    Other preventive measures can also be adopted. Avoiding UV exposure that causes sunburn, especially at mid-day, is one such precaution. If you cannot stay out of the sun during this time of the day, wear clothes that will help protect your skin, and cover your head and face with wide-brimmed hats and UV-resistant sunglasses. The American Academy of Dermatology recommends the application of sunscreen that has a sun protection factor (SPF) of 30 or higher and that offers broad spectrum protection (from both UVA and UVB) and is water resistant as well. This is an essential tool in reducing the risk of skin cancer, especially melanoma.
    The Skin Cancer Foundation cautions against prolonged exposure to the sun in order to obtain Vitamin D. For light-skinned individuals, 20-30 minutes of sunlight in a day is enough to ensure that your body gets its required amount of Vitamin D. For a darker-skinned individual, this exposure could be extended to 2-3 hours. Any longer and the risk of skin cancer increases significantly.
    Quitting smoking is also a smart move since smoking is considered a risk factor for skin cancer. The use of tanning lotions instead of a sun bed and ensuring that any herbal remedy you imbibe, for whatever reason, is free of toxins such as arsenic is also advisable.




Dr Bussakorn Mahakkanukrauh, MD, is dermatologist at Samitivej Sukhumvit Hospital. Call (02) 711 8700-2.