Expert Advice

The Baltimore Sun

Skin cancer is the most common type of cancer and melanoma is its deadliest form. "In 2007, over 100,000 new cases of melanoma will be diagnosed, with over half of them being invasive [beyond the top layer of the skin]," says Dr. Jennifer Cooper, a dermatologist at the University of Maryland Medical Center. "Over 8,000 people are expected to die from melanoma this year. So educating people [about] what to look for and when to see their doctor is critical so that skin cancer can be detected in early stages."

What should everyone know about skin cancer?

Over 1 million cases of skin cancer will be diagnosed this year. The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Both basal cell and squamous cell carcinoma of the skin have an excellent prognosis ... if detected and treated early. Melanoma is the most serious form of skin cancer.

What's the biggest mistake people make with their skin in summer?

They use sunscreen but don't use enough and forget to reapply. Sunscreen needs to be reapplied at least every two hours. They also forget sunscreen should be used in conjunction with other sun protective measures such as broad-brimmed hats, protective clothing and umbrellas. ... I prefer to recommend at least SPF 30 since people tend not to apply sufficient amounts to their skin. It takes one full ounce (the amount to fill up a shot glass) of sunscreen to sufficiently cover skin if a person is wearing a bathing suit. ... If a bottle is lasting all summer, you are not using nearly enough.

What's a misconception about skin cancer?

That it only happens to older individuals. There are studies suggesting that there is increasing incidence of non-melanoma skin cancer in younger individuals, especially in women. There is also the misconception that only sunburns contribute to skin cancer and that a tan is protective. Both a tan and a sunburn are a response to injury of the skin by ultraviolet radiation. ... There is really no safe way to tan using ultraviolet light.

What's the most important method of prevention?

Sun protection is the one intervention we all can make. We can't change whether we are fair-skinned or have light hair and eyes. [But we can be] applying sunscreen 30 minutes before going out, ... seeking shade under umbrellas or trees, ... avoiding the sun at its peak hours between 10 a.m. and 3 p.m. Tanning booths are just as dangerous as natural sunlight and should never be used. For people who insist that they have to have a tan, I suggest using a self-tanner, with the caveat that the color they get is not protective.

To what degree do people with dark skin need to worry about skin cancer?

Individuals with dark skin types are less likely to develop skin cancer than more fair individuals. However, it does happen. Melanoma in blacks and Hispanics is more likely to be diagnosed at a later stage than in whites. Since skin cancer does happen in all colors of skin, it is advisable to employ the same sun protective measures.

What should people look for and when should they see a doctor?

People should examine their skin monthly and become familiar with their moles. Both basal cell and squamous cell skin cancer can look like a sore or pimple or scaly spot that just does not seem to heal. They may bleed easily. Melanoma can arise in a mole that a person already has or arise on normal skin. When looking at your moles, you want to follow the ABCDE rule, which can help with warning signs for melanoma.

A-Asymmetry -- In a normal mole, the sides should match if you folded it in two.

B-Border -- The edges of the mole should be smooth, not irregular or notched.

C-Color -- Pigment should be even; if the color is not uniform or has multiple colors, see your doctor.

D-Diameter -- Most melanomas are greater than 6 mm in diameter, but if a smaller mole looks unusual or is changing, see your doctor.

E-Evolution -- Any changing or symptomatic (itch, bleed, etc.) mole should be brought to the attention of your doctor.

Michelle Deal-Zimmerman

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