Smart Sunscreen Strategy Needed to Prevent Skin Cancer

Sunset in Hawaii. (Dr. Noorali Bharwani)
Sunset in Hawaii. (Dr. Noorali Bharwani)

There are three types of skin cancers. Basal cell cancer (BCC) and Squamous cell cancer (SCC) are not lethal but can leave you with scars and deformities on your face and other parts of the body. Then there is melanoma. If not detected early and treated melanoma can be lethal.

When exposed to sunrays, some people burn easily and others slowly. Those who burn easily have a higher risk of skin cancer than others. But everybody is at some risk of getting skin cancer. So be smart and prevent skin cancer. Here are some guidelines.

Minimize sun exposure. Avoid the sun or stay in the shade when the sun is the strongest (10 a.m. to 4 p.m.), and dress right for the occasion. Wear a hat and clothing that’s made from tightly woven fabric.

Use appropriate sunscreen. The American Academy of Dermatology (AAD) guidelines recommend people use sunscreens with three important qualities:

  1. Use broad-spectrum sunscreen to protect against ultraviolet A rays and B rays. Ultraviolet A rays make up 95 percent of the UV spectrum and are most associated with wrinkling. Ultraviolet B rays, cause sunburn and are stronger at midday and in the summer. Both types of rays can cause skin cancer.
  2. Use water resistant sunscreen – no sunscreen is “water proof” but water resistant means you can go up to 80 minutes in the water before you need to reapply.
  3. Use sunscreen with SPF of at least 30.

To understand what sunscreens people actually use compared to what they need to prevent burning, the researchers looked at the most popular sunscreens on Amazon – the top one per cent, or 65 products.

The researchers found 40 percent – 26 of 65 – of the products did not meet AAD requirements. Most products that failed to meet the standards, 72 percent, did so because they were not water resistant.

A Consumer Reports study (May 2016) found only the following five met the AAD criteria:

  1. Hawaiian Tropic Sunscreen Silk Hydration SPF 30
  2. Neutrogena Age Shield Face Lotion Sunscreen SPF 110
  3. EltaMD UV Physical SPF 41
  4. Neutrogena Ultra Sheer Dry – Touch Sunscreen SPF 55
  5. Neutrogena Sunscreen Ultra Sheer Stick SPF 7

Make sure you use enough sunscreen. Apply sunscreen 15 to 30 minutes before you go outside. For lotions, a good rule of thumb is a teaspoon per body part or area.

For sprays, apply as much as can be rubbed in, then repeat. Regardless of which kind you use, reapply every two hours and after swimming or sweating. Use spray sunscreens carefully. Sprays are flammable; so let it dry before going near an open flame.

Consumer Reports article concludes by saying, “Tests over the past four years indicate that choosing a chemical sunscreen with an SPF of 40 or higher will give you a better chance of getting at least an SPF 30. Using any sunscreen is better than using none, but it’s just one part of a smart sun protection strategy.”

Take care and enjoy the summer.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Making a Mountain out of a Molehill to Prevent Skin Cancer

A boat sailing on River Nile in Aswan, Egypt. (Dr. Noorali Bharwani)
A boat sailing on River Nile in Aswan, Egypt. (Dr. Noorali Bharwani)

The other day a gentleman asked me, “Doctor B, I have a mole. Do you think I have melanoma?” I didn’t think he had a mole. I thought it was a skin tag. He said, “OK doc, tell me what does a mole look like and when should I worry about it.”

Defining a mole is not easy. People use the word very loosely to describe any blemish on the skin as a mole.

The majority of moles appear during the first two decades of a person’s life, with about one in every 100 babies being born with moles. Acquired moles are a form of benign new growths, while congenital moles, or congenital nevi, are considered a minor malformation and may be at a higher risk for melanoma. Moles are also known as nevi. Most of them have no malignant potential. But real moles and sunburns have a potential to become cancerous.

Real moles are skin growths that are usually brown or black. During sun exposure, teenage years and pregnancy, these cells multiply and become darker. They can be anywhere on the skin, alone or in clusters. Most moles appear in early childhood and by the age of 20, one can have anywhere between 10 to 50 or more moles. Some moles may appear later in life.

Most moles are benign. The only moles that are of medical concern are those that look different than other existing moles or those that first appear after age 20. If you notice changes in a mole’s colour, height, size or shape, you should have these moles checked. If the moles bleed, ooze, itch, appear scaly or become tender or painful then it is time to have them removed and checked for cancer.

The following ABCDEs are important signs of moles that could be cancerous:

  • Asymmetry – one half of the mole does not match the other half.
  • Border – the border or edges of the mole are ragged, blurred or irregular.
  • Colour – the colour of the mole is not the same throughout or has shades of tan, brown, black, blue, white or red.
  • Diameter – the diameter of a mole is six millimetres or larger.
  • Evolution – are the moles changing over time?

Melanoma is one of the three common skin cancers. The other two are basal cell carcinoma and squamous cell carcinoma. Melanoma is the most serious form of skin cancer. If diagnosed and removed early then the cure rate can be excellent. Once the cancer advances and spreads to other parts of the body, it is hard to treat.

Does melanoma occur in children? Yes, approximately two per cent of melanomas occur in patients under the age of 20 years and about 0.4 per cent of melanomas occur in pre-pubertal children.

We can reduce the risk of skin cancer by protecting against sun exposure and sunburn. Natural protection (shade) is considered the best protection. And sunscreen (SPF 15 or higher) should be adjunct to natural protection. Wear sun protective clothing. Wear wide brim hats. And use eyeglasses that block both UVA and UVB light.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!