Tag: skin cancer

What is a mole?

Defining a mole is not easy. People use the word very loosely to describe any blemish on the skin as a mole. I looked up the word on dictionary.com and it generated 25 results.

If I was part of a government or business organisation and was looking for a mole then I would be looking for a different kind of a mole compared to when I see a patient with a mole. If you Google the question, “What is a skin mole?” then you get 2,590,000 web references. So let us talk about skin moles.

Skin lesions and blemishes are very common. Most of them are benign and have no malignant potential. Moles are also called nevi (singular: nevus). Some other examples of “moles” are freckles, skin tags, lentigo and seborrheic keratoses. But real moles and sun burns have a potential to become cancerous.

Real moles are skin growths that are usually brown or black. There is a localised collection of pigmented cells called melanocytes. 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.

Some people are born with small to large moles and some of the moles have hair (hairy moles). Some moles will not change at all, while others will slowly disappear over time. As the years pass, moles usually change slowly, becoming raised and lighter in color. Often, hairs develop on the mole.

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 color, 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. For Canadian males, the rate for melanoma has tripled since the late 1960s. For Canadian females, the rates have varied over the years but still show a gradual increase. The incidence of other two skin cancers is also on the rise.

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 and can be deadly. The death rate from melanoma continues to rise about two percent annually.

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.

Summer is almost here. We should try and prevent skin cancer by protecting against sun exposure and sun burn. 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.

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Summer is not over yet. In fact, the way the weather has been acting up, we may end up with many more days of sunshine. May be we will get an early winter. But as long as the sun is shining, it continues to emit the harmful ultraviolet (UVR) rays. So, do not be in a hurry to put away your sunscreen lotion.

Chemical sunscreens were discovered in 1926. By 1928, the first commercial sunscreen, containing benzyl salicylate and benzyl cinnamate was marketed in the United States. Subsequent sunscreen evolution was primarily directed toward ultraviolet B (UVB) protection to lessen development of sunburn from overexposure to the sun.

Since 1960, the sunscreens contain para-amino-benzoic acid (PABA). It wasn’t until 1980, that sun protection factor (SPF) 15 became available in the market. PABA has several disadvantages and it has been replaced by PABA esters. These absorb well in the UVB range, are easier to formulate in nonalcoholic vehicles, and are less staining and less allergenic. Researchers continue to develop better sunscreens. Some scientists have determined that the viscous “red sweat” of the hippopotamus is an excellent, broad spectrum sunscreen. May be next time you see me, I will smell like a hippo.

Sunscreen should be efficient, water resistant and safe. It should spread easily, maximize skin adherence, should be non-stinging, non-staining, and inexpensive. Most popular sunscreens are available in creams and lotions (emulsions). Both are oil-in-water or water-in-oil preparations, although lotions spread more easily. Some sunscreens are oil based and greasy, some are in gel form but they tend to sting and irritate the skin. Sunscreens in the form of a stick are wax based but are difficult to apply in larger areas. Aerosols are wasteful with spray lost to the air. Increasingly, sunscreens are being incorporated into cosmetics, including lipsticks, and moisturizers.

The ability of a sunscreen to protect the skin from UVR-induced erythema is measured by the SPF. Erythema is defined as redness of the skin caused by dilatation and congestion of the capillaries, often a sign of inflammation or infection. In this case, the redness is from sunburn.

SPF 15 blocks 93 per cent of UVB. Some argue that SPF 15 is sufficient and that higher labeling claims are misleading and costly for consumers. But some studies have shown that higher SPF (SPF 30) sunscreens conferred better clinical and microscopic tissue benefits.

Most people who use sunscreens apply it at much lower concentrations than the 2 mg/cm2 at which they are tested. The resultant SPF is considerably reduced, typically to about 20 to 50 per cent of the labeled SPF for chemical sunscreens. It is important to remember that under-application, uneven application and delayed application of sunscreens result in unnecessary sun exposure and skin damage.

What the sunscreen does is to lessen the development of sunburn from overexposure to the sun by absorbing UVB sunrays. Recurrent sunburn causes permanent damage to the skin and causes skin cancers like squamous cell cancer (SCC), basal cell cancer (BCC) and melanoma. But the use of sunscreen alone will not reduce the incidence of skin cancer, especially BCC and melanoma. You should avoid sunburn by other means wearing appropriate clothings, wide-brimmed hat and appropriate sunglasses and avoid sun exposure between 11 a.m. and 3 p.m.

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Melanoma is one of the three common skin cancers which is caused mainly by exposure to sunrays. The other two are basal cell carcinoma and squamous cell carcinoma.

For Canadian males, the rate for melanoma has tripled since the late 1960s. For Canadian females, the rates have varied over the years but still show a gradual increase.

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 and can be deadly. The death rate from melanoma continues to rise about two percent annually.

Skin is the largest organ of our body and has many important functions to protect us from environment. Skin is constantly exposed to sun, wind, industrial elements and other causes of external and internal injury.

Melanoma arises from cells called melanocytes. These cells contain melanin (melas = black) – a principal pigment responsible for the color of human skin, hair, and eyes. Melanin also acts as a filter to decrease the harmful effects of ultraviolet rays to the dermis.

When the skin is exposed to ultraviolet radiation, there is immediate increase in the number of melanocytes and production of melanin pigment. This results in tanning. The amount of melanin produced is genetically determined. That is why some people burn easily without tanning.

The risk of skin cancer is increased in individuals who spend too much time outdoors; children who have had episodic sunburn, and if there is a family or personal history of skin cancer (especially melanoma). Males are affected more than females.

There are two important things to remember about prevention of skin cancer: cover up and stay out of the sun.

We need to remember that skin tanned by ultraviolet radiation is damaged skin which predisposes to cancer. We need to avoid sunburn and generally reduce exposure to ultraviolet radiation by staying out of the midday sun, wearing protective clothing, seeking shade, and applying sunscreen.

We should have moles or sun burnt skin surgically removed if they show signs of change or non-healing. Bleeding, chronic irritation, change in color or size should warn us to have these moles removed.

Despite having a good understanding of the relation between overexposure to the sun and skin cancer, 81per cent of North Americans still think they look good after being in the sun. Just like the smokers. They know smoking kills but they still smoke.

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.

Prevention of skin cancer is very important. This should start in childhood. More than 90 percent of skin cancers occur on sun-exposed areas of the body. So, protect yourselves from the damaging effects of sun and tanning beds.

Artificial tanning machines are also dangerous. Recently, the World Health Organization (WHO) said the increased popularity of artificial tanning machines is one of the main reasons for a rapid increase in incidence of skin cancer, particularly among young women in Europe and North America.

WHO suggested Governments should pass laws on the responsible use of sun beds, banning their use for all people under 18.

So make an investment in sunscreen, wide brimmed hat, sunglasses which filter ultraviolet rays and stay away from the sun between 10 a.m. and 3 p.m. Enjoy the summer, get enough vitamin D for the winter but be sun smart.

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