Statistics show that each year there are more new cases of melanoma, the most serious form of skin cancer, diagnosed than the year before.
Dr. Andrew Goldberg has seen the statistics, but more importantly he has seen the patients, as a plastic surgeon at Inova Fairfax and Inova Fair Oaks hospitals.
"The effects of significant skin exposure show up, historically, later in life," Goldberg said. "Malignant melanoma is on the uprise, and it's being diagnosed at a younger age than the year before."
What makes the statistics more troubling is that skin cancer, in any of its three most common forms, is virtually preventable. However, in some cases skin cancer can be linked to a genetic component, said Dr. William Alms, a dermatologist with Dermatology Associates of McLean.
"Ultimately covering up is the best [prevention]," Alms said. "But you need to get out and enjoy life. The amount of exposure to the sun is the key. Wear sports gels that you can't sweat off, or stick with SPF 15 or greater sunscreens."
THE AMERICAN CANCER SOCIETY (ACS) estimates 90,000 people in the Mid-Atlantic Division — consisting of Delaware; Maryland; Virginia; Washington D.C.; and West Virginia — will be diagnosed with basal cell skin cancer this year. Basal cell carcinoma is the most common form of skin cancer and is curable when treated through surgery.
However, Tia Mason Howard of ACS said this year an estimated 13,000 Virginians will be diagnosed with melanoma, which can spread throughout the body, typically to the liver, lungs and brain. The third type of skin cancer, squamous cell carcinoma, is treated the same as basal cell.
Basal cell carcinoma typically appears as sores that don't heal and can include bleeding. It is most common on the face and neck but can also show up on the abdomen, leg and scalp.
While basal cell is treatable, "Once the tumor is removed there is a less than 1 percent chance it will reappear in the same spot. However, there is a 20 percent chance a tumor will show up in another exposed area," Goldberg said.
By contrast, squamous cell carcinoma is found in the tissue that forms the surface of the skin, the lining of the hollow organs and the passage of the respiratory and digestive tracts. Under a microscope, the squamous cells look like fish scales.
Melanoma cells produce pigment in the skin, appearing as a dark, mole-like spot that spreads and has an irregular border. Goldberg said melanoma can be found less than a millimeter under the skin or as deep as 4 millimeters and "very early diagnosis" is the key to treating and preventing the cancer from spreading.
"MOST SUN exposure happens while we're a child out in the sun or playing sports. Typically there is a lag time between the exposure and presentation of cancer, often about 10 to 15 years," Goldberg said. "So what you do as a teen-ager could affect you in your 30s."
Sunscreen of SPF 15 or better is the best defense against skin cancer, short of avoiding all sun and ultraviolet (UV) light. The doctors said that while tanning beds can be safer than the sun, because they emit UV light, prolonged exposure can also cause skin cancer.
But using sunscreen is no guarantee, said Alms. "Once you're over SPF 15 or better, the sunscreen is blocking out a good number of the UV rays," he said. "But none are perfect, none are absolute. It depends on your skin type and how often you reapply."
The SPF of the sunscreen is the Sun Protection Factor and refers to how long a person can stay out in the sun. For example an SPF of 15 offers 15 times more protection against the UV A and UV B rays than if the person was not wearing any sunscreen at all. Goldberg said an SPF 15 to 20 normally blocks 90 percent of the UV rays, SPF 30 blocks 95 percent and SPF 40 blocks 98 to 99 percent of the UV rays.
"The government does the SPF ratings, so it doesn't matter what brand of sunscreen you use," Alms said. "It comes down to cosmetics. Which ones don't feel oily or feel like they clog the pores."
He also recommends people use a daily moisturizing lotion that contains sunscreen for everyday chores, such as shopping or other limited sun-exposure activities.
In addition to using sunscreen, people should avoid the midday sun, typically the hours of 10 a.m. and 2 p.m.; wear big brimmed hats to protect the face, ears and neck; find shaded areas; and when possible wear comfortable clothing that covers the legs and arms.
"You can minimize the damage by taking care of your skin. Don't smoke cigarettes," Goldberg said. "The skin can heal itself, but you can't undo the damage."