Skin Lesions: When To Be Concerned

As summer draws near, we need to remind ourselves of sun safety. Sure winter sun exposure is just as dangerous as sun exposure in warmer temperatures. But, people spend much more times outdoors in the summer. The incidence of all types of skin cancers have risen. In fact, more than 2 million people every year are diagnosed with some form of skin cancer.

What Can We Do To Protect Ourselves Against Skin Cancer?
1. The most important weapon we can use is sunscreen. Everyone, no matter the skin type or color, should use sunscreen. The American Academy of Dermatology recommends everyone use sunscreen that offers the following:
Broad-spectrum protection (protects against UVA and UVB rays, Sun Protection Factor (SPF) 30 or greater and be water-resistant.
2. Apply sunscreen 30 minutes before going outdoors. Be sure to cover the whole body. Reapply every 2 hours or after swimming.
3. Wear protective clothing.
4. Stay in the shade when possible.
5. Avoid direct sun exposure from 10 am until 2 pm.
6. Avoid tanning beds!

Many people have different kinds of skin lesions. The vast majority of them are benign. However, certain skin cancers, such as malignant melanoma can be be deadly. Sun exposure can cause premature aging of the skin and photodamage. It can result in freckles and hyperpigmentation. Additionally other skin conditions increase in incidence as we age, such as seborrheic keratosis and actinic keratosis. How do we know when a skin abnormality is normal and may show an underlying skin cancer?

Danger Signs Of Skin Lesions:
1. A skin mole that is asymmetrical. The mole is not perfectly round but rather has areas that do not match up if you were to draw a line through the midline.
2.The border is uneven. It can appear jagged, notched or scalloped.
3. Color is often a good indicator. If a mole has different colors, some zones darker than others, it should be considered suspicious. Similarly, if a mole changes color over time, eg starts to get darker, more concern should be given.
4. Usually, melanomas are larger than the head of an easier. The diameter of the lesion is also a reason for raising suspicion.
5. The mole is evolving or changing. When such a lesion changes size, shape, color or starts bleeding or itching, a cancer should be ruled out.
6. The “ugly duckling sign”. A patient may have just one mole that is an outlier. It is one that looks different from all the others. This is also a warning sign. This is a reason a patient should get to know their body and keep observation of their skin abnormalities.

If you do have any moles or skin abnormalities that you are concerned about, you should have them examined by your physician. The doctor will most likely check your skin and see if there are any suspicious signs seen. They may examine it using a dermatoscope, a small handheld, lighted magnifying device. They may decide that it warrants a biopsy, where the doctor may just cut out a small piece of the abnormality or excise the whole thing. As a family doctor, I do those initial steps in my office. However, if there is a high suspicion for skin cancer or I am unsure of the diagnosis, I refer the patient for further evaluation to the dermatologist.

While the incidence of skin cancer is rising, there are still ways that it can be prevented. Appropriate use of skin screen and avoiding tanning beds is paramount in achieving this. Additionally, going to your doctor as soon as you have concerns will help any cancers be treated at an earlier stage and improve outcomes.

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