Every new patient that I see is offered a complete skin examination. Even if the patient is coming in for a cosmetic consultation about Botox or lasers, he or she is encouraged to have a full skin check to look for skin cancer. I have found many suspicious growths this way, but what is really scary is that I’m finding more and more melanomas, and in younger and younger people.
What I’m seeing in my office isn’t just me. A recent study released by the Mayo Clinic (http://www.mayoclinicproceedings.org/article/S0025-6196%2812%2900209-1/abstract) reported an increase in the number of melanomas in young people (ages 18-39), especially women. These researchers found that in the past 30 years the number of melanoma cases increased 4 times in men and 8 times in women.
So why is this? The number one reason is tanning. Young women are not only baking themselves on the beach but they are going to the tanning bed. A CDC study (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6118a2.htm?s_cid=mm6118a2_w) reported that one-third of women ages 18-21 used a tanning bed in the past year, and women in their 20s used tanning beds more than 10 times in the past year. That is really shocking to me. I’m going to say it: it’s really, really irresponsible. You might as well be begging for skin cancer.
The amount of ultraviolet radiation released by a tanning bed can be 7 times as much as the sun. Many tanning beds emit mostly UVA and less UVB. UVB are the burning rays, so people think “I didn’t get burned so I must be OK.” Wrong! UVA rays are the really damaging rays, the ones that penetrate into your skin’s DNA leading to skin cancer and premature aging. Think wrinkles, brown spots, and leathery skin. How attractive! You wouldn’t want to go get a full body X-ray every day, would you? Going to a tanning bed is also exposing yourself to radiation, why would you voluntarily do that to your body?
I’m not saying avoid the sun, stay home, don’t play tennis or golf or go swimming. Do what you enjoy but be smart about it. Apply a sunscreen with an SPF of at least 30 and apply A LOT of it. Reapply it every 1 to 2 hours, or immediately after you have been swimming or sweating. Even if it is water-resistant or sweat-resistant if you wipe your wet skin you wipe off your sunscreen. Wear a hat with a wide brim. There are so many cute, fashionable hats out there!
When it comes to sunscreen most people don’t apply enough. The SPF number on the label is tested in a lab where a thick layer is applied. Almost no one in real life applies that much. In a typical application, most people are getting about half the protection that is on the label, which is why the higher the SPF you use the better. And SPF tells you about your protection from UVB not UVA. There is no good reference that tells you about your protection against UVA, no keyword like “SPF.” The only way to know if your sunscreen protects you against UVA is to make sure the label says “broad spectrum protection” or “UVA/UVB protection.”
The labeling rules for sunscreen are changing. Over the next few months sunscreen manufacturers will have to comply with a new rule from the FDA. In order to say “broad spectrum” on the label, the sunscreen will have been tested and proven to offer equivalent protection against both UVA and UVB. So if a product says “Broad spectrum SPF 30” you can be confident that there is a protective factor of 30 against both UVA and UVB. If it doesn’t offer adequate protection against UVA, even if it has a high SPF against UVB, there will be a warning on the label that says that the product has not been proven to protect against skin cancer.
The FDA passed this rule last year, but the date by which manufacturers need to comply isn’t until December 2012. So this summer you will still need to read the label. Look for SPF 30 or higher. Look for the words “protects against UVA and UVB.” Look at the ingredients. I advise my patients to choose sunscreens with zinc oxide, or with zinc oxide, avobenzone, and oxybenzone. These ingredients together will give you the best protection against both UVA and UVB.