Skin cancer prevention

June 14, 2009 5:39:23 AM PDT
As you're heading out to the enjoy the nicer weather this weekend, don't forget your sun block! Manhattan dermatologist and Associate Professor of dermatology at Mt. Sinai School of Medicine, Dr. Judith Hellman, joined us with tips for preventing skin cancer. Can people use the same skin-protection products in summer that they use the rest of the year?
No, different products should be used. Heavier creams and ointments, so helpful during the winter months, are not good in hot, humid weather. This is the time to change to gels and serums, both in prescription and cosmetic topical products. Acne-prone skin especially benefits from the adjustment to lighter topicals. Visit your dermatologist for a quick adjustment of your daily routine. Another item to keep in your beach bag... sunglasses. They protect both the eyes and the skin around the eyes as well.

There has been much talk lately about SPFs (sun protection factors) and how this rating system may not be very beneficial to the consumer. Your thoughts?
It is true that the difference in protection between SPF 15 and 30 is greater than between SPF 30 and 45. However, SPF 45 is still a much better shield for your skin than SPF 15. During the summer, an SPF 30 is the minimum, not the maximum needed. You can get SPF 80 in any drugstore with ease. The FDA is now considering revising the system to be called SPF 50+ once over SPF 50.

Can a person check their own skin for possible signs of various cancers, or should a physician do this?
It is possible to do a self-check, but obviously you can't get a look at your back. But only a dermatologist can provide a diagnoses. That said, individuals can use what we call the "ABCDE" guidelines, at least once a year:

A- Asymmetry:
Normal moles or freckles are completely symmetrical. If you were to draw a line through a normal spot, you would have two symmetrical halves. In cases of skin cancer, spots will not look the same on both sides.

B- Border:
A mole or spot with blurry and/or jagged edges.

C- Color:
A mole that is more than one hue is suspicious and needs to be evaluated. Normal spots are usually one color. This can include lightening or darkening of the mole.

D- Diameter:
If it is larger than a pencil eraser (about 1/4 inch or 6mm), it needs to be examined by a doctor. This is includes areas that do not have any other abnormalities (color, border, asymmetry).

E- Elevation:
Elevation means the mole is raised above the surface and has an uneven surface.

Patients say "I have had this mole all my life." That doesn't mean that it cannot turn cancerous over the years. All moles should be checked with the ABCDE's in mind.

Which common skin conditions can be exacerbated during the summer?
Sweating in the summer can exacerbate acne, as can using the wrong products (heavier creams/lotions). Even sunscreens can block the pores and worsen acne. I tell my patients to wash off the sunscreen once they get back home and cleanse the skin.

Medications used for acne can be a source of sun sensitivity in the summer, for example the commonly used Tetracycline type medications, Sulfa antibiotics (Bactrim is the brand name) not to mention Accutane. Accutane causes severe dryness and a very high sensitivity to sun exposure and should be used with caution (or started in the fall season).

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