The skin is our bodies’ largest organ. Though it has many different functions, it is primarily a protector. Nowadays, there’s a heightened awareness of the sun’s damaging effects on our skin. We know that excessive UV (ultraviolet) exposure and repeated sunburns, especially at a young age, can lead to serious skin concerns later in life. In recent years, we have started to see SPF (sun protection factor) in many products that we put on our skin.
UV damage occurs on the most exposed areas of the body, such as the face, ears, neck, and arms. Some sun damage can be very subtle, such as a small scaly area on the forearm, the scalp, or the top of the ear. Often it can be scratched off, but it usually grows back again. These lesions, actinic keratosis, are common on aging skin and in some people can develop into a skin cancer if left untreated.
Sun spots, or solar lentigo, are more like freckles, flat, but larger. These are local areas of increased pigment in the skin. They may get darker with prolonged sun exposure. Normally, they are not a concern, but may be difficult to distinguish from dangerous skin cancers. Chronic sun exposure can also lead to premature wrinkles and thick, leathery skin (photo-aging).
Allergic-type reactions can develop from the sun’s rays as well, so-called “sun poisoning.” These can be treated with limiting sun exposure and using topical or oral allergy medicines (cortisone, antihistamines). Many commonly used medicines, such as some antibiotics, can make the skin more susceptible to burning.
Melanoma is the most concerning lesion. This skin cancer can quickly grow deep into the skin and then travel to distant areas of the body (metastasize) before it’s even recognized. The name comes from melanin, which is the color-producing chemical in the skin. So, these are usually dark lesions. Normal moles and other benign, dark-colored lesions, such as seborrheic keratoses, are difficult to distinguish from melanomas unless you are familiar with your moles and your skin and notice a change.
These changes include:
A- Asymmetry, lesion doesn’t look the same on both sides
B- Border, the edge of the lesion is blurred, jagged or irregular
C- Color, the lesion gets darker or has varying colors in it
D- Diameter, it is greater than a quarter-inch
E- Elevation, it becomes raised or uneven
Other changes to look for include itching, bleeding, and fast growth of a mole.
As with many medical conditions, the best treatment is prevention. Avoid the sun when the rays are most harmful (10 am to 2 pm) and protect your skin with clothing and sun block. SPF 30 to 45 is fine; ratings above this may not provide much additional protection. Mixing a 30 and a 45 won’t give you a protection rating of 75, it will just dilute the two to somewhere in between. Apply the sun block at least 20 minutes before exposure to give it a chance to soak in. Reapply sun block about every two hours. Wide brim hats protect your face, scalp and the top of your ears.
Finally, check your skin regularly so you can identify any changes. If you notice any new or changing skin lesions, have them checked by your doctor. Many skin lesions can be treated effectively in your family doctor’s office, if caught early.
The content in this column is for informational purposes only. Consult your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.