Skin cancer - what you need to know

Skin cancer is the most common cancer in the United States. It is estimated that nearly 9,500 people are diagnosed with skin cancer every day, making it the most commonly diagnosed type of cancer among women and men. Connector spoke to some of Dubai’s leading dermatologists to find out more.

Which is the most common form of skin cancer?
“The most common skin cancer is the Basal Cell Carcinoma, in fact, this type of cancer is the most frequently occurring form of all cancers,” says Dr Juliane Reuter, German board certified dermatologist at Koster Clinic.

Basal cell carcinoma is the most common form of skin cancer, agrees dermatologist Dr Lana Kashlan. She adds that squamous cell carcinoma is the second most common and malignant melanoma, the deadliest form, is the third most common. “About 90% of non-melanoma skin cancers are related to sun exposure,” states Dr Kashlan.

Which is the most dangerous form of skin cancer?
“Melanoma is the most dangerous type of skin cancer as it can be deadly if left untreated. Melanoma originates from the cells that produce pigment in the skin and often resemble moles or can appear within existing moles,” says Dr Kashlan.

Dr Reuter adds that the most dangerous skin cancer is malignant melanoma as it may spread to other body parts at later stages.

How important is it to wear sunscreen in Dubai?
Wearing sunscreen is important to prevent sunburn as well as to counteract UV-induced skin ageing says Dr Reuter. “However, a proper balance of sun exposure with sunscreen and limited sun exposure without sunscreen (dependant on the skin type) is advisable as the UVB radiation is necessary for our skin to produce Vitamin D, which is vital for mind and body health”.

Dr Kashlan says “Daily sunscreen use is critically important in Dubai, where the amount and intensity of sun exposure is quite high for the majority of the year. Not only is sunscreen important in terms of preventing skin cancer, but also we know that sun’s harmful rays directly cause wrinkling and ageing of the skin”.

What are the best factors/types to choose?
“I generally recommend using a daily sunscreen with an SPF of 30 or better,” says Dr Kashlan. “SPF or sun protection factor is a measure of a sunscreen’s ability to prevent UVB from damaging the skin. Here’s how it works: If it takes 20 minutes for your unprotected skin to start turning red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer. The higher SPF’s block out more of the sun’s harmful rays, thus preventing sunburn and skin damage. The other important thing to consider when picking a sunscreen is to choose one labelled ‘Broad Spectrum’. This means that the sunscreen blocks out UVB and UVA radiation. UVB causes more superficial damage to the skin, leading to sunburns and skin cancer. UVA penetrates the skin deeper and leads to sun related wrinkles and ageing and also can contribute to skin cancer development”.

The best would be a water-resistant, broad-spectrum sunscreen covering UVB as well as UVA radiation says Dr Reuter. “The best factor, that suits most skin types, is factor 30 as it filters 96% of the UV radiation”.

Is there a right or wrong way to apply sunscreen?
“Sunscreen has to be applied preferably before leaving the house as it takes 30 minutes for most sunscreens to display their full protective properties. It has to be reapplied every 40 to 80 minutes in a generous coating,” says Dr Reuter.

“The biggest mistakes people make when applying sunscreen are not using enough and not re-applying. The key to getting adequate sun protection is to make sure to apply enough sunscreen to cover the whole exposed area (one ounce or one shot-glass full) and to re-apply every two hours you’re out and immediately after swimming,” says Dr Kashlan.

What other problems can not wearing sunscreen cause?
“UVA radiation causes chronic skin damage and premature skin ageing with signs such as wrinkles and dark or white spots,” says Dr Reuter.

She added “Besides skin cancer prevention, daily sunscreen use is the most effective anti-ageing cream available,” says Dr Kashlan. “Brown spots, sagging of the skin, and wrinkles can all be related to the harmful effects of sun exposure and so regular sunscreen use helps to prevent early ageing of the skin and keeps skin looking healthy”.

Low levels in Vitamin D are prevalent in this part of the world. Is there a time where we could be out in the sun and not wearing sunscreen?
“The optimal time to be in the sun to maximise vitamin D production is as near to noon time as possible (between 10am and 2pm). But we are talking about as little as a few minutes depending on the individual skin type! The closer to noon time, the shorter the necessary exposure time to produce vitamin D because UVB rays are most intense at this time. Pale skin will reach an “equilibrium point” after 10 to 20 minutes of exposure to UVB light, at which point vitamin D will no longer be produced. A light-skinned person needs at least three of these 10 to 20 minute sessions per week, in bright noon sunlight and with few clothes in order to maintain a healthy Vitamin D level. In darker skin it can take two to six times longer (or up to an hour or two), to reach the ‘equilibrium point’ depending on the amount of skin pigmentation,” says Dr Reuter.

What signs can we be looking out for in order to protect ourselves?
During direct sun exposure if the skin shows a very light shade of pink, it is about time to stop the sun exposure in order to prevent sunburn says Dr Reuter. Getting to know our own skin is vital to recognise potentially cancerous changes on the skin she added.

And when should we go to a doctor?
“A dermatologist should be consulted if moles are noticed that display any sort of activity (changes in colour, size or shape), if any non-healing or chronically scaling, rough skin changes appear. “The earlier skin cancer is detected, the better the healing chances are,” says Dr Reuter.

Dr Kashlan says “For non-melanoma skin cancers, be on the lookout for pink, rough sores or bumps that do not heal. These spots can often first appear as scaly spots that feel like sandpaper. For melanoma, we recommend looking for moles that have Asymmetry, Border irregularity, Colour variation, Diameters greater than 6mm, and are Evolving, meaning they have changed. This is referred to as the ABCDE’s of melanoma. But even more important, is to be on the lookout for anything that is new or changing or doesn’t look like the rest of the moles on your body. I recommend doing a monthly self-check of your skin. The more familiar you are with what you have on your skin, the earlier you will detect anything that is new or changing. Finally, anything that is bleeding, scaling, or not healing needs to be checked by a dermatologist”.

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