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The Four S's of Summer

by the Social Diary Health Expert Columnist Ruth S. Jacobowitz
Column #13, June 11th, 2006

Sun, sunscreen, safety, and skin cancer prevention: It’s your typical summer story.

It was a usual getting ready for the beach time. With bathing suit in hand, I went into my husband’s bathroom to ask him to put sunscreen on my back. He began and then said, “What’s this?” having found a small dark something on my back that he couldn’t remember ever seeing before,

Unable to see it myself, I asked “Is it really dark, does it have uneven borders, and is it about the size of the diameter of an eraser on a pencil?” These were all the symptoms of melanoma that came to my mind in that instant. Upon learning that the something met that negative criteria, I called my dermatologist quickly.

Waiting a few days for an appointment wasn’t comfortable, but there was nothing else to do except repeatedly ask my husband whether the offending spot was still there. It was.

Finally my appointment time arrived and I learned that my something was called a barnacle, a mark that might even fall off. But isn’t that disgusting name? It sound as if I’m a static something that has been perpetually submerged in water like pilings.

Barnacles on the skin are actually benign lesions called seborrheic keratosis that don't ever turn into cancer, They can look dangerous but in reality they are just annoying.

Other than hating the diagnostic name and being grateful for the benign diagnosis, I realized that this was the time for my skin cancer reminder to all my readers.

The three main types of skin cancer are basil cell carcinomas, squamous cell carcinomas, and malignant melanomas—the kind I was worrying about. The first two grow slowly and are relatively easy to treat. Melanoma, however, is a fast growing cancer that spreads rapidly.

All three types of skin caners are typically caused by over-exposure to ultraviolet light from sunlight or sunbeds.

Melanomas, sadly, can show up in adulthood as a result of overexposure in childhood. There are other possible causes of skin cancer such as radiation and exposure of a long period of time to certain chemicals---paraffin, arsenic, soot, creosote, coal tar, etc.

Most basal cell carcinomas occur on the face, but they can be on other sun-exposed areas the upper chest, or back. They begin as a small pink, pearly spot that is oval or round in shape. As they grow they may change size and texture and bleed. One thing they do not do is heal themselves so a trip to the dermatologist is mandatory.

Squamous cell carcinomas are more common on the head, neck, and limbs. They are usually fairly irregular in shape, tough in texture and can be tender. Here again, see your physician.

Malignant melanoma is one of the most dangerous kinds of cancer. They grow and spread and must be found and treated quickly for the treatment to be successful.

As the beautiful days of summer are upon us, I beseech you to put on plenty of sunscreen each day and lather it on your partner, your children and grandchildren. Further if you’re at the pool or beach, one application is not enough.

The relationship between the skin and the sun is somewhat mysterious. If you go out on a bright summer day and spend an hour in the sun, you get a sunburn unless you happen to have taken the time to get a nice gradual tan. The fair skinned among us never get a tan, so they always get sunburned. Unless of course they are wearing a sunscreen...

Most people use sunscreen improperly by applying only 25% to 50% of the recommended amount. Sunscreen should be applied liberally enough to all sun-exposed areas that it forms a film when initially applied. It takes 20-30 minutes for sunscreen to be absorbed by the skin, so it should be applied at least a half an hour before going out in the sun

A useful instruction is to reapply sunscreen after 2-4 hours in the sun. However, one study has shown that reapplying sunscreen 20 to 30 minutes after being in the sun is more effective than waiting 2 hours. It is possible that this time period is more effective because most people do not apply enough sunscreen initially. Sunscreen should also be reapplied after swimming, excessive sweating, or toweling.

Sunscreen should be applied daily. The daily use of a low-SPF sunscreen (15) has been shown to be more effective in preventing skin damage than the intermittent use of a higher SPF sunscreen. So the four Ss remain summer, safety, sun and sunscreen.

* Ruth S. Jacobowitz is a health advocate, lecturer, and the author of five consumer health books and a lecturer on health matters. Her newest book is Final Acts—a novel. Visit Ruth at her web site www.ruthjacobowitz.com .

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