Posts Tagged ‘skin cancer’

An Even Tan Only Comes Without the Sun! Notes from a San Francisco Bay Area Dermatologist

Wednesday, August 11th, 2010

To help answer the question of why different types of skin cancer tend to occur in different parts of the body given they all are caused by UV exposure, researchers at the University of Edinburgh recently conducted a “tanning” study published in the Journal of Experimental Dermatology.

The study exposed the backs and buttocks of 100 volunteers to six doses of UVB rays. A week later their skin was analyzed, revealing that the buttock area remained lighter in color and was much more resistant to tanning than the back area, despite the same level of UVB exposure. In the UK’s Telegraph, Professor Jonathan Rees (Unviersity of Edinburgh) reported the reason being that the skin on bottoms is thicker than other areas of the body. Part of the defense mechanism of a tan is to thicken the skin in a given area to protect its lower layers from UV damage. Areas where the skin is already thick, like our bottoms, is less likely to tan as a defensive response to UV exposure.

What is the take home message? If you are seeking an even, all-over tan, then you are chasing an impossibility. The skin is not physically able to tan in this way and this study is simply more evidence to discourage tanning through UV exposure at all! The still safest and most effective way to get an even tan is through topical tanning products like lotions, tan towels and shower bars.

Still Tanning Despite the Risks? Notes from a San Francisco Bay Area Dermatologist

Sunday, July 18th, 2010

Excessive sun exposure and tanning bed use increases the risk of getting melanoma, basal cell cancer and other non-melanoma cancers. We have several patients who, despite having been treated for serious skin cancer, continue to tan. Why? Well, it turns out that they may suffer from a tanning addiction. They suffer uncomfortable physical and mental symptoms when they try to stop. Many repeat tanners exhibit addictive behaviors similar to those exhibited by people addicted to substances such as meth and alcohol. In a recent study (Arch Dermatol 2010 Apr;146:412) 70% of study participants who visited tanning parlors met criteria for addiction to indoor tanning. Study participants who met criteria for addiction also had greater anxiety and greater alcohol and marijuana use. Tanning addiction seems to involve the same drives as other forms of substance related disorders. Of course , it is important to distinguish addicted from non-addicted tanners. It is hoped that lessons learned from treating other addictions can be translated into concrete interventions to reduce risky tanning behavior.

Tanning - A New Addiction: Notes from a San Francisco Bay Area Dermatologist

Tuesday, June 1st, 2010

There is no question that exposure to high levels of ultraviolet rays cause skin cancer, not to mention premature aging and pigmentation issues of the skin. Despite this fact, however, tanning salons and outdoor sun tanning still remain popular, especially among young adults. So what keeps people returning to those booths and baking on their beach towels when they know the indisputable risks?

Well, Mosher and Danoff-Burg propose that habitual indoor tanning may, in some cases, be best characterized as an addiction with behavioral and physiologic dependency. Roughly one third of the college students who took screening tests (one that is commonly used to screen for alcoholism and a tanning-specific substance related disorder test) met criteria for addiction to ultraviolet tanning. This subgroup also showed a greater tendency for substance abuse and anxiety, suggesting that habitual tanning may be a predictor of other addictive behaviors, such as alcoholism and cigarette smoking.

Looking at tanning with this mindset and identifying patients who show signs of addiction toward tanning will hopefully give the medical community a new way to approach this topic with their patients and help them avoid this risky behavior before they encounter potentially life threatening conditions like melanoma.

If it is simply the “tan look” that people seek, tanning alternatives continue to improve and are a great way to get a glow without any risk. Our staff and patients are currently loving the products by TanTowel. The self-tanning towelettes are easy to use, with a simple swipe on action. Streaks and discolorations are easily avoidable with the towelette. They also have a great self-tanning soap that is used conveniently in the shower to supplement your towelettes or to achieve a more gradual glow. The towelettes and soap along with their self-tanning lotion give the most natural looking color that I have found among sunless tanning products. Check with our office today for more information on the Tan Towel products and to give yourself a summer glow without the harmful UV rays!

Derm Terms: Notes from a San Francisco Bay Area Dermatologist

Sunday, March 28th, 2010

In dermatology, there are lots of terms for various spots and lesions that may appear on the skin. These terms can be confusing, especially if you aren’t sure which are the “bad” kinds and which are less of a worry.

One of the most common terms is actinic keratoses or AKs, which are most often seen on the face, ears, lips and backs of hands, but can appear on any sun damaged area of the skin. AKs are spots where the top layer of skin is dividing too rapidly. They usually show up as a dry, scaly and rough textured patches of skin. They may be brownish, red or flesh colored. Some may even be crusty..

AKs tend to arise more frequently after age forty, but if you are fair skinned with light colored eyes and have had average to heavy sun exposure they may appear earlier.

AKs are also called “precancers” because if left untreated, they have the potential to progress into squamous cell carcinoma, a potentially deadly form of skin cancer. Because of this potential, it is important to have any AKs treated as they come up. Cosmetically, they make the skin appear more aged and makeup doesn’t cover them very well.

Treatment may include cryosurgery (freezing the spot with liquid nitrogen), numbing the area and scraping the lesion off or use of a prescription cream that targets the damaged cells and destroys them. Luckily, most AK treatments are fairly inconspicuous and the recovery time is minimal. For more extreme cases or areas where there are too many precancers to treat individually, we may use PDT or photodynamic therapy treatment. This process involves a light microdermabrasion to the skin, followed by the application of a chemical that is activated by a laser to eradicate the errant skin cells. This treatment requires you to stay indoors 24 hours afterward. The result is skin that will look, feel and be much healthier.

To prevent AKs and skin cancer, sun safety is always your best bet. Always apply and re-apply sunscreen to exposed areas of skin and do your best to stay out of the sun!

I can never say enough about the benefits of topical retinoids like Retin-A, Refissa, Atralin or Retin-A Microgel, but yet another positive point is that they can actually help the skin ward off AKs. Their exfoliating properties keep these damaged cells from taking hold and help the skin stay smooth.

As always, if you notice any new spots or moles that have changed, have a dermatologist look at them for any potential issues. Be sure to check in with the blog as more derm terms will be discussed!

“Jersey Shore” Tanning Intervention: Notes from a San Francisco Bay Area Dermatologist

Tuesday, February 23rd, 2010

Having two teenagers, you learn to stay up on what today’s youth is watching, listening to and surfing for, especially if it can impact them negatively. A recent trend among the younger set is watching the MTV reality show “Jersey Shore.” While I can’t say I’ve actually watched this show myself, I’ll admit to being familiar with images of the cast that I’ve seen on magazines and television excerpts, mostly because of the shock and concern I feel for them and their overly tanned skin. When I learned of the “tanning intervention” that the TV show “Extra” had with the cast, I was delighted. These young adults are not only ruining their skin and dramatically increasing their chances of skin cancer with their tanning habits, but they can potentially influence viewers into thinking tanning is “cool” - a dangerous trend. Check out this clip from Extra and share it with someone who needs to know about the dangers of tanning!

Dermatology - One of the Most Satisfying Specialties: Notes from a San Francisco Bay Area Dermatologist

Wednesday, February 10th, 2010

A recent study conducted by UC Davis has found that dermatology ranks as one of the most satisfying medical specialties to practice. One of the reasons dermatology tops the charts is its diversity, ranging from medical to aesthetic. This couldn’t be more true for my practice. Being able to help a patient suffering from acne or skin cancer to advising another on choosing a cosmetic treatment right for them is one aspect of my job that I enjoy immensely. There is nothing more satisfying than helping patients set and achieve their skin goals, seeing them through the process from beginning to end. Its the relationships I have with my patients who are of all ages and walks of life that always keep me smiling.

Further Evidence on the Benefits of Vitamin D: Notes from a San Francisco Bay Area Dermatologist

Wednesday, September 23rd, 2009

We continue to hear more and more about Vitamin D. Dermatologists have for years counseled their patients to practice rigorous sun protection, which may contribute to low vitamin D levels in certain patients. Now we are encouraging vitamin D supplementation as a way to raise vitamin D levels.

As highlighted in Dermatology Times, the UK’s Telegraph (9/22, Devlin) reported that patients with colon cancer “who had higher levels of vitamin D…when diagnosed with colon cancer were 50 percent more likely to survive than those with low levels,” according to a study appearing in the British Journal of Cancer. Meanwhile, a second study, published in the Journal of Clinical Oncology, showed that “patients who had high levels of the vitamin when they were diagnosed with skin cancer were more likely to have thinner tumors.” Meanwhile, “skin cancer patients who had the lowest levels of vitamin D in their blood when they were diagnosed were almost a third more likely to relapse than those with high levels,” researchers found.

This study correlates higher levels of vitamin D with increased survival from colon cancer and a better prognosis with skin cancers. The sun is not needed to get adequate vitamin D. Vitamin D supplementation is widely available in oral form and I recommend 1000-1500 mu of vitamin D a day along with 1000mg mg of Calcium a day . Vitamin D testing is now available and may be recommended for you by your primary care doctor or dermatologist.

Confused about Vitamin D? Notes from a San Francisco Bay Area Dermatologist

Wednesday, August 5th, 2009

There is so much information circulating now on vitamin D, its benefits to your health and how one should go about obtaining it, that its no wonder people are confused.

Let’s start with why is vitamin D important to our health. We have long known that vitamin D allows our bodies to absorb and use calcium, which is essential for healthy bones. However, there are some recent studies that suggest it may also play a role in preventing certain cancers and diseases. This information, combined with the fact that vitamin D levels appear lower among Americans today than 15 to 20 years ago (American Journal of Clinical Nutrition), have sparked the conversation on whether or not we are getting enough vitamin D for optimal health.

Some of the confusion is caused by the fact that vitamin D is produced by the skin following exposure to the sun’s UV rays (specifically UVB rays), yet we are consistently told to avoid the sun, tanning beds and to glob on sunscreen daily.

So, what is wrong with tanning or tanning beds to get our vitamin D? As a dermatologist, I continue to recommend that my patients minimize their sun exposure, avoid tanning beds and always wear their sunscreen. The potential risk for skin cancers and photo damage is too great to obtain your vitamin D through tanning.

Another argument against sun exposure for vitamin D is that the amount produced by the skin varies depending on time of day, season, latitude, age and skin pigmentation. For example, UV exposure is unlikely to produce enough vitamin D in darker skin, so relying on the sun alone puts these skin types especially at risk for deficiency. Also, the skin of the elderly has a reduced ability to produce vitamin D from sunlight. Between November and February, UVB radiation is insufficient to produce adequate vitamin D for people living above 42 degrees north latitude, which includes Boston, northern California and other northern areas.

So how do we ensure we are getting enough vitamin D? Diet and supplements remain the safest and most consistent way for people of all ages and skin types to get their Vitamin D. Vitamin D can be found in fortified dairy products and cereals, orange juice, egg yolks, oily fish and dietary supplements. Try to look for supplements containing vitamin D3, the form most easily absorbed by the body.

If you still feel that the sun is a good way to get your vitamin D, it is important to realize that for lighter skin types, a few up to fifteen minutes of mid-day sun exposure on your forearms, a few times a week, would provide adequate vitamin D, so tanning will never be a safe or recommended option.

I support current recommendations from United States dermatology groups, which are 1,000 - 1500 IUs (international units) a day of vitamin D and 1000 mg of calcium for a healthy adult. Check with your doctor to be sure this amount is appropriate for you. This potential role of vitamin D and disease prevention is of great interest and I look forward to more information as further studies are conducted.

Tanning Beds Can Cause Cancer: Notes from a San Francisco Bay Area Dermatologist

Wednesday, July 29th, 2009

As summarized in Dermatology Daily for the American Academy of Dermatology, The CBS Evening News (7/28, story 8, 2:15, Couric) reported that, according to a paper published online July 29 in The Lancet Oncology, tanning beds may “pose as big a risk as tobacco and asbestos.” Medical correspondent Jon LaPook, MD, explained that the “international panel of cancer experts upgraded the warning on tanning beds from probably to definitely able to cause cancer.”

The AP (7/29, Cheng) points out that “a new analysis of about 20 studies concludes the risk of skin cancer jumps by 75 percent when people start using tanning beds before age 30.” In addition, researchers from the International Agency for Research on Cancer (IARC), the “cancer arm” of the World Health Organization, “found that all types of ultraviolet radiation caused worrying mutations in mice, proof the radiation is carcinogenic. Previously, only one type of ultraviolet radiation was thought to be lethal.” Now, “the new classification means tanning beds and other sources of ultraviolet radiation are definite causes of cancer, alongside tobacco, the hepatitis B virus, and chimney sweeping, among others.”

AFP (7/29, Hood) quotes study leader Vincent Cogliano, PhD, as saying that sunbed use causes “melanoma of the skin and…of the eye.” Cogliano also said “it is not the IARC’s role to issue recommendations, but that he hoped the new evaluation would focus attention on the issue.” Internationally, “physicians hailed the decision, and called for tighter regulations for the multi-billion dollar tanning industry.” Nina Goad, spokesperson for the British Association of Dermatologists, stated, “It is high time that steps were taken to regulate the industry, to prevent children using sunbeds.” Meanwhile, George Reuter, of France’s National Union of Dermatology, said, “We have been trying for a long time to call the attention of the government to the potential risks.”

BBC News (7/29) reports that the UK’s Sunbed Association “supports a ban on” tanning bed use for those under 16 years of age, but “argues there is no scientific evidence for a ban on young people aged 17 or 18.” Chief executive Kathy Banks said, “Research has shown that over 80 percent of sunbed users are very knowledgeable about the risks associated with over-exposure to ultraviolet [light], and the majority of sunbed users take 20 or less sunbed sessions a year.” But, Jessica Harris, Cancer Research UK’s health information officer, called for UK “ministers to implement a ban on under-18s using sunbeds immediately, and to close salons that are not supervised by trained staff.”

CBC News (7/29) explains that up “until now, only UVB radiation from solar rays was known to cause a genetic mutation,” but the IARC team “found the same mutation in the skin of mice treated with UVA.” Therefore, “the agency decided to reclassify all types of ultraviolet radiation — UVA, UVB, and UVC — as carcinogenic to humans, or Group 1 carcinogens. Previously, the three UV types were grouped as probable carcinogens.” CBC points out that the “WHO has warned people younger than 18 to avoid tanning beds. The Canadian Cancer Society has called for minors to be barred from using tanning beds, and the American Cancer Society advises people to try bronzing creams instead of tanning beds.”

The UK’s Press Association (7/29) notes that “several case-control studies provide consistent evidence of a positive association between the use of ultraviolet-emitting tanning devices and ocular melanoma.”

The UK’s Daily Telegraph (7/29) reports that the IARC study “follows research earlier this year that found the deadliest form of skin cancer, malignant melanoma, has become the most commonly diagnosed cancer among British women in their 20s.” According to “the latest available” Cancer Research UK figures, “338 women aged between 20 and 29 were diagnosed with melanoma, compared with 298 for cervical cancer.” In fact, “cases of melanoma have increased by a third since 2003, when there were 220 cases.” Overall, skin cancer cases in the UK “have more than doubled in the last decade.”

According to HealthDay (7/28, Reinberg), the Food and Drug Administration “is considering strengthening its warnings about the risk of skin cancer and eye damage” related to tanning bed use, the agency said. Meanwhile, Jeffrey C. Salomon, MD, “an assistant clinical professor of plastic surgery at Yale University School of Medicine,” who was not involved in the study, said that “the time has come for the FDA to restrict the use of tanning beds and to issue stronger warnings of their dangers.”

New York’s Newsday (7/29, Altherr), the Minneapolis Star Tribune (7/29), WLS-TV Chicago (7/28), the UK’s Sun (7/29), and WebMD (7/28, Boyles) also covered the story.

Eyelids and Skin Cancer, an Overlooked Danger: Notes from a San Francisco Bay Area Dermatologist

Monday, June 22nd, 2009

Did you know that the eyelid region is one of the most common sites for non-melanoma skin cancers? Recently, and article was published in the Skin Cancer Foundation Journal bringing attention to this important topic.

The thinness of the skin around the eyes and the lack of proper sun protection, makes it very susceptible to skin cancer and sun damage. Basal cell carcinoma and squamous cell carcinoma are the most typical cancers we see in the eyelid area.

Generally on the body, non-melanoma skin cancers appear as spots or sores that don’t heal. However, skin cancers in the eye area may present with a scar-like appearance or texture or as a mass or tumor-like growth. These cancers must be removed to keep the cancer from spreading into other ocular structures and causing further damage. If caught early, you can minimize the amount of tissue that needs to be removed to treat the cancer, giving a more pleasing cosmetic result. The Moh’s micrographic surgery technique used for removal has a five year cure rate of 99 percent for basal cells and 98.1 percent for squamous cells.

The best way to prevent skin cancer in the eye area is to examine the area yourself often or take pictures on occasion for comparison and see if any changes have occurred. If you notice any differences have them checked out by a dermatologist as soon as possible.

Wearing sunglasses that block 99-100 percent of the sun’s UV rays helps prevent cataracts and skin cancers. Broad-spectrum sunblock is also important on your eyelids. If you find lotions too irritating, choose a dry sunblock and lightly dust it over the area. We carry Colorscience mineral sunblocks and makeup that would be a good choice to protect the eyes. They also make a product specific for the eye area called Colorscience Eyescreen that is silky, light and provides good protection. Contact our office for more details.

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