Florida isn’t called the sunshine state just for fun. In fact, according to board-certified dermatologist Dr. Tara Ezzell of Dermatology Associates, the intensity of the Florida sun makes this state one where people must be conscious of their exposure.
“In Florida, I always tell my patients, the sun is looking for you. You needn’t seek sun exposure. Even getting your mail, running to the grocery store or taking the dog out, those simple indoor-outdoor activities even require sun protection,” said Ezzell.
According to Dr. Robert Skidmore of Florida Skin Cancer and Dermatology Specialists, skin is most susceptible to sun damage before the age of 18. If someone gets two blistering burns before the age of 18, he or she has a much higher chance of developing melanoma.
Skidmore recommends his patients apply SPF 30 that has both UVA and UVB protection to any exposed limbs every day before going outside. To use it effectively, Skidmore said, reapplication every hour and a half is essential, no matter how high the SPF may be. Even those with more natural melanin aren’t exempt from taking measures to protect themselves from the Florida sun. Ezzell said, “For all complexions, I recommend 30 on a daily basis and 45 if you’re going to be out and doing activities.”
Ezzell explained, “There are short and long term effects of sun exposure on the skin, but mainly when the sun hits the top layer of skin, it penetrates to the DNA in the cells, and it causes mutations. As those mutations build up, you develop skin cancer later in life.”
Both dermatologists recommend “blocker-based” sunscreen lotions, which contain zinc and titanium to reflect the sun. Ezzell prefers these physical protectors to chemical-based sunscreens, but Skidmore said chemical-based sunscreens are okay to use, as all the ingredients have been approved by the FDA.
The three most common forms of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. While basal cell and squamous cell carcinoma, when treated early, are rarely mortal, they do cause suffering. Treatment for both requires surgical procedures, which can takes weeks to heal, cause patients to lose work time and can leave disfiguring scars. Non-melanoma cancers can be identified by a pink bump that doesn’t heal.
“Normally with basal cell and squamous cell skin cancer, we find them on routine screenings, and they are treated with surgical procedures, especially on the head and neck, which is the most common place for skin cancer,” Ezzell explained.
Melanoma is a much more aggressive and less predictable tumor, and it is one of the leading causes of death in people under age 45, according to Ezzell. Identifying melanoma requires the ABCDEs of irregular or changing moles. The things to watch for are “asymmetry”, irregular “borders”, more than two “colors”, “diameter” (any mole bigger than a pencil eraser should be examined,) and “evolution,” or any changes in a mole.
Skidmore also states that any mole that bleeds or itches should be examined by a dermatologist.
While sun protection is a vital part of preventing skin cancer, lots of things can lead to greater risk of skin cancer, said Ezzell. Some of those things include smoking tobacco, viruses like human papillomavirus, physical burns from fire, immune-suppression and radio-therapy medical treatments and a “whole host of others that we currently are unaware of.”
While skin damage under the age of 18 can have the greatest impact, parents or guardians need to be especially protective of children under 6 months old. Children in this age range should not be exposed to the sun, according to Skidmore. “The skin is just so sensitive and so in need of protection,” he said.
“Children are the least likely to shade-seek or avoid sun,” Ezzell counseled. “Not only are parents responsible for protecting their children from the sun but also for enlisting them to learn to protect it themselves.”
If you have been diagnosed with skin cancer, Skidmore said it is especially important to “wear protective clothing and sunscreen over any exposed skin, especially during the hours when the sun is most intense, between 10 a.m. and 2 p.m.”
Ezzell recommends wearing protective clothing, avoiding the sun in its key hours, wearing sunscreen and seeking shade as healthy habits. According to her, ultraviolet protection factor (UFP) rated clothing is now widely available in stores, and clothing makes the biggest difference in sun protection.
“We don’t have good studies on the reversal of sun damage,” Ezzell explained, but reversing sun damage may not be impossible. According to Ezzell, some studies show that wearing sunscreen actually helps to reverse sun damage, and some theoretical studies show that using topical antioxidants like vitamin C and green tea extracts can also reverse some damage. Latest research has been on using topical repair enzymes, but the data is not yet absolute. When it comes to protecting the skin, Ezell cautioned, “By far, the best treatment is prevention.”