Are You Helping Your Clients Avoid Skin Cancer?

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Are You Helping Your Clients Avoid Skin Cancer?

Posted: November 29, 2010

Editor’s note: As a spa professional, you are in a unique position to be able to help clients identify skin cancer. Be sure to make note of any marks that appear odd, according to the information below, and be sure to recommend a visit to the dermatologist if it is in order. Also, it is important to be able to refer clients to a reputable dermatologist if they don’t already have one. One more thing … make sure that clients perform the home skin care checks as advised in this piece.

Skin cancer is a scary subject. “No one wants to think about developing a disfiguring, even deadly, disease, therefore so many Americans live in a state of denial,” says Joshua Fox, MD, a leading dermatologist and medical director of Advanced Dermatology of New York and New Jersey. “Most people know they are supposed to be checking their skin monthly for changes that might be cancer, but they aren’t exactly diligent about it. It’s something that gets put off for later, often indefinitely.”

But skipping the skin scans can be dangerous, says Paige Farkas, MD, a dermatologist specializing in skin cancer screening at Advanced Dermatology. “There have been significant advances in the treatment of skin cancer, including the deadly types, but we know that the front-end things–detection, diagnosis and immediate treatment–are still critical.” In fact, she says, despite the fact that skin cancer is among the simplest types of cancer to identify since it’s visible on the outside of the body, the rates continue to rise. And although nonmelanoma cancers have a relatively good prognosis, melanoma, the deadliest form of skin cancer, can quickly become lethal. In fact, new research shows that melanoma cells have a unique ability to override even the healthiest immune system, eventually spreading far beyond the initial site.

The truth is, checking your skin regularly, and making an appointment to have your dermatologist do the same, is the best and only way to catch skin cancer before it spreads. “For the past 25 years, we’ve told people to pay attention to the ABCDs of pigmented skin irregularities,” Fox says. “Asymmetry, border irregularity, color variation, and diameter more than 6 mm (about ¼ inch). These are still the key to identifying a problem growth among a bunch of innocuous looking freckles and moles,” he says.

Here are the rules of skin cancer screening. Make sure your clients do these at home.

DR, WHAT IS IT? WHEN NEW GROWTHS APPEAR ON YOUR SKIN

DR, WHAT IS IT? WHEN NEW GROWTHS APPEAR ON YOUR SKIN
Leading dermatologist Dr. Joshua Fox explains benign growths

New Hyde Park, NY, February 2009 – The skin is the organ most exposed to the outside environment and it provides our first line of defense against a wide range of toxins, bacteria, viruses, foreign bodies, and diseases that could have serious and sometimes lethal impact. The many tumors and rashes that appear over time on different parts of the skin can be traced to more than 200 diseases, most of which are treatable, and most of which are completely benign. But it is the risk of malignancy or another life-threatening disorder, and the want to look beautiful, that makes it important to know when a growth or skin eruption requires medical assessment or can be treated simply.

Skin lesions may appear as pigment changes, such as a patch, as bumps, lumps, moles, warts, as flaky or crusty patches, or manifested in a wide number of other types of abnormalities. Joshua Fox, M.D., founder of Advanced Dermatology, P.C. in New York and on Long Island, and a spokesman for the American Academy of Dermatology and the American Society of Dermatologic Surgery, helps to clarify what we need to know about the changes we see on our skin.

MOLES: Most people are aware of the need to examine moles which appear benignly throughout life, and to check for new changes that occur, particularly in parts of the skin exposed to sunlight. Melanoma is the deadliest form of skin cancer taking about 41,000 lives worldwide, although it is far less common than the other skin carcinomas. The incidence of melanoma continues to grow at alarming rates among light-skinned people. According to the American Cancer Society, 60,000 people in the United States developed melanoma in 2007, and more than 8,000 died of the disease. The most suspicious moles are either congenital nevi, moles from birth, or dysplastic nevi, usually larger more irregular moles with irregular shape and or/color, which are found in an estimated ten percent of the American population.

WARTS: Warts are very common growths that occur on various parts of the body as a result of the human papilloma virus (HPV). “These are benign growths that affect all skin types and may go away without treatment, although if they persist, many people seek medical help to remove them due to irritation or just the unsightly appearance. The wart or virus also may promote certain skin cancers like some squamous cell carcinomas and cervical cancer,” Dr. Fox explains. They can be treated chemically, via cryotherapy, or with lasers, or surgically removed in a dermatologist’s office.

KERATOSIS PILARIS: Another type of common skin lesion is keratosis pilaris, in which the cells that normally flake off from the skin’s surface instead become trapped and plug hair follicles. They appear as hyperkeratotic, rough raised bumps based in hair follicles which can multiply in an area like the arms, thighs, buttocks, back and occasionally the face. “This is a common occurrence, particularly among teenagers,” Dr. Fox says, “and is not cause for serious concern.” Moisturizing is the first line of treatment for keratosis pilaris. He also suggests taking long baths and gently rubbing the skin surface with a course washcloth or buff puff. However, in some people this can cause irritation and/or discoloration. If the condition doesn’t go away, there are many effective topical treatments available with or without a prescription.

Seborrheic keratosis is a growth that appears usually over the age of 40, and can become irritating and itchy. It usually appears as brown keratotic stack on a lesion anywhere on the body. There are no particular topical or at-home treatments for this form. A dermatologist can treat areas with cryosurgery (freezing), dermatologic surgery or lasers to eliminate the discomfort and unsightliness.

SKIN TAGS: Skin tags are an annoying type of growth that about half of all people develop as they age. These are small pieces of hanging flesh that develop in areas that are prone to rubbing against clothing or other skin; or are moist areas such as the upper thighs, under arms, neck, and under women’s breasts from underwire bras. Another common site is the eyelid. “Most skin tags are small, but they continue to grow and often become painful or annoying because of their location,” according to Dr. Fox, who recommends a visit to dermatologist to have them removed if they are painful, irritating, bleeding, infected or get caught in clothing.

MELANOMA/SKIN CANCER: It is so important to be familiar with the moles on your body and to perform regular self-examinations of your skin. Melanoma often develops in a pre-existing mole that begins to change or in a completely new mole. Melanoma is a serious skin cancer and the mortality rate is remarkably high considering the fact that it is nearly always curable in its early stages; however, this high number can be attributed to the late diagnosis of the disease in which the cancer spreads to other parts of the body. Melanoma most often appears on the trunk of men and the lower legs and arms of women, although it can be found on the head, neck, scalp or elsewhere. Melanoma represents approximately 5% of all skin cancers in the USA, but accounts for about 75 % of all skin cancer deaths. The World Health Organization estimates that as many as 65,161 people a year worldwide die from malignant skin cancer, approximately 48,000 of whom are registered. The American Academy of Dermatology (AAD) estimates that in 2009, about 116,500 new melanoma cases will be diagnosed in the U.S. with 8,420 deaths (~1 death every hour). Incidence rates are at least 16 times greater in Caucasians than African Americans and 10 times greater than Hispanics. Moreover, even though skin cancers are not as prevalent in individuals with darker skin, they can have more morbidity and fatalities since they may go undiagnosed for longer. Researchers estimate that 1 out of 50 people in the U.S. in 2010 will be diagnosed with melanoma at some point in their lives. Specifically, among Caucasians, the rate of increase of melanoma incidence is 3-7% each year. Melanoma grows from pigment cells (melanocytes) in the outer layer of the skin (epidermis) and mucous membranes and tends to spread out within the epidermis before moving into the deeper layer of the skin (the dermis). In its advanced stages it can spread to other organs of the body. Frequent self-examination for the ABCDE (Asymmetry, Border Irregularity, Color, Diameter and Evolving) characteristics of abnormal moles is suggested.

These are the most common types of growths that may appear over time on the skin, and the majority are no cause for concern. Many other types of benign lesions are also possible such as dermatofibromas, cysts, freckles, fibromas, keloids, lipomas, and granulomas, as well as many more rare types. While an assessment of anything unusual or a mole that is irregular in shape or size is critical, many other skin lesions can still cause a discomfort, pain or embarrassment you don’t have to live with. Dr. Fox notes that there are a wide range of treatments available which you can discuss with your dermatologist. “Many patients don’t realize that most of the treatments can be performed at the time of the consultation visit so you go home without the problem you may have endured for months or years. Usually there is little to no mark left behind. It’s especially important to become educated to the changes that occur on your skin,” says Dr. Fox. “You need to recognize what you are prone to, how you can prevent it, and what options are available to treat it­, as well as which lesion can get you into trouble.”

U.S. TEENS FACE GROWING RISK OF DEADLY SKIN CANCER

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U.S. TEENS FACE GROWING RISK OF DEADLY SKIN CANCER

Leading dermatologist dispels myths, says teens need better protection to avoid cancer

New York, NY, November 2008 – Of the approximately 1.3 million Americans who will learn they have melanomas or other skin cancers this year a growing percentage will be young people. According to the American Cancer Society, melanoma is now the most common cancer among Americans aged 25 to 29, and it is the Number One cause of cancer death among 15 to 20 year olds. Melanoma is linked to too much exposure to the sun in the first 10 to 19 years of life, a period during which according to some reports almost 80 percent of a person’s lifetime sun exposures occurs. Despite skin cancer’s devastating effects on teenagers and the many health risks faced by teens seeking the perfect tan, young sun worshippers continue to soak in the sun’s dangerous rays at an alarming rate.

Study after study has shown that teens ignore the warnings in their quest to “look good.” In the recent American Academy of Dermatology Sun Exposure Teen Study, 63 percent of teens said they look better when they’re tan and 43 percent of teens admit they lay out in the sun, while less than one-third say they always use sun block. Nearly the same percentage say they never use sun block. Joshua Fox, MD, a leading dermatologist and founder of Advanced Dermatology, P.C., warns that teens are at a greater risk and seeks to dispel some of the myths that sun-seeking teens believe, including:

1. Skin cancer is only for older people. In fact, says Dr. Fox, “while melanoma usually develops many years after a person’s excessive sun exposure as a child, we are finding it with alarming increased frequency in kids. For example, just last week I had an eighteen year old boy, who liked outdoor sports, diagnosed with an invasive melanoma. Research shows that many forms of skin cancer start as a result of over-exposure to the sun during childhood. One blistering sunburn in childhood or adolescence may more than double a person’s chances of developing a melanoma later in life.”

2. Tans make you look healthy. Dr. Fox says, “There is no such thing as a healthy tan and asserts that tans do just the opposite.” “Both sunburns and suntans compromise skin cell DNA and cause changes that over time age the skin, giving it a wrinkled, leathery appearance with enlarged pores and cause brown liver spots and white and yellow splotches. But if you are partial to the appearance of having the “color of a tan” try applying a self-tanner which can last for several days. Dr. Fox warns that this does NOT protect the skin from the sun’s exposure.

3. Tanning salons are safer than the sun. While the indoor tanning industry tells kids that tanning beds and sun lamps are safer than lying on the beach in the hot sun, “ongoing use of indoor tanning can be quite dangerous,” Dr. Fox says. “It can increase the risk of developing malignant melanoma by more than 55 percent, and it could nearly double the chances of several other types of skin cancers.” Most sun lamps and tanning beds emit mainly UVA radiation. While these rays don’t necessarily cause sunburn as quickly as does UVB radiation from sunlight, that does not make them safe. “UVA rays actually cause deeper skin damage, and like UVB rays, they also may be linked to immune system damage, premature skin aging and skin cancer promotion,” Dr. Fox says, citing a report of the American Academy of Dermatology. “UVA is a carcinogen, and studies have shown that tanning salons frequently exceed ‘safe’ UV limits, with the rays emitted in aStudy after study tanning parlor being up to 15 times that of the sun.”

4. Sunburn is worse than a tan. “Both are dangerous,” says Dr. Fox, “because both cause DNA damage to the skin cells. While sunburn has been directly linked to skin cancermelanoma, tans also are dangerous because they cause slower damage to the skin, so teens may not realize that they are causing harm.” Most teens realize that a sunburn is bad for you.

5. Sunscreen is only for the beach. “Teenagers at the beach on a hot summer’s day are not the only ones at risk,” says Dr. Fox. “Sun damage occurs anywhere, any time your skin is exposed to sunlight, during all four seasons, whether at the beach or park, on a boat, a ski mountain or golf course. Kids must use sunscreen every time they are outdoors in the sun – even on cloudy days.”

6. Tans are healthy. Many people associate a suntan with good health and vitality. “While Vitamin D is necessary to the body and may help prevent certain cancers,” Dr. Fox says, “just a small amount of sunlight is needed for the body to manufacture it, far less than the amount that creates a suntan and sunburn. Actually a person is better off taking Vitamin D supplements than going out into the sun”.

7. Tan sprays have SPF. Many teens protect themselves from the sun by using self-tanning sprays thinking they’ll get that “healthy” tan look without the sun damage. “That’s only true if a person avoids the sun entirely.” Dr. Fox explained that, while tanning sprays may make teens look tan, they don’t offer any protection from the sun’s damaging rays. “Self-tanners may, in fact, make the skin more susceptible to damage. You will still need to apply a broad spectrum sunscreen with an SPF of at least 30 after self-tanning,” he says.

SEEKING THAT SUMMER GLOW YEAR ROUND? SKIP THE SUN AND TANNING BED FOR A “SPRAY TAN”

SEEKING THAT SUMMER GLOW YEAR ROUND? SKIP THE SUN AND TANNING BED FOR A “SPRAY TAN”:

Leading dermatologist discusses the newest – and safest – way to achieve sun kissed skin sans the risks

Ever since Coco Chanel returned from a French yachting voyage with a suntan in 1920, women, men, and even young teens have revered tanned skin as a sign of beauty and good health. Yet, the truth about skin that is exposed to the sun’s harmful UVA and UVB rays is just the opposite. Sun-damaged skin is prone to premature aging, causing wrinkles, uneven skin tone, enlarged pores and age spots. What’s more, UV exposure is the leading cause of skin cancer, which strikes one million Americans each year – nearly double the number of all other cancers combined. Although many of these cancers are rarely life threatening, they all can be disfiguring if they need to be surgically removed from the face, shoulders, chest or other commonly exposed area. Melanoma, of course, is the deadliest skin cancer and it is thought to be almost exclusively caused by sun exposure or use of tanning beds.

Fortunately, “spray-on tans” are a new alternative to “baking” on a tan that can provide a realistic, natural-looking tan without any UV exposure at all. Joshua Fox, MD, founder of Advanced Dermatology, P.C. in New York and on Long Island, and a spokesman for the American Academy of Dermatology and the American Society of Dermatologic Surgery, explains, “Based on the available research, ’spray tans’ are a safe alternative to any UV-based tanning process, because they color the skin using an FDA-approved compound called DHA that simply tints the dead skin cells at the very top layer of the epidermis.” While a ‘spray tan’ does not actually fade, Dr. Fox points out, “it will disappear as the layer of skin is sloughed off – usually within a week.”

Getting the word out remains a challenge

“Despite the fact that ‘spray tans’ provide all the aesthetic benefits of a suntan without the serious dangers,” Dr. Fox notes, “recent research suggests that many sun-worshippers and tanning bed fans are still not getting the message.” For example, a study completed at Northwestern University and published in the April edition of Archives of Dermatology analyzed the knowledge, attitudes and behavior of young adults regarding indoor tanning over the course of 12 years. Researchers found that, between 1994 to 2007, the percentage of participants who knew that limiting tanning can help prevent melanoma actually decreased from 77% to 67% — a factor that coincided with an increase in the number of subjects who thought “having a tan looks better,” from 69% in 1994 to 81% in 2007. “Perhaps the most surprising statistic of all is that tanning bed use has remained at around 26-27% between 1994 and 2007, despite the fact that we learned during this time period just how dangerous these tanning beds can be,” Dr. Fox says.

In another recent study, researchers at Boston University Medical Center found that 44% of young adults surveyed had either used sunless tanning products like a ‘spray tan’ over the preceding 12 months or had planned to use them over the following 12 months. Unfortunately, these self-tanners were also more likely to use a tanning bed than those who had not used the sunless method. “There are certainly misconceptions and myths that still exist about the use of tanning beds, including the notion that the UVA rays in these machines are ‘healthier’ than UVB rays, but this is simply not the case,” Dr. Fox says. “In fact, UVA rays have been shown to penetrate more deeply than UVB rays, which are the main culprits in a ‘surface’ sunburn,” he adds. UVA also promotes skin cancer, wrinkling and other bad effects on the skin.

A ‘spray tan’ can either be applied at home by oneself or can be applied in a booth in a salon by trained personnel, to ensure even coverage. There are many choices of spray-on products so one should try to match the color. At a salon, the cost is usually between $25 and $40 per application, and the effects last about a week. After application, the tanning substance stays on the skin for about four hours before it can be showered off. While the compound itself is deemed safe, Dr. Fox offers two caveats: “’Spray tan’ participants should avoid inhaling the compound during application, and always remember that a ‘spray tan’ does not offer any significant protection at all from the harmful rays of the sun. In fact, DHA may make skin more sensitive and susceptible to UV damage – so a broad-spectrum sunscreen with an SPF of 30 is a must.” But the DHA product itself – without sun exposure – is safe and recommended if used to avoid tanning. Dr. Fox also recommends supplementing your diet with Vitamin D pills since you may not be getting enough supply from the sun.

SEEKING THAT SUMMER GLOW YEAR ROUND? SKIP THE SUN AND TANNING BED FOR A “SPRAY TAN”

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SEEKING THAT SUMMER GLOW YEAR ROUND? SKIP THE SUN AND TANNING BED FOR A “SPRAY TAN”: Leading dermatologist discusses the newest – and safest – way to achieve sunkissed skin sans the risks

Advanced Dermatology, September 2008 – Ever since Coco Chanel returned from a French yachting voyage with a suntan in 1920, women, men, and even young teens have revered tanned skin as a sign of beauty and good health. Yet, the truth about skin that is exposed to the sun’s harmful UVA and UVB rays is just the opposite. Sun-damaged skin is prone to premature aging, causing wrinkles, uneven skin tone, enlarged pores and age spots. What’s more, UV exposure is the leading cause of skin cancer, which strikes one million Americans each year – nearly double the number of all other cancers combined. Although many of these cancers are rarely life threatening, they all can be disfiguring if they need to be surgically removed from the face, shoulders, chest or other commonly exposed area. Melanoma, of course, is the deadliest skin cancer…and it is thought to be almost exclusively caused by sun exposure or use of tanning beds.

Fortunately, “spray-on tans” are a new alternative to “baking” on a tan that can provide a realistic, natural-looking tan without any UV exposure at all. Joshua Fox, MD, founder of Advanced Dermatology, P.C. in New York and on Long Island, and a spokesman for the American Academy of Dermatology and the American Society of Dermatologic Surgery, explains, “Based on the available research, ’spray tans’ are a safe alternative to any UV-based tanning process, because they color the skin using an FDA-approved compound called DHA that simply tints the dead skin cells at the very top layer of the epidermis.” While a ‘spray tan’ does not actually fade, Dr. Fox points out, “it will disappear as the layer of skin is sloughed off – usually within a week.”

Getting the word out remains a challenge

“Despite the fact that ‘spray tans’ provide all the aesthetic benefits of a suntan without the serious dangers,” Dr. Fox notes, “recent research suggests that many sun-worshippers and tanning bed fans are still not getting the message.” For example, a study completed at Northwestern University and published in the April edition of Archives of Dermatology analyzed the knowledge, attitudes and behavior of young adults regarding indoor tanning over the course of 12 years. Researchers found that, between 1994 to 2007, the percentage of participants who knew that limiting tanning can help prevent melanoma actually decreased from 77% to 67% — a factor that coincided with an increase in the number of subjects who thought “having a tan looks better,” from 69% in 1994 to 81% in 2007. “Perhaps the most surprising statistic of all is that tanning bed use has remained at around 26-27% between 1994 and 2007, despite the fact that we learned during this time period just how dangerous these tanning beds can be,” Dr. Fox says.

In another recent study, researchers at Boston University Medical Center found that 44% of young adults surveyed had either used sunless tanning products like a ‘spray tan’ over the preceding 12 months or had planned to use them over the following 12 months. Unfortunately, these self-tanners were also more likely to use a tanning bed than those who had not used the sunless method. “There are certainly misconceptions and myths that still exist about the use of tanning beds, including the notion that the UVA rays in these machines are ‘healthier’ than UVB rays, but this is simply not the case,” Dr. Fox says. “In fact, UVA rays have been shown to penetrate more deeply than UVB rays, which are the main culprits in a ‘surface’ sunburn,” he adds.  UVA also promotes skin cancer, wrinkling and other bad effects on the skin.

A ‘spray tan’ can either be applied at home by oneself or can be applied in a booth in a salon by trained personnel, to ensure even coverage. There are many choices of spray-on products so one should try to match the color.  At a salon, the cost is usually between $25 and $40 per application, and the effects last about a week. After application, the tanning substance stays on the skin for about four hours before it can be showered off. While the compound itself is deemed safe, Dr. Fox offers two caveats: “’Spray tan’ participants should avoid inhaling the compound during application, and always remember that a ‘spray tan’ does not offer any significant protection at all from the harmful rays of the sun. In fact, DHA may make skin more sensitive and susceptible to UV damage – so a broad-spectrum sunscreen with an SPF of 30 is a must.”  But the DHA product itself – without sun exposure – is safe and recommended if used to avoid tanning.  Dr. Fox also recommends supplementing your diet with Vitamin D pills since you may not be getting enough supply from the sun.