On the European Day for the prevention of skin cancer, we talked to two leading dermatologists, Dr. Urbà González and Dr. Pizarro Redondo, to learn about the most important aspects of this disease, especially those related to its prevention.
It is necessary to know that moderate sun exposure without sunburn can be beneficial for our health. According to Dr. Pizarro Redondo, from the Melanoma Prevention and Early Diagnosis Unit of the International Dermatology Clinic, the keys to good sun protection are:
- Seek shade: when you can, especially around midday and in times of higher light intensity, especially in spring and summer.
- Appropriate clothing (conditioned by the time of year and the activities to be performed): hats with wide visors or wide-brimmed hats, sunglasses of proven quality that provide good protection against ultraviolet radiation (otherwise they are counterproductive, since by limiting the visible light that reaches our eye, the pupil dilates and even more ultraviolet light enters our eye).
- Sunscreens (topical sunscreens). We should move with protection indexes between 20 and 50 (although it depends on the type of skin, the time of the year, the latitude where we are and the time of day). It should be taken into account that the real index reached on our skin is usually lower than the one indicated on the package, because we usually use a lower amount of sunscreen than necessary to reach that level of protection.
The application of the cream should be repeated every 1-2 hours. And, obviously, in spring and summer we should be more careful with sun protection than in autumn and winter, except that some recreational or sporting activities in the mountains, especially in the snow, require high sun protection because the snow reflects a lot of the sun’s rays, and amplifies the exposure.
In addition, in spring and summer it may be advisable to routinely use a sunscreen face cream or makeup that incorporates sun protection. This will help us maintain younger looking facial skin and reduce the risk of facial skin cancer in the long term.
Skin Cancer Risk Factors
In its most frequent forms (carcinomas or epitheliomas and melanoma), the risk of skin cancer depends on genetic and constitutional factors as well as environmental factors. As explained by Dr. According to Dr. Pizarro Redondo, genetic and constitutional factors condition our skin type, our phototype (greater or lesser ease of burning and tanning), the way in which our skin defends itself and repairs the damage caused by ultraviolet light, the number and type of moles, etc.
Moreover, according to Dr. Pizarro, high pharmacological doses of some isolated antioxidants not only do not help us to prevent the disease but seem to increase its incidence (some recent studies suggest that they could even facilitate the formation of metastases in melanoma). Therefore, when taking vitamin and antioxidant supplements, it is better to opt for those that contain low doses of many of these elements than for those with very high doses of some isolated antioxidants.
On the other hand, a diet rich in fruits and vegetables provides us with adequate doses of vitamins and antioxidants, which are beneficial for our health and our skin.
Children and the sun
According to Dr. Pizarro, in the first two years it is not advisable to “put a child in the sun”. It is better to keep them in the shade as much as possible. Obviously there will be activities during which they will be in the sun; then we should apply sunscreen creams (preferably topical photoprotectors of the “physical type” that contain metallic microparticles (zinc, titanium) that are hardly absorbed, do not usually produce allergic reactions and reflect sunlight quite well). The disadvantage of these sunscreens is that they are somewhat denser and more difficult to spread.
Intense sun protection has a drawback: it hinders the synthesis of vitamin D, which could cause a bone disease called rickets in children due to lack of calcium absorption and inadequate incorporation of calcium into the bones. For this reason, vitamin D supplementation is routinely administered to very young children under the supervision of a pediatrician.
In older children and adults, sunscreens with chemical filters are usually used more often, especially because they are less dense and spread better. The area where the product is to be applied and our skin type may condition the choice of products with different presentations (cream, milk, spray, gel, emulsion, oil, stick, lipstick).
As the years go by, any signs of sun damage on our skin become more evident. But we must not forget that the risk of skin cancer in adulthood, especially melanoma, is largely conditioned by sunburns suffered during our childhood, adolescence and early youth. It is therefore very important to educate families and schools in this regard.
Tell me what skin you have, and I will tell you what sunscreen you need.
The greater or lesser clarity of our skin and the greater or lesser facility to burn and tan condition the measures to be adopted in the sun. In addition, says Dr. Pizarro, the presence of many moles and/or atypical moles obliges us to be stricter with sun protection measures, even in people with dark skin tones.
The color of our skin and our response to the sun conditions what we call “phototype”, which ranges from 1 to 6 (1 corresponds to very light skin that always burns and never tans and 6 is black skin). In our environment, phototypes 2 predominate (fair skin that burns easily and tans slightly), 3 (fair skin that burns fairly easily but achieves a noticeable tan later) and 4 (slightly tanned skin that does not usually burn although it may do so after initial intense exposure and tans easily).
As is obvious, lower phototypes require stricter sun protection measures, without forgetting that moderate sun exposure is not necessarily harmful but we should always try to avoid sunburn and very prolonged sun exposure over time.
There are other characteristics of our skin that may condition the type of protection chosen. For example, in acne-prone skin, topical photoprotectors with low-fat excipients, better adapted to this type of skin, should be sought. And in people with allergies to some of the components of chemical topical photoprotectors it may be necessary to opt for topical photoprotectors of the physical type, although they are somewhat denser and spread worse.
Detection of Skin Cancer
There are different types of skin cancer, and each has its own particular characteristics. However, explains Dr. Urbà González, dermatologist at the GO&FER Clinic, they all have in common that they can be easily detected thanks to the external nature of the skin.
The appearance of new lesions on the skin or a change in any spot or mole can be signs of the onset of cancer. “The most typical changes are a change in color, shape or size,” explains the specialist, who adds that “the appearance of easy bleeding or discomfort, such as itching or pain” are also typical.
Symptoms of skin cancer
Melanoma is a malignant tumor that originates in the cells that give color to the skin, or melanocytes. According to Dr. Urbà, these cells usually grow benignly to form the typical moles. When these cells become malignant they produce the cancer called melanoma. When this occurs, the color of the moles usually becomes darker, they may grow in size and acquire more irregular shapes, bleed or cause some kind of discomfort.
Sometimes, however, moles that become malignant may lose color and become lighter in color.
When should a dermatologist be consulted?
As a preventive measure, it is advisable to see a dermatologist at least once for a complete skin check-up (even if you do not have any problems). In this check-up, explains Dr. Urbà, the specialist, depending on the examination and the history, can give guidance on the need for more or less regular check-ups.
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the other hand, each person should have a general idea of their skin to know (without details) their appearance and the moles they have. This is known as self-examination, and allows early detection of any changes. The change or appearance of new skin alterations are precisely the most important signs that help detect skin cancer, and are the main reason to consult a dermatologist.