Frequently Asked Questions
What is skin cancer?
please see the "types of skin cancer" link.
Is there such thing as a healthy tan?
This is a delicate question and the answer should be "no". But our skin has certain protective mechanisms that become active whenever our skin is exposed to sun light. One is pigmentation which is caused by melanin and the other is the thickening of the epidermis and horny layer of the skin. However these mechanisms occur only after chronic light exposure and cannot fully remove the chances of getting a sunburn or cause other skin reactions due to UV radiation.
Even tanning beds cannot provide you with a healthy tan since they use an amount of UVA radiation that is two to three times higher than from the sun at sea level. The best way to get a "healthy" tan is using a selftanning cosmetic product. They usually contain an active ingredient called dihydroxyacetone that stains the outer layer of our skin so it will appear darker. But be aware that this type of tan will not provide sunprotection since it has no impact on the production of melanin.
Is actinic keratosis serious?
Yes, actinic keratosis is serious. Although it looks quite harmless and is considered to be a precancerous skin disease it carries quite a high potential to develop into a malignant skin cancer such as squamous cell carcinoma.
Can I get a sunburn on a cloudy day?
YES! 70% to 80% of UV radiation can pass through thin clouds. On cloudy days your skin might feel cooler and because of this it is less likely you will notice you are getting burned, which can become quite a problem.
But isn't sunlight good for me?
It is true that the body needs a small amount of sunlight in order to produce vitamin D, however much less than it takes to get a tan. Most people today associate a suntan with good health and vitality, yet few realize that sun exposure accumulates over the years and leads to premature aging of the skin and can cause many forms of skin cancer.
I think I have skin cancer, what should I do next?
If you have a spot, mole, or lesion that you think might be skin cancer, you need to see your doctor or a dermatologist immediately. The earlier you find skin cancer, the better your chances are of being cured.
What is a biopsy? When do I need one?
A skin biopsy is the best diagnostic technique for many cutaneous lesions that cannot be diagnosed visually. This procedure implies the excisional removal of a small part of tissue including the epidermis (the top skin layer), the dermis, and, variably, underlying fat. This is usually done in local anesthesia, which means the patient gets an injection which will keep away the pain. After the removal of a small piece of skin, the wound is closed with a few stitches. Skin cancer should be ruled out in each new skin lesion, particularly in those arising on sun-exposed skin. Ultimately, the diagnosis is established by skin biopsy. Several techniques are available, the choice of biopsy technique depending on the size and location of the suspicious lesion.
I have children, how do I protect them (and myself) from UV-radiation?
Since children get 80% of their lifetime sun exposure before the age of 18 and their skin is very sensitive they need special sun protection. Playing out in the sun is fun so let them wear a shirt, put on a wide brimmed hat and put on a good amount of sun protection cream with at least SPF 15. Reapply every one to two hours. Use sunblock on very exposed areas. They come in different colors and can even be fun for your children.
Your protection should be about the same and in behaving sun smart you can also be a role model for your children.
Do I get a tan even when I use a high SPF?
Yes, you will get a tan. It will just take longer. However the SPF is a shield to prevent you from sunburn. A SPF 20 for instance allows you to stay in the sun 20 times longer without getting sunburnt than with no sun screen at all. Therefore you will tan as much as with a SPF 8 if you stay proportionately longer in the sun. But anyhow always be aware that a high SPF is not your license to stay in the sun and fry. Any impact of UV-radiation - be it a tan or sunburn - can lead to skin cancer!!! Sun screen should not be your first choice of protection better cover up and stay in the shade!
How are skin cancers classified?
Primary cutaneous cancers are classified on the basis of their cell origin within the skin. Skin cancers are most commonly derived from keratinocytes (e.g., squamous cell carcinoma) or melanocytes (e.g., malignant melanoma), which are normal components of the epidermis, the top layer of the skin.
What are the most common non-melanoma skin cancers?
Most frequently, basal cell carcinoma and squamous cell carcinoma are detected.
What is the most important cause of non-melanoma skin cancer?
Most cases of pre-cancerous and cancerous skin lesions are caused by sun exposure.
What is an actinic keratosis? What do actinic keratoses look like clinically at an early stage?
Actinic keratoses are sun-induced pre-cancerous lesions of the skin. They are very common in elderly patients with light skin color and a history of sun exposure. Actinic keratoses initially appear as tiny, palpable bumps on normal sun-exposed skin that gradually enlarge and become red and scaly.
What is Bowen’s disease?
Bowen’s disease is a precancerous lesion, the malignant cells being restricted to the top skin layer. It appears as a red, scaly or crusted lesion, and may be located anywhere on the skin, including non-sun-exposed skin surfaces.
What are basal cell carcinomas?
Basal cell carcinomas are the most common malignant skin tumors. They are locally destructive tumors that rarely metastasize.
At an early stage, what do typical squamous cell carcinomas look like clinically?
Often the initial appearance is an ill-defined, red lesion with a rough skin surface.
How can I best prevent skin cancer?
The easy answer is to avoid sun exposure, particularly during childhood. Help us to support the idea that pale skin is more attractive than tanned skin! Use protective clothing, apply sun protection and do the self-skin exam on a regular base.
What is and what causes melanoma?
Melanoma is a malignancy of melanocytes, special cells in the skin which synthesize skin pigment. It is the most rapidly increasing form of cancer in the US. Although all causes of melanoma are not known with certainty, epidemiologic studies suggest that brief, intense exposure to ultraviolet radiation contributes to the development of melanoma.
When am I at risk of developing melanoma?
- have a fair complexion
- stay in the sunlight for short, intense periods of time
- have numerous atypical-appearing moles or large congenital melanocytic nevi
- have previously had melanoma or have had an immediate family member diagnosed with melanoma
then you are at risk for developing melanoma.
Where on the body does melanoma most commonly occur?
Melanoma can occur on any part of the body. Primary tumors are most common on the trunk in men and on the lower extremity (thighs, legs, feet) in women.
Does a biopsy of melanoma increase the risk of spreading tumor cells or causing metastases?
Studies have concluded that incisional biopsies of melanoma do not cause the tumor to spread locally or metastasize.
What is the impact of sun on skin cancer?
The sun causes at least 90% of all skin cancers! The number of blistering sunburns and the total amount of sun exposure in a lifetime are important risk factors. Sunburns are directly related to melanoma risk. Lifetime cumulative sun exposure directly correlates with basal cell and squamous cell carcinoma risk. Look out, anyone can get skin cancer, although some people are at greater risk than others!
I have an outdoor job, do I have a higher risk of getting skin cancer?
Yes! Workers who are exposed to the sun on a daily basis, such as farmers, fishermen, and construction workers, are at a higher risk for developing non-melanoma skin cancer.
What are sunscreens in the broadest terms?
Sunscreens are agents that block the ultraviolet radiation absorption of the skin. Clothing, hats, sunglasses, and chemical or physical agents, including lotions, creams, pastes, and gels can be regarded as sunscreens.
What should I consider in selecting a sun protection cream?
The sun protection cream should block both UVB and UVA. You should consider a sun protection factor (SPF) rating of 15 or greater, depending on the intensity of UV radiation and your skin type. SPF 15 blocks about 93% of harmful UV radiation.
How much sun protection cream should I apply? How often should I reapply it?
Covering of the face, arms, legs, and upper trunk requires approx. a handful of sun protection cream. The sun protection cream should be applied evenly and rubbed into all sun-exposed skin. It should be applied 30-60 minutes before sun exposure and, under normal conditions, reapplied every 2 hours. Sun protection cream should be reapplied more often if swimming, sweating, or rubbing has removed some of the product. But be aware that reapplying does not increase the SPF!
Is “sunburn” an indicator for “skin damage”?
No! Skin damage occurs before sunburn is visible.