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July 2018 Summertime is a great time to enjoy the outdoors, and many of us like the look of a “healthy tan,” but the truth is, tans aren’t healthy. They’re a sign of skin damage, a sign that we’ve been overexposed to the sun—a major risk factor for skin cancer. Skin cancer is among the most common types of cancer in the United States, and the deadliest type of skin cancer—melanoma—is caused by exposure to ultraviolet light via sunlight or tanning beds. This doesn’t mean you have to hide indoors all summer. It simply means you need to plan ahead. Find shade during the middle of the day. Wear a hat and clothing that covers your arms and legs. If you’re poolside or somewhere else where protective clothing isn’t practical, use broad-spectrum sunscreen (one that blocks UVA and UVB rays) with a minimum SPF of 30, and reapply it every two hours if you’re in the water or actively perspiring. Be sure to do the same with your children no matter how much they complain. There are four main types of skin cancer: actinic keratoses (AK), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. AK looks like a dry, scaly patch on your skin. BCC looks like a flesh-colored, pearl-like bump or pinkish patch of skin. SCC looks like firm, red bump, scaly patch or a sore that heals and then reopens. To identify melanoma, you need to know the difference between healthy moles and unhealthy moles. Use the ABCDEs of melanoma to tell the difference. A stands for asymmetry. If one half of your mole doesn’t look like the other half—if it has an irregular, non-circular shape—it could mean trouble. B stands for border. Healthy moles have clear, smooth, even borders. If borders are scalloped, notched, or ill-defined, pay attention. C stands for color. Typically, benign (non-cancerous) moles are made up of one consistent color, but malignant (cancerous) moles have different shades in a single mole, often tan, brown and black but sometimes small patches of red, white or blue, too. D stands for diameter. Diameter measures the length of a mole. Small moles are safer. Big moles, those greater than a quarter-inch, are suspect. E stands for evolving. Healthy moles don’t change over time. Unhealthy ones do. If you notice a mole changing (growing taller or wider, changing color, itching, crusting, or bleeding), you should seek medical attention. As you check your skin for moles, remember they can be located in hard-to-see areas (your scalp, the middle of your back, the soles of your feet, etc.), so use a mirror or a loved one to thoroughly check your whole body. It’s also important to remember that some skin types are more prone to skin cancer than others. You are at higher risk if you are fair skinned, have a family history of skin cancer, spend a lot of time in the sun (or in tanning beds), have blond or red hair, have blue or green eyes, have skin that burns easily, or if you are prone to certain types (or a large quantity) of moles. Another risk factor is getting serious sunburns as a child, regardless of skin type. Sometimes, even careful people get sunburned. Outdoor events can go longer than expected, or a cloudy day may lull you into a false sense of security. It is not hot temperatures but UV rays that burn our skin, so don’t be fooled by clouds or cool days. Wear sunscreen even on cloudy days. With one in five Americans developing skin cancer during their lifetime, it’s well worth the time to protect your skin from the sun and do a regular, thorough self-exam. Our skin is our largest organ. We need to take care of it! Like many other types of cancer, skin cancer is highly treatable when discovered early, so if those moles aren’t playing by the rules, make an appointment with your medical provider right away. Talitha Marty is a physician assistant at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino Counties.