Saving Your Skin

From skin cancer to skin infections, local dermatologists offer advice on how to stay safe this summer.

More than 5 million skin cancer cases are diagnosed annually in the United States, and in the past decade, the number of new melanoma cases diagnosed has grown by 53 percent. In 2018, an estimated 9,320 people will die from melanoma.

Melanoma is an aggressive form of cancer with risk factors that include a family history of the disease and the presence of atypical, large,or numerous (more than 50) moles.

Many of these cases could have been prevented by protecting skin from excessive sun exposure and not using indoor-tanning devices.

“The No. 1 cause of skin cancer is ultraviolet radiation (sunlight) and the best way to avoid sunlight is to seek shade, wear sun-protective clothing, or wear sunscreen,” said Dr. Deirdre Hooper, a dermatologist with New Orleans-based Audubon Dermatology. “You should protect yourself from the sun at all times. There is no ‘healthy’ tan or ‘safe’ base tan.”

Dr. Erin Boh, professor and chairman of dermatology at Tulane University’s Department of Dermatology, stresses that skin cancer can affect anyone, regardless of skin color.

“Even if you’re able to tan, you’re still at risk,” she explained. “One in five Americans will develop skin cancer during their lifetime. Sun exposure is the most preventable risk factor for skin cancer, so the key is to put a barrier between yourself and the sun. I suggest generously applying a broad-spectrum sunscreen every two hours while in the sun.”

The vast majority of skin cancers are basal cell carcinomas and squamous cells carcinomas (non-melanoma). About 4.3 million cases of basal cell carcinoma and nearly 1 million cases of squamous cell carcinoma are diagnosed every year according to the Skin Cancer Foundation.

Feeling the Heat

In Louisiana, approximately 1,000 new cases of melanoma of the skin were reported over the last year, mirroring numbers in most states in regards to population.

Hooper emphasizes that skin care needs to be a daily concern.

“A lot of people tell me they wear sunscreen when they go on their beach vacations or are spending a day in the sun, but they don’t think about incidental sun exposure—going to the store, heading out for cocktails, etc.,” she said. “The average American gets around 30 hours of sun a week just from incidental exposure.”

Dr. Kyle Coleman, a dermatologist with Etré Cosmetic Dermatology and Laser Center, cautions patients to go above and beyond just sunscreen and don a hat with a brim of at least 6 inches, as well as clothing that covers the chest, shoulders and arms, since the region’s high humidity can cause sunscreens to sweat off more easily.

Treatment Options

If you do end up with skin cancer, Dr. Elizabeth Grieshaber, a partner in Terezakis and Grieshaber Dermatology in Metairie, said the primary treatment is removal by excision.

“Squamous cell carcinoma and melanoma can be more aggressive and can spread to other organs and parts of the body,” she warned. “If this occurs, treatment usually consists of a combination of therapy with chemo, radiation and surgical modalities.”

Currently, surgery is the most effective treatment for skin cancer and Hooper noted about 90 percent of cases are treated this way.

Boh added that the earlier the cancer is detected, the better the surgical outcome and the smaller the scar.

“The newest technologies are focused on the early diagnosis of skin cancer,” Boh said. “Computer scientists are using artificial intelligence to train computers how to detect skin cancer. It may be used as a tool to help patients and dermatologists identify skin cancer, however, currently you can’t trust an app to tell you if you have skin cancer. There is no substitute for a full-body skin exam with a board-certified dermatologist.”

One new therapy gaining acceptance is SRT (superficial radiation therapy), which is used to treat non-melanoma forms of skin cancer. Hooper explained that the treatment uses very focused, low-dose radiation that only goes skin-deep to stop cancer cells from spreading. SRT is a good method for elderly people and those who can’t be treated with surgery because their immune systems could be compromised.


Know Your Body

The best way to detect skin cancer early is to be aware of new or changing skin growths, particularly those that look unusual.

Hooper said that the No. 1 thing to look for is growth on your skin that is not healing the way you would expect.

“A common report I get is, ‘I have this pimple that doesn’t go away,’ or ‘I have a spot that bleeds every time I wash my face or shave,’ and these are things that should heal or go away,” she said. “These are common signs of non-melanoma skin cancers.”

Another concern is a spot on your body that is chronically flaking (skin falls off and comes back).

Other Summer Skin Concerns

It’s not only skin cancer that people need to be wary of. There are numerous problems with the skin that can cause trouble.

Because New Orleans can get so warm, humid and wet in summertime, skin infections are common, especially in body folds between the legs, under arms or between toes.

“People don’t know what to do with them and are sometimes embarrassed to talk about them,” Hooper said. “I talk to people about trying to keep cool and dry and maybe apply powder to body folds after a shower if they are prone to getting red, itchy or flaky.”

Another problem caused by New Orleans’ humidity is little red bumps on the skin called miliaria.

“Cool soaks with an oatmeal-based bath can help calm the skin down,” Coleman said. “In areas where skin rubs, try a cornstarch-based powder to prevent irritation.”

While burning and skin cancer are natural concerns, another important thing to remember about sun exposure, Boh warned, is that it’s the No. 1 most preventable cause of early skin aging.

“To look young, stay away from tanning beds and wear sunscreen daily,” she said.

“Two of the most important skin products for anti-aging are retinols and sunscreen,” said Dr. Vineeta Estes, medical director at The Sculpting Center of New Orleans. “Topical retinol products are essential for reversing the effects of photo damaged skin. They improve the appearance of fine lines, wrinkles, and discoloration. Daily sunscreen protects the skin from further damage.”

When considering sunscreen, Dr. Grieshaber said to look for an SPF of 30 or higher and something that is broad spectrum, meaning it blocks both UVA and UVB.

“The ingredients in sunscreens matter,” she said. “My two favorite active ingredients are zinc oxide and titanium dioxide. These are physical rather than chemical blockers so you get better UVA coverage with these ingredients.”

Avoiding Skin Cancer

Stay in the shade—especially during high-sun times (from 10 a.m. to 4 p.m.)

Avoid tanning.

Don’t use UV tanning beds.

Liberally apply sunscreen to your entire body a half hour before heading outside.

Cover up — this includes wearing a broad-brimmed hat and UV-blocking sunglasses.

Reapply sunscreen every two hours or after swimming.

See a dermatologist every year for a professional skin exam.

Examine your own skin at least once a month for any new or changing moles.