Getting Under Your
Skin
What you need to know about sun damage.
Dr. Coyle S. Connolly, DO
TWEENS & TEENS News MayJune
2008
Susan, a fair-skinned girl, spent her childhood
weekends playing outdoor sports. She also took
frequent trips with her family to the mountains
and the beach. In her teens, Susan became a
lifeguard. Her cute freckles and tanned skin
were summer fixtures. She’d visit the
tanning salon when her summer glow began to
fade. Sure, Susan had her share of sunburns;
but she felt her deep tan protected her from
many of those painful burns.
What Susan and her parents did not know was
that by the age of 10, the insidious early warning
signs of sun damage were already evident. More
and more freckles were popping up on Susan’s
skin. Her rosy complexion was becoming more
persistent. Tiny spider veins could be seen
on her nose and cheeks. In other words, Susan’s
skin was aging faster than she was.
Visible Signs of Sun Damage
•Brown Spots (Lentigos)
•Red Spider Veins (Telangiectasia)
•Yellow Sallow Skin (Solar Elastosis)
•Wrinkles (Rhytides)
•Blocked Pores (Comedones)
At age 19, Susan came to my office with a suspicious
dark spot on her leg. A skin biopsy was performed
that very day revealing melanoma skin cancer.
Fortunately, this potentially deadly form of
skin cancer was caught before it had a chance
to spread to internal body organs. However,
as a result of the melanoma skin cancer, Susan
is susceptible to more future skin cancers.
She’ll need to perform monthly self-exams
and visit a dermatologist annually. The six-inch
scar on Susan’s leg is a daily reminder
of the necessity for sun protection and skin
surveillance.
While malignant melanoma is influenced by genetics,
excessive sun exposure throughout childhood
is thought to trigger the gene that expresses
the cancer. Susan is now also at risk for the
development of non-melanoma skin cancers, such
as basal cell and squamous cell cancer. I urge
families to watch for the warning signs of skin
cancer.
Consider the facts and take the necessary steps
to protect yourself from the sun’s dangerous
rays.
It is difficult for many young people to comprehend
that excessive sun received today will generally
cause problems in the future. This is the essence
of the problem. There is a lag phase of 10,
20 or even 30 years or more between early sun
exposure and the development of wrinkled, blotchy
skin and skin cancer.
A visual aid portraying future damage may help
tween and teen patients better understand the
gravity of the situation. Fair-skinned or love
the sun? Speak to your doctor about the following
technologies: A handheld woods light (think
glowing black light posters) highlights brown
sun spots— a symptom of sun damage. More
sophisticated complexion analysis photographic
systems, such as Visia, take stunning pictures
of damaged skin. The images are enhanced to
show the aging process in visual terms right
before patients’ eyes.
The key to healthy skin is behavior modification,
meaning taking steps every day to reduce sun
exposure. First, apply a broad spectrum sunscreen
to all sun exposed areas. Broad spectrum sunscreen
blocks most ultraviolet A (UVA) and ultraviolet
B (UVB) sun rays. Use an SPF (sun protection
factor) of 15 or higher. Keep in mind that SPF
refers only to UVB and not UVA radiation, so
always confirm the product is labeled broad
spectrum and contains key ingredients, including
Avobenzone, mexoryl, zinc oxide and titanium
dioxide.
Studies show that most people apply too little
sunscreen to adequately cover all sun-exposed
areas. Use at least one ounce of broad spectrum
sunscreen to liberally cover parts of the skin
not covered by clothing, such as the face, neck
and tops of the ears. Apply sunscreen 15 minutes
before leaving the house. This allows the sunscreen
ingredients to properly bind to the skin. Just
as important, a sunscreen should be reapplied
every two hours or after water exposure. Moisture
in the form of sweating or swimming removes
the product. I also emphasize the need to use
sunscreen every single day, not just on sunny
days. Eighty percent of UV radiation reaches
the skin on cloudy days.
Appropriate clothing is also critical in the
sun protection process. Closely woven cotton
wear is fine as long as it stays dry. Hold beachwear
and other outerwear up to the light. If the
material lets in visible light, it will fail
to block ultraviolet radiation. There are now
specially designed clothing lines that offer
an UPF (ultraviolet protection factor) of 50
or more that are both light and durable. Broad-brimmed
hats are highly recommended, yet almost never
worn by kids who prefer baseball caps. Brims
should be several inches wide to provide coverage
to the lower face and neck, which baseball hats
and visors don’t offer.
Protect your eyes, too. Solar radiations may
induce a clouding of the eye lens (cataracts),
growths on the cornea (Pterygium) and, rarely,
loss of vision. To combat these possibilities,
100 percent UV protective sunglasses in a wrap
around style should be worn during outdoor activities.
Though sunscreen, clothing and glasses help
combat damage, the most important point is to
avoid the sun whenever possible. Arrange outdoor
activity earlier in the day (before 10am) and
later in the day (after 3pm), when the sun is
not as strong as the in-between hours.
More than 30 percent of teens have visited tanning
salons on multiple occasions. The tanning industry
offers inexpensive payment plans to make harmful
radiation exposure accessible to adolescents.
The tanning industry also distorts the truth
to fuel the multibillion dollar industry. The
industry promotes the false notion of a safe
tan.
The only tanning that is safe is the use of
sunless self-tanners void of ultraviolet exposure,
like what’s on the shelves in drugstores.
Safe and natural-looking, L’Oreal Sublime
Bronze offers a great alternative to artificial
tanning. I also instruct teens to check out
models with alabaster complexions. These models
know what we dermatologists have been preaching
for years. Tanning ruins your looks— with
the potential of making you a victim.
Warning Signs of Skin Cancer
Melanoma accounts for 1-5 percent of all skin
cancer cases, occurring on sun-exposed and non-sun-exposed
areas. People’s backs and legs especially
get affected. Here’s what to watch for
when you see a weird patch of skin or a mole:
•Asymmetry, such as one half of the mark
appearing different than the other half.
•A jagged or irregular border.
•The mole or mark is not uniform in color,
like with some combination of brown-black-red.
•The mark is bigger than 6mm in diameter,
about the size of a pencil head eraser.
Typically involving sun-exposed areas, basal
cell cancer accounts for 90 percent of skin
cancer cases while squamous cell cancer accounts
for 10 percent. Here’s what to watch for:
•A spot or growth that does not fade after
a couple of months.
•Bleeding that looks shiny or crusty.
Adolescents and their parents should also
know pertinent medical facts prior to any
skin cancer discussion.
•Most sun damage to our skin occurs
before the age of 18.
•Skin cancer is the most common form
of cancer in America.
•One in five Americans will develop
skin cancer in his or her lifetime.
•Malignant melanoma kills one person
every hour.
•Most skin cancers are curable when
detected and removed early.
•Ultraviolet radiation (UVA/UVB) from
the sun mutates DNA. This damaged DNA leads
to skin cancer development and prematurely
aged skin.
Dr. Coyle S. Connolly, DO, is a board-certified
dermatologist with a New Jersey practice,
Connolly Skin Care (www.connollyskincare.com).
He’s also a respected teacher, editor,
writer, researcher and entrepreneur. Dr. Connolly’s
commitment to outstanding patient care and
comprehensive practitioner instruction has
put Connolly Skin Care among the top 1 percent
of providers for dermatology in the United
States.
