Dermatology update

Skin cancer, Mohs Surgery, and tanning beds

By Shawna Beechinor, PA-C NOTE: According to the American Cancer Society, skin cancer is the most common cancer in the United States, and women age 49 and under are more likely to develop melanoma than any other cancer except breast and thyroid cancers. Shawna Beechinor, PA-C, a Board-Certified Physician Assistant, sat down with us to talk about skin cancer, skin surgery, indoor tanning, cosmetics, and her favorite ways to help prevent skin cancer, including her favorite sunscreens. (Sponsored content by Dermatology Clinic of Idaho.)

Q. What skin cancer tips do you share most often? A. A change in your skin is the most common sign of skin cancer. Be aware of new skin growths or a change in a mole and remember that while exposure to UV radiation is the No. 1 risk factor for developing skin cancer, it can also affect areas of the skin not exposed to sun. Finally, if you have a wound that won’t heal, have it examined by a doctor. This type of lesion Q. The people of Boise love outdoor Shawna Beechinor is generally considered skin cancer until activities. What can we do to help lower our skin proven otherwise. cancer risk? A. One of the best ways to help lower your risk is to avoid Q. Talk to us about tanning beds. the factors that can cause skin cancer, the greatest of which A. Just one indoor tanning session can increase the user’s is exposure to ultraviolet radiation. For example, try to avoid risk of developing melanoma, squamous cell carcinoma, outdoor activities when the UV rays are their strongest, and basal cell carcinoma. As of 2014, the Food and Drug usually from 10 a.m. until 4 p.m. If you must be outdoors, Administration (FDA) advised that indoor tanning beds and use a combination of clothing, wide-brim hats, broad- sun lamps emitting ultraviolet radiation must carry a visible spectrum sunscreen, and lip balm to protect your skin. For black-box warning indicating no one should use them under the most complete coverage against the sun’s rays, long- 18 due to increased risk of skin cancer. Many countries now sleeve, and long-pant sun-protective clothing with Ultraviolet ban minors from the use of indoor tanning beds, and Brazil Protection Factor (UPF) of 30 or higher can protect against became the first country to declare a population-wide ban in UVA and UVB rays. Use broad-spectrum sunscreen and 2002. lip balm with 30 SPF or higher. And don’t forget your eyes! A tan may make you feel like you have a healthy glow, but Sunglasses can block 99-100% of UV light, so look for labels your skin is damaged by UV rays every time you tan. A tan like “100% protection against both UVA and UVB” or is a visible sign of that injury. As the damage builds, you “100% protection against UV400.” accelerate your skin’s aging and your risk for all types of skin cancer, including melanoma, which is the deadliest form of

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skin cancer. According to the Centers for Disease Control (CDC), Idaho is one of five U.S. states with the highest skin cancer rates. Our state bans indoor tanning beds for anyone younger than 13 years old and requires in-person parental consent or a doctor’s prescription for minors aged 14 to 17 years old. So, I encourage banning the tan and growing the glow with sunless tanning products.

Q. Tell us about your favorite sunscreens. A. There are two types of sunscreen – physical and chemical. Physical sunscreens may also be referred to as mineral or natural sunscreens and contain the active ingredients zinc oxide and/or titanium dioxide. These types of sunscreens work by sitting on top of the skin to deflect UV rays, which means they protect against UVA and UVB as soon as they are applied. While physical sunscreens offer the best protection, they are known to cause a chalky-white residue. Nowadays many mineral-based sunscreens are light, easy to apply, and come in various tints to match your skin tone. I prefer mineral-based sunscreens like Elta® MD’s tinted sunscreen, which I use every morning.

Chemical sunscreens work by creating a chemical reaction that changes UV rays into heat, which is then released from the skin. Chemical sunscreens can often be easier to apply, especially in spray-on form.

Whichever type you choose, the best sunscreen for you is the one that you will use routinely. As you search for your perfect sunscreen, be sure to check the label for the following information: • Broad-spectrum (protects from both UVA and UVB rays) • SPF of at least 30 or higher • Fragrance-free • Non-comedogenic (won’t clog pores) • Oil-free

Q. How is skin cancer diagnosed? Discuss the process and expectations for skin cancer treatment. A. To diagnose skin cancer, a biopsy must be taken and evaluated by a dermatopathologist. The type of skin cancer, and whether it has been detected early or late, will determine the type of surgery required to remove it. If the skin cancer involves sites that do not have much redundant skin, such as the face, hands, and feet, a skin-sparing procedure known as Mohs Micrographic Surgery is often the treatment of choice. This outpatient procedure, which is performed under local anesthesia, is named after Dr. Frederic Mohs, who developed the precision technique in the 1930s. When using the Mohs technique, the skin cancer is removed using a scalpel, then immediately evaluated under a microscope to determine whether the excision was successful. This process continues, layer by layer, until the cancer is completely removed.

If Mohs Surgery is not required, a simple surgical excision will be performed. Regardless of technique, a patient who has had one skin cancer removed is at risk for developing another. Follow-up exams will be required every 6 to 12 months to keep a close eye on the skin. Continued on Page 15

Dermatology Clinic of Idaho is Treasure Valley’s go-to medical practice for trusted skin care and top-notch patient care. Get to know their team by following them on social media and book consultations online at IdahoDerm.com or call 208.376.4265.

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