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Melanie Cole (Host): According to the American Cancer Society, skin cancer is the most common cancer in the United States. In fact, more skin cancers are diagnosed in the US each year than all other cancers combined. The number of skin cancer cases has been going up over the past few decades. The good news is there’s a lot you can do to protect yourself and your family from skin cancer, or catch it early so that it can be treated effectively. My guest today, is Dr. Emily Newsom. She’s a board-certified dermatologist with UCLA Health in Santa Clarita, and she’s affiliated with Henry Mayo Newhall Hospital. Welcome to the show, Dr. Newsom. Tell us a little bit about skin cancer. What is the main cause of it?

Dr. Emily Newsom (Guest): Oh, okay, well thank you for having me. The main cause of skin cancer is having light skin and sun exposure over many years. Although it can occur in any skin type, it’s more common in lighter skin individuals.

Melanie: When people hear that, and they hear that lighter skinned individuals -- or that it’s more common that way when we talk about the sun, there are different types of rays in the sun that can contribute to skin cancer. Can you speak about the ultraviolet radiation a little bit?

Dr. Newsom: Yeah, sure. There are UVA and UVB. We used to think that only UVB was harmful, but now we know that UVA is also harmful. UVA is what is in tanning beds, and what is – UVA also comes from the sun and penetrates window glass, so we’re getting UVA while we’re driving in our cars.

Melanie: So, let’s talk about recognizing skin cancer. As a dermatologist, how often do you think we should be checking our body for various things – moles, and colors, and things we shouldn’t be seeing?

Dr. Newsom: That’s a good question. There’s no official recommendation for how often to get checked by a dermatologist. Generally, people who have risk factors should be seen once a year by a dermatologist. The risk factors would include family history, having a lot of moles, having fair skin, or getting a lot of sun exposure. As far as getting checked, things to look for, any mole that’s changing or growing, developing different colors, or getting larger in size are things to look for.

Not all skin cancers are brown. Some skin cancers can be skin-colored or red, so something that’s bleeding, a pimple that doesn’t heal for many months, something that’s just unusual that’s just not healing for months are a lot of how I see skin cancers present.

Melanie: Now, what about something more serious like melanoma? Is there a rule of thumb, a guide, something that we can use to look at these things and say, “Woah, this is definitely different. I need to get in to see a dermatologist right away?”

Dr. Newsom: Yeah, exactly. I take care a lot of melanoma and non-melanoma skin cancers. The nonmelanoma skin cancer is a basal cell, and squamous cell and those are more common, but melanoma is the most serious type of skin cancer. Some things to look out for are moles that are changing, and we talk about the “ABCD’s” of melanoma. A is for asymmetry. B is for border – so an irregular or smudged border. C is for color, so if there are multiple colors -- black spots, brown spots, the color is in an asymmetrical distribution in the mole. D is for diameter, so most melanomas are going to be at least the size of a pencil eraser or larger. E is for evolving, so the most important thing is change, and something that’s out of the ordinary seems to be getting bigger, or developing more colors, any change.

Melanie: We can look over our own body, we can see a dermatologist to look it over, tell us what we can do to prevent skin cancer. Let’s talk about sunscreens because people don’t always use them correctly – maybe they put them on, and they jump right into the water – what do you tell your patients, Dr. Newsom, about the best types of sunscreens to use, what to look for on the label, and how to use them correctly?

Dr. Newsom: Okay, that’s a great question. Generally, I recommend sun protection as much as possible to prevent skin cancer and also, so slow down the aging process of the skin. What I recommend is you want to look for a sunscreen that has an SPF of 30 or above. The ones that are higher are actually really good, and the way that you apply them – generally, people don’t apply them as thick as they should. If you get a higher SPF, when you apply it you’ll have a better chance of getting at least 30. The SPF is actually only measuring UVB protection, so you also want to look for the words “broad-spectrum” on the sunscreen label, and that will let you know that you’re also getting covered for UVA.

As far as waterproof, the FDA made a new rule that they’re actually not allowed to use the word waterproof, and they have to say water-resistant and for how long. Honestly, most sunscreens are really not water-proof, so you have to reapply after swimming or sweating. You also have to reapply every two hours, which is really, really hard, so I generally recommend covering up with a hat with a wide brim, long sleeves, a scarf -- whatever you can do to protect yourself -- and sunscreen for the areas you can’t cover. That way, you’ll be covered, and you won’t have to worry about replying every two hours. I try to re-apply as much as possible.

Melanie: And what about with kids, what do you tell parents, Dr. Newsom, about getting sunscreen on their kids that won’t always stand still for it?

Dr. Newsom: [LAUGHS] That’s a good question. I really like that swim shirts are getting more popular because it’s so much easier to put the kid in a swim shirt – they make a lot of really cute ones now. They’re great gifts for grandkids or kids, and their friends are wearing them too, so they’re not going to fight you too much. If they’re wearing long sleeves, it’s better than short sleeves, and it’s just going to make it a lot easier to protect them. As far as sunscreen, if you’re able to make it part of a routine and get the kids used to it, and as they get older have them involved in putting it on themselves so that they’re taking some responsibility, too.

Melanie: And now I’m going to ask you to speak to the parents of teenagers because they don’t listen, and they don’t see the skin cancer side of this. Maybe appealing to their vanity, how do we get our teenagers to not only use sunscreen and to think about the long-term of their skin health, but also to stay away from things like tanning beds?

Dr. Newsom: That’s a great question, and that’s a big struggle for parents and anyone that works with teenagers. There’s actually just as many tanning beds as Starbucks in this country, and they target high school and college age, mostly women. It can actually be addicting because they get something called a tenner’s high. Tanning beds are really bad. They’re really dangerous. I try to tell people if they want the brown color to use sunless tanner, the lotions or the spray tans because that’s going to be safer.

It’s hard to get teenagers to do anything, but like you said, sometimes appealing to vanity – there actually have been studies that show that it’s more powerful than scaring them about skin cancer. Sunscreen is definitely number one beauty secret for staying young, preventing wrinkles, brown spots, aging. The only problem is teenagers don’t really think they’re going to age, so it can be tough to get through to them.

Melanie: [LAUGHS] All we have to do is really show them our wrinkles, and our crow’s feet, and our brown spots on our hands, and maybe they will run in the other direction and use the sunscreen that we’re discussing. Now, what about --

Dr. Newsom: Exactly.

Melanie: Can you repair – is it possible to repair damage sun – if you’re of a certain age and back in the day you were baby oil and iodine, and now you’re in your 40s or 50s, can you repair that or is the damage done?

Dr. Newsom: Well, some of the damage is definitely done, but there are some ways to rejuvenate the skin. Say you’re in your 40s or 50s, by protecting yourself now, you’re going to save yourself trouble down the line when you’re in your 70s and 80s. For instance, I’m cutting off skin cancers off 70 and 80-year-olds all the time, sometimes every month, and it’s pretty hard on them. If you’re able to protect yourself now, that’s definitely going to give you an advantage down the road.

Also, there are other things that you can do. There are certain prescription topical creams and treatments that do help rejuvenate the skin. Like I said, sunscreen number one. Number two, a retinoid, something like Retin-A, can also help reverse some of the damage.

Melanie: So then wrap it up for us, Dr. Newsom, with your best advice about preventing skin cancer in the first place, and what you’d like us to know about recognizing possibly dangerous skin cancers?

Dr. Newsom: Okay, well, skin cancer is extremely common. I literally take out skin cancers all day, every day. It’s so pervasive, and I don’t think everyone really realizes it. There needs to be a little bit of a cultural shift towards sun protection. It’s very, very important, and it’s worth the effort. If you don’t like hats – there’s so many different styles, you can find a hat that works for you. If you don’t like putting on sunscreen, you have to try a few different ones and find the one that’s maybe not too greasy, and you like the feel of. Just putting in that little extra effort is going to go really far in one, preventing skin cancer, and two, keeping your skin healthy, preventing aging of your skin – easy bruising, brown spots, wrinkles, crow’s feet, all of that. Sun protection all the way.

Melanie: Sun protection all the way. Great information. Thank you so much for being with us today. You’re listening to It’s Your Health Radio with Henry Mayo Newhall Hospital, and for more information, you can go to HenryMayo.com, that’s HenryMayo.com. This is Melanie Cole. Thanks, so much, for listening.