When it comes to protecting skin from sun damage, limiting exposure is the first step. Ultraviolet radiation from the sun can damage skin is as little as 15 minutes.
UV radiation ranges from 1-11 throughout the day and generally peaks between 10 a.m. and 4 p.m. Before heading outdoors, it’s a good idea to monitor UV levels online or on a weather app.
“If you start getting a 7 or 8 on the scale, you need to be cautious,” said Jaime Gish, a nurse practitioner at Owensboro Health Regional Hospital who specializes in dermatology.
The next step is physical protection. This includes physical sunscreens with zinc oxide or titanium oxide, wide brim hats, protective clothing and seeking out shade under trees, buildings or umbrellas.
These sun safety habits are important for people of all skin colors. It’s common for people with dark skin tones to assume they’re at a low risk, so skin cancers — though far less common — frequently aren’t caught until a later stage with a lower survival rate.
“Any skin tone can still have sun damage and sunspots,” Gish said. “It’s important for everyone alike.”
Sun protection is also important for all age groups. The Centers for Disease Control and Prevention reports that one in three U.S. adults get sunburned annually. While the occasional vacation sunburn might not seem so bad, even mild sunburns cause damage to skin — in fact, the change in pigment is your body’s way of telling you it’s injured.
“It’s really irreversible. You can’t undo past damage or burns,” Gish said. “It’s very important to protect the skin.”
If there is enough damage, skin cancer may form. The three most common forms of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Acral lentiginous melanoma is an uncommon form of melanoma that disproportionately affects sub-Saharan African and Asian ethnic groups and usually develops on the palms of the hands, soles of the feet or under the nails.
Kentucky has one of the highest rates in the nation of melanoma, which caused about 8,000 deaths in 2017, with an age-adjusted rate of 27.3 per 100,000.
“I think skin cancer rates are high in Kentucky because of our jobs,” Gish said, pointing to the high percentage of people working in agriculture and construction.
The Bluegrass also has prominent cultures of fishing, hunting and outdoor sports like tennis and golf.
Indoor tanning exposes users to high levels of UV radiation and increases skin cancer risk, which is greatest for those who begin tanning at a young age, according to the CDC.
“Those devices can emit UV radiation that is 10 to 15 times higher than the sun at peak radiation,” said Janae Kittinger, a plastic surgeon at Owensboro Health Regional Hospital. “More people develop skin cancer from indoor tanning than people develop lung cancer from smoking.”
But, smoking causes cancer almost anywhere in your body.
Ultimately, sun exposure happens and it’s best to prepare for the worst scenarios. That’s why early detection is essential.
Folks should get in the habit of monitoring their skin for irregularities or changes and getting checked out by a healthcare provider regularly and as soon as a spot is noticed since early detection greatly improves patients’ survival rates, Kittinger said.
At Owensboro Health, Gish and Kittinger frequently collaborate. Gish screens for cancer and Kittinger performs incisional biopsies or surgical reconstruction.
If a skin cancer is diagnosed, the two women work to get a patient scheduled for a consultation or surgery within one to two weeks. Sometimes Gish will even walk over to Kittinger’s office after diagnosing a patient to see if she can squeeze a patient into the OR schedule, Kittinger said.
“Our clinic is very unique that we work very closely together,” Kittinger said. “Previously, reconstruction patients were having to go to Louisville.”
A common reconstructive surgery Kittinger performs involves excising the cancer and reconstructing the skin, most commonly on the face, with adjacent health tissue.
“As a plastic surgeon, we try to treat that skin cancer to preserve their health and their appearance,” Kittinger said.
But it’s best to avoid it.
“Skin cancer is like any other form of cancer,” Kittinger said. “Prevention is the key.”