Enjoy the sun, but protect your skin from UV radiation
Sunlight is something we crave, because it makes us feel good and we absorb vitamin D from it. However, too much of the sun’s ultraviolet rays can lead to skin cancer.
“The vast majority of skin cancers, basal cell and squamous cell carcinomas, are related to chronic sun damage,” Dr. David Chen of Advanced Dermatology of Norwich said during a telephone interview. “We know for a fact that UV radiation is a carcinogen, meaning if you get too much UV radiation, your skin cells can undergo cancerous changes, and that effect is cumulative.”
Those most at risk have fair skin and red hair, he said, however everyone should protect themselves. Skin cancer can be any color ranging from clear, pink and blue to brown, black and multi-colored.
The East Lyme resident suggests people check their bodies once monthly. “It’s helpful to work with a partner or a spouse just to take a look at your skin.” If you see something that wasn’t there a month ago, something that seems to be bleeding, hurting and not going away, ulcerating (turning into a sore that just won’t heal), he said it should “be checked out sooner rather than later.”
“All cancers should be treated,” said Chen, who performs Mohs surgery and functional and aesthetic reconstruction. The main reason for treating basil cell, squamous cell and melanomas “is all three types of growths are cancerous, meaning they will not stop growing. Their behavior can range from being very locally destructive all the way to metastasizing throughout the body.”
He explained the Mohs micrographic surgical outpatient procedure (named after Dr. Frederic E. Mohs who created the technique in the 1930s), is referred to as “margin control.” Once the patient is anesthetized at their office, he said he basically takes “a very small margin, around what we can physically see as what is remaining of the skin cancer in the spot that we’re working with. Once we remove that piece of skin, we take it to the lab and process it in such a way that we’re able to look at the entire peripheral margin, as well as the depth margin in the microscope, to see if there’s any residual skin cancers left over on those margins. And if there is we come back, anesthetize some more and take a little bit more, where there’s still skin cancer. We check that again and we keep going until all of it is out.”
This micrographic technique allows “us to achieve very high cure rates,” with basil cell and squamous cell carcinoma, Chen said.
“I find the work extremely gratifying because you can tell somebody at the end of the day that their skin cancer’s been taken care of. And I also really enjoy the patient-care aspect of my work and learning about my patients, just like how they’re learning about me.”
Tips for avoiding UV radiation
Chen pointed out that “having a previous history of skin cancer puts you at higher risk for developing another skin cancer” somewhere on your body in the future.
Ways to protect your skin include wearing a wide-brimmed hat and long-sleeved UPF (Ultraviolet Protection Factor) shirts and pants, sunglasses with UV protection and taking walks at sunrise or sunset, he said. Avoid going out “between the hours of 10 a.m. and 3 p.m. on bright sunny days when the sun is particularly harsh.”
Make a habit of liberally applying a broad-spectrum, water-resistant sunscreen (with protection from UVA and UVB rays) of 50 SPF or higher 15 minutes before heading to the beach, golfing, playing tennis, water/snow skiing, paddle boarding, boating, gardening, walking, running, or doing anything else outside.
Remember: the sun reflects off the water, sand and snow. Apply sunscreen to all exposed areas of your body, including the tops of your feet, neck, ears and top of your head if you’re bald. Reapply sunscreen every two hours and immediately after getting out of the water or sweating.
Tips from the American Academy of Dermatology’s website, aad.org, include using sunscreen year round, seeking “shade if your shadow is shorter than you are” between 10 a.m. and 2 p.m. “Use sunscreen whenever you are going to be outside, even on cloudy days.”
The organization also encourages people to “Avoid tanning beds, as their ultraviolet light “can cause skin cancer and premature skin aging.”
Consider using a self-tanning product if you want to look tan, but continue to use sunscreen with it.”
Additionally, check to ensure your sunscreen hasn’t expired and protect your lips by applying “a lip balm with a SPF of at least 15.”
“Some people don’t love the idea of the sunscreen,” because it’s sticky and uncomfortable, Chen said, adding that some moisturizers have sunscreen in them and individuals should find one that works best for them.
Chen said he counsels patients by trying to establish a rapport with them and getting “them to understand risk mitigation, like ‘What can we do to have you still enjoy the sun without harming yourself? How can we get you to enjoy this in a moderate fashion that is safe and effective and good for your health without overdoing it so that you’re burning your skin and creating risk for skin cancer?’”
“There are claims that one needs to get a certain amount of sun exposure every day in order to produce enough vitamin D to be healthy. It’s just not true. The majority of people can get their vitamin D from nutritional supplements and from vitamin D-fortified foods,” Yale Medicine Dermatologist and Dermatologic Surgery Chief David J. Leffell stated on the website, yalemedicine.org/news/vitamin-d-myths-debunked.
Vitamins D2 and D3 occur naturally in salmon, tuna, mackerel and beef liver and egg yolks, while other foods such as milk, cereal and some juices are fortified with these same vitamins, according to this website article.
Advanced Dermatology is located at 111 Salem Tpke. in Norwich (in the Old Ames Plaza) and at 5 Durham Road in Guilford. They may be contacted through their website at advanceddermatologyct.com, or by telephone at 860-859-2262 or 203-453-6166. For more about information skin protection, as well as basal cell/squamous cell carcinomas, melanomas and other types of cancers, go to the American Academy of Dermatology’s website, aad.org and the American College of Mohs Surgeons’ website, mohscollege.org.
“Dr. Chen received his M.D. from Northwestern University’s Feinberg School of Medicine. During his time in medical school, he performed basic sciences research in the Paller lab, winning research grants from Alpha Omega Alpha and the American Skin Association,” according to according to advanceddermatologyct.com.”
Dr. Chen completed a transitional year at the University of Hawaii/Queen’s Medical Center. He subsequently finished three years of dermatology residency at the University of Colorado, Anschutz Medical Center, where he served as chief resident during his senior year.”
After his residency, “he pursued fellowship training in Mohs Micrographic Surgery, cutaneous oncology, and facial reconstruction, at the University of Vermont Medical Center.
“Prior to joining the team at Advanced Dermatology, Dr. Chen was an assistant professor at the University of Vermont Larner College of Medicine. He has published in internationally recognized dermatology journals and textbooks, and presented at regional and national conferences, in topics of reconstructive techniques, medical education, and complex cutaneous oncology.”
Jan Tormay, a longtime resident of Norwich, now lives in Westerly.