Is melanoma only developed through moles?
Moles are just one way that melanoma develops, but more often than not melanomas may develop on normal skin where a mole wasn’t previously present. There are many types of melanoma; for example, melanoma that arises in the eye, or gut, or on the sole of the foot, on the areas where there are no moles.
The most common melanoma type in individuals with darker skin is the one which happens on the non-sun exposed areas, such as soles of the foot, and are not necessarily associated with a mole. This is different from people with lighter skin, whose melanomas most commonly start on the sun-exposed areas and are frequently associated with the pre-existing mole.
There is a type of melanoma that can develop in a freckle — usually a large freckle — that can change very slowly over time and become darker and multi-colored. Because the change is very slow in this type of melanoma, people may not be able to notice the change. This is why it remains so important to keep an eye on your skin.
How can people be proactive about their skin health?
Everyone should see a dermatologist at least once in their life to figure out what care is necessary for their skin health. For some people who have fair skin and a lot of moles, the dermatologist may recommend that they come in more frequently for melanoma surveillance than someone who has fewer moles and no history of sunburns. We also use a “mole map” — a series of digital images of the whole body’s skin surface (like a world map of your skin). Such maps help us to track the moles over time and detect any changes very early, before they can be noted by a patient. Mole mapping is recommended for anyone who has a personal or family history of melanoma, abnormal moles, fair skin, a lot of moles, and other factors. We find many melanomas and very abnormal moles using this system and use this preventive measure to save a person’s life.
Sun exposure is one of the major risk factors for melanoma. Consequently, people who had many sunburns are at higher risk for melanoma and skin cancer. Excessive sun exposure can also lead to changes in certain types of moles and may increase their chance of transforming to melanoma. While dark skin is protected from the sun by higher levels of melanin, which acts as a shield against harmful UV-rays, all skin tones should be shielded from the sun with some form of sunblock or SPF protection daily.
What is the best thing people can do to protect themselves from having to deal with skin cancer later in life?
People need to be vigilant about their skin and take note of anything abnormal or changing. If you notice something that doesn’t feel right, don’t hesitate to have it checked out. If there is a genetic predisposition for melanoma, focus on what we can do to protect ourselves. One of the clear and well-established risk factors for melanoma and skin cancer is sun exposure. Sun protection is especially important for people who have family history of melanoma, fair skin, and many moles. Sun protective clothing and sunblock use are cornerstones of such protection. Wear a hat and other sun protective clothing, and seek out shade whenever possible.
When choosing a sunscreen, what are some things people should look for on the label?
I recommend a physical sunblock, which contains a high concentration of zinc oxide (at least 10 percent, but more is better; some sunblock products contain as much as 20 percent zinc oxide). It is very important to make sure that you are using enough sunblock (a full shot glass to cover the entire body) and are reapplying frequently, especially if you sweat or swim. Remember that when you look at the SPF it only reflects UVB coverage and not UVA rays, which can also cause skin cancer. Recent studies have shown that people who put on sunblock spend more time in the sun and sunburn more. This is because the sunblock application gives people a false sense of security. Application of a sunblock once a day is not going to be sufficient to protect you from harmful UV radiation. People should be diligent about combining all these measures — frequent application of good sunblock and wearing sun protective clothing.
Is there any truth to media reports that the blue light from digital devices such as smart phones and computers may damage our skin?
There is no scientific literature of any significance available to support any of these claims. Visible light does penetrate the skin, but it does not create inflammation or damage to the skin. For certain types of light to be damaging, we have to use selective photosensitizing medications to activate the light. There is not a shred of significant evidence that the light is damaging to the skin.
Test your knowledge of skincare by taking this quiz.