Transcript: Summer skin care, melanoma and skin cancer web chat

Welcome to this Wednesday’s Live Web chat on melanom and skin cancers. Type in your questions now and we have several experts who can answer them.

Our experts today are LaDonna Finch of the Inflammatory Skin Disease Institute in Newport News who can answer your prevention questions.

We’ll also have Dr. Donna Courvette of the Williamsburg Dermatology practice.

Great to be here!

Donna Corvette MD

Board Certified Dermatologist

Dermatology Center of Williamsburg

www.dermatologycenterofwilliamsburg.com

And Dr. Victor Archie, radiation oncologist with Virginia Oncology Associates.

Hi Donna, Welcome to the chat. Can you answer my first question. Is it ever OK to tan?

No tan is a good tan. All tans can create future skin cancers. sad but true.

Wear a sunblock on a daily basis SPF>25, BROAD spectrum sunscreen every day rain or shine.

One in 5 Americans will develop skin cancer in a lifetime. The main cause=sun. Protect your skin from the sun. This is key.

Melanomas are highly linked with sunexposure and sunburns; ONE American dies of melanoma every HOUR.

Skin cancer can look like a mole which changes color, a bump which doesnt heal or go away, a black spot, a pink, scaley spot….

There are ABCDs that ould be helpful- Asymmetry Borders Color and Diameter

A skin cancer has many shapes and sizes. The most impt part of skin cancer is early recognition and involving the dermatologist EARLY.

Unfortunately most patients tend to wait and watch their spots. This gets the patient into trouble. I ask my patients not to wait more than one month. Be safe – get the spot evaluated early. don’t wait.

Donna – Should you go directly to a dermatologist or can your primary care provider check it?

The scaley spot which continues to peel may represent a precancer- actinic keratosis, a squamous cell cancer or a basal cell cancer. Have a dermatologist take a look.

Prue- my first profession was a board certified internal medicine physician. I did not really understand cancer until I became a board certified dermatologist.

periodic self exams are very important

When you do a self-exam, what are you looking for?

look for the spot which does not heal, the mole which changes, the scaley persistent spot.

The most impt point. Do not wait and watch your spots. Go to an expert.

any changes that may have occurred- this is where the ABCDs are helpful

Guest- I would rec that you have the scaley spot evaluated- it may be a precancer or skin cancer.

How is skin cancer diagnosed by a dermatologist?

Skin cancer is diagnosed by visual inspection and taking a good history

When a spot is suspicious, we take a biopsy of the lesion

If it is cancerous, then what happens?

If is it a cancer- it is removed. the earlier we detect, the better outcome

Sun avoidance is the best defense against skin cancer- we can not always avoid so it is important to use a sun block.

We remove cancers many different ways, surgical excision, scrape and burns, radiation, moh’s surgery, creams……

Could you describe what happens if the cancer is not detected and removed in the early stages?

Basal cell cancers rarely metastasize- move to other regions of the body. but undetected and left to grown they can leave deforming scars and be quite mutilating. the earlier you discover and treat a skin cancer, the better.

There are many ways to block the sun from topical product over the counter to clothing. There is something that works for everyone.

Melanomas left undetected, may kill a patient. More than 75% of skin cancer deaths are from melanoma.

Readers: We are talking to dermatologist Donna Corvette and LaDonna Finch, director of the Inflammatory Skin Disease Institute. They can answer your questions about summer skin protection, treatment and how to avoid skin cancers. 1 in 5 will develop skin cancer over a lifetime. Ask your questions until 1 p.m.

Squamous cell cancers left undetected may spread to other areas of the body and kill a patients. Rarely happens, but I have seen this happen many times.

Reference Jim’s question. Is there a particular age you should start being screened?

Key point early detection of skin cancer is crucial to the well being of a patient. Work with your doctor. Don’t watch your spots grow, get them evaluated. Be safe.

Annual skin cancer screens are very impt. Age- any age. My youngest patient who is suffering with metastatic melanoma is 15 years old.

May is Skin Cancer Awareness and Prevention Month, you may find there are free skin check in your area.

If anyone knows of a free skin check in Hampton Roads next month, please let us know.

Laying out at the beach is not a good idea. Wear a broad spectrum sunscreen blocking UVA and UVB early day rain or shine and reapply

For all your health news, go to www.dailypress.com/health and check out our daily updated Health Notes blog.

Expense of an exam- depends on the insurance coverage you have.

Without insurance, how much would it cost to get checked? Does it involve any invasive procedures or is it strictly visual?

My website is very informative. Shows you photos of skin cancers with good teaching points. www.dermatologycenterofwilliamsburg.com

A broad spectrum block apply often and allpy at least a golf ball size amount. most people do not apply enough. If a both of sun block last a season you are not using enoug. Avoid the hig intense sun hours and even take an umbrella.

Expense of skin exam- approx $125

LaDonna means a BOTTLE of sunblock — you need more!

I agreee with LaDonna. Most pts do not apply enough sunscreen or reapply every 2 hours. No tan is a good tan. All tans predispose a patient to a future skin cancer.

What about SPF factor?

look for an SPF>25.

the chemicals in a sunblock are the most impt features.

look for broad spectrum.

look for titanium dioxide and zinc oxide – these are blocks.

LaDonna — are there any substitute products you can use to produce the appearance of a tan?

Indoor tanning is dangerous. No tan is a good tan- whether you get it naturally or in a box.

there are many self tanners which a perfectly safe on the market.

How can you convince teen girls NOT to tan?

Yes some of the moisturizers now add a sun glow like ingredient

Prue- you probably cannot tell a teenager that they will develop a cancer. I show my teens photos of missing noses- this makes quite the impact.

To answer those indoor tanning questions: IS it ANY less dangerous to tan indoors?

Prue- they are both extremely dangerous.

Readers: We are talking to dermatologist Donna Courvette and LaDonna Finch, director of the Inflammatory Skin Disease Institute. Ask your questions now until 1 p.m.

The main cause of skin cancer is SUN exposure

At ISDI we do educational programs that may give teenagers a better understanding of the damage they are doing.

Just remember early detection is key. The majority of patients watch and wait. They do not seek early advice. They wait until the cancer starts bleeding and scabbing. Just don’t diagnose yourself. Go to a dermatologist.

Another sun-related question. Is there a time of day that’s less dangerous? Or a location — is it worse to tan in Florida than in Virginia?

Basal cell cancer is the most common cancer in humans. One million people are affected every year.

The sun also causes premature aging –

Most dangerous time in sun is bwt the hrs of 10-4pm.

Squamous cell cancers usually show up as nonhealing sores, or crusty scaley spots.

Melanomas are not typically painful. don’t wait for symptoms-

In parts of Va and Fla there are many outdoor activities with the beach and the water this tends to have people out more and longer.

What type of a skin peel are you referring to Emmy-Lou?

FYI when using sun block if you aplly 15 SPF twice it does not equal a 30 SPF

There are microdermabrasions and dermabrasions. Who did the procedure? A dermatologist or a spa? this might help me answer your question.

LaDonna — thanks for that tip. Are there any brands you recommend particularly? Did you say you have classes for teens to teach them about dangers – -or how to take care of their skin? If so, when are they?

Emmy-Lou anytime you have a procedure- protect your skin from the sun until you are completely healed.

Not only skin treatments need protecting from the sun, also if you are taking certain medications you may need to avoid the sun.

Prue-the brand of sunscreen is inconsequential. The public needs to be knowledgeable about what is in the sunscreen or block.

My all time favorite is TIZO- a tinted sunblock which looks like a makeup and blocks the harmful rays of the sun. Skinceuticals also makes a nice product. Most dermatologists have their favorite brands at their office.

Donna — Could you explain the differences between the types of dermabrasion. And how they would differ if performed at a spa or dermatologist office.

I have worked with Aveeno , they often are at different events with a photo screening so you can have a picture taken to see the deep damage of sun

Prue- classes for teens? I don’t know about these but I tend to go to my son’s school and teach the kids about the dangers of tanning.

Readers: Today’s chat is with skin experts LaDonna Finch and Donna Courvette. The sun’s rays are dangerous. They’ll tell you that there’s no such thing as a safe tan and also how to avoid damaging your skin. Ask your questions now until 1 p.m. EST.

Photoscreening is often done at Dermatology offices. We have a device which can detect precancerous lesions and reveal sundamage. We have events at our offices at least quarterly- to help educate the public.

Photoscreening sounds great. I haven’t heard of that. (It also sounds scary). I’ve read that 90 percent of the cases of skin cancer in people under 20 are with girls. What is the reason for this?

To protect your skin from the sun: wear sunglasses, sunblock every day rain or shine, wear a good hat. If you notice a spot on your skin, don’t self diagnose. Go to your dermatologist. Be safe.

Photoscreening shouldn’t be scary. Simple to do.

I agree protect yourself from the sun everyday and every season.

Their are several clothing lines which protect the skin from the sun rays- sun precautions is a nice line. solumbra as well.

We really need to get the word out about skin cancer. Don’t be afraid. Don’t hold onto your spots. Get them evaluated by a board certified dermatologist. Waiting is the main problem I see in my practice.

Where would you find those lines of clothes?

Clothing- ck the internet. Easiest way. I have brochures in my office.

When you say waiting — are you talking about weeks, months or years? Typically, how fast does skin cancer develop?

Many patients wait years. Unfortunately. By time they see me their cancer is the size of an egg. My longstanding patients do not do this. When they see something, they typically do not wait more than one month. This is safe.

There is a camera you put your face up to under a drape- take the picture it shows the damage that could surface. it is easy and painless – makes a huge statement of what the sun can do.

Are there particular areas of the body that are more prone to skin cancer lesions?

Prue- a melanoma can kill you in 6 months. Don’t watch and wait on the mole which is changing. Get to your dermatologist and get a biopsy right away

Prue- areas of body more likely to develop a cancer: sunexposed areas.

What is the treatment for melanoma? Is it just removal or are there other treatments?

Mary- a dermatologist has many different ways of treating sundamaged skin- chemical peels, microdermabrasions, products…..

Good question Pru- often farmers see it on the ears due to exposure with even wearing a hat that did not cover the ears. So it is the area that are exposed the most

Prue- melanoma is typically treated surgically. Simple- all gone. But…if the melanoma is deep, the treatment is much more involved…interferon, lymph node dissection. ….

Do you feel bad when you have skin cancer? Is it painful? Are there other symptoms?

Melanomas can occur anywhere on the body. Even under a toe nail.

Readers: We have just a few more minutes for you to ask your questions of our skin experts LaDonna Finch and dermatologist Donna Corvette. They’re here until 1 p.m.

Melanoma may suddenly appear without warning or pain

When you wait to FEEL a skin cancer….it is late in the game. I tell my pts…when you see a spot…don’t wait more than a month, get in- let me see it. Go to an expert.

For all your health news, go to www.dailypress.com/health and also check out our daily updated blog, Health Notes.

Are you more likely to get melanoma if someone in your family has/had it or is it strictly environmental?

Excessive sun and sunburn is the most preventable cause of melanoma

Patients are trained to go to a doctor when they have symptoms- this was my first careeer-internal medicine. I never needed to tell a patient to come in. But as a dermatologist….I tell patients…come in let us take a look. let us help you.

Melanoma is associated with genetics, environment and sun-exposure. Sun is not the only risk factor.

Melanomas affect all races. On dark skinned patients- melanomas often develop on the foot, underneath a nail, mouth,genitalia..

Sunburns- what to do? nothing much you can do. YOur skin will heal. But safe to get your yearly skin examinations.

Does aloe help? or does that just relieve pain?

watch the spots to be sure there are no changes- the are over the counter products that can help fade the spots.

Aloe can soothe the skin. It will not prevent a future skin cancer. the damage is done.

Experts: In the last couple of minutes would you tell readers how they can contact you and give some parting advice of how to take care of yourself now that gardening/beach season is almost here

Skin cancer is extremely prevalent. I recommend a yearly skin evaluation every year. On your birthday. Get into your birthday suit and get your exam by an expert. Learn how to recognize skin cancer. Come in early. Don’t procrastinate.

Allow the sun burn to process naturally- do not pick or peel.

I have a last question. Is “waterproof” lotion more effective or not?

My office is in Williamsburg, Virginia in Newtown- across from the Williamsburg Courthouse. The directions are on my website. www.dermatologycenterofwilliamsburg.com

757.645.3787

You no longer need to wait 6 months to get into the clinic- I have two dermatology trained physician assistants in my office. We are here for you. Please take time to look at your skin and stay safe.

With the summer months fast coming remember to block the sun not the fun and feel free to call the ISDI 757- 223- 0795 for any information

Waterproof is not more effective.

Remember skin cancers are CURABLE if detected early! Be safe!

One person dies every hr of melanoma. If the melanoma is detected early—-the cure rate is 95%.

So, what I’ve learned today is that you should: 1. Cover up or use ample 25 SPF factor every time you go out and reapply it liberally.

2. Get an annual skin cancer screening from a dermatologist.

3. Not wait more than a month if you observe a spot/change/new.

4. Never tan on purpose — indoor or out.

Anything else?

Get the scaley rough spot on your arm or face evaluated.

That a protecting block that works for you sprays, jels,creams,lotions or clothing and make it a part of you daily routine.

Donna — is there any particular color associated with that “scaley rough spot”? pink/red/brown?

Know your body. You only have your health, right. Don’t wait for symptoms. Be proactive. Know your skin. Be safe.

skin cancers can be any color? pink, flesh colored, black, brown……

the little flesh colored bump on the nose may be a basal cell skin cancer.

And remember the sun is all year long- everyday- every season so protect yourself

Experts, Thank you very much for your time and expertise today on all matters relating to skin cancer. It’s certainly convinced me that I should head to a dermatologist soon.

the rough pink spot which doesnt go away ….may be a precancer (actinic keratosis), squamous cell skin cancer, basal cell cancer. ….

Please give your contact information one more time and then I’ll close the chat. Thanks again for all your information.

Yes,protect yourself all seasons…even when you ski.

Dermatology Center of Williamsburg

757.645.3787

www.dermatologycenterofwilliamsburg.com

The little place on your le- if you are a female shaving- that never stops bleeding may be a basal cell

Join us every Wednesday for a health-related web chat. ALSO, this Friday, April 22, we’ll be talking to experts in our monthly FITNESS FRIDAY web chat about BIKING for fun and fitness, and where to ride on the Peninsula.

Bye

Prue- thank you for the invitation. I hope we all helped some of your viewers. Take care,