Moles, Malignancy and Melanoma

Know the signs of melanoma and how to protect your skin

By Susan Tulino, Novant Health UVA Health System

Heading into the warm summer months means exchanging our winter clothes for t-shirts and swimwear. In Virginia’s hot, humid summer months, many of us share the same mindset: the less fabric we have to wear, the better.

But this means that we’re exposing more of our skin to potentially harmful ultraviolet (UV) rays. Though dangerous sun exposure can happen year-round, the temptation to bare skin in the summer prompts Michael Perez, MD, a family medicine and aesthetics physician at Novant Health UVA Health System Bull Run Family Medicine – Manassas, to remind us of the signs and symptoms of melanoma.  

What is Melanoma?

Melanoma is a skin cancer that typically begins within a melanocyte skin cell in the top layer of skin, the epidermis. It is commonly caused by UV rays, which can damage the DNA in our skin cells. Damage to the DNA can affect certain genes that control how skin cells grow and divide. When these genes don’t work properly, the affected cells may become cancerous.

The American Cancer Society (ACS) reports that rates of melanoma have been rising for the last 30 years, and estimates that nearly 96,500 Americans will be diagnosed with some form of the disease this year.

Risk factors that might make someone more prone to melanoma include:

  • Frequent UV exposure
  • Moles
  • Fair skin, freckles and light hair
  • Family or personal history
  • Weakened immune system

Despite these factors, skin cancer is not discriminatory — anyone of any age, ethnicity or gender can get melanoma.

What to Look For

Fortunately, many cases of melanoma can be detected early through regular self-exams and by paying attention to any new moles or dark spots on the body.

Dr. Perez recommends using the “ABCDE rule” as a guide, and seeing your doctor if any of the following apply to a new or changing mole:

  • Asymmetry
  • Border is irregular, ragged or blurry
  • Color is not consistent
  • Diameter is larger than 6 millimeters across
  • Evolving in size, shape and/or color

“Melanoma doesn’t always manifest in these ways and can be surprisingly subtle, so it’s important to visit a doctor with any uncertainties,” said Moira Sutton, MD, a radiation oncologist at Novant Health UVA Health System Cancer Center at Lake Manassas. “If skin cancer is diagnosed early enough, it usually means less invasive treatments — malignant moles can be removed in quick outpatient procedures by a physician or a dermatologist  — and have a very high likelihood of survival. Early detection also means a much lower chance that the cancer has spread, which is where more aggressive treatment becomes necessary.”

In fact, the ACS reports that the five-year relative survival rate is 98 percent for localized melanoma — melanoma that hasn’t spread beyond the skin where it began.

“Despite high survival rates, melanoma is not to be taken lightly,” said Dr. Sutton. “It’s a serious diagnosis that takes thousands of lives each year.”

Prevention Measures

“One of the easiest ways to prevent melanoma is to take precautions against UV rays and limiting direct sun exposure,” said Dr. Perez. “Sun exposure adds up day after day, so shelter and clothing are your first lines of defense. Seek out shady spots, wear hats, keep your skin covered with light materials and wear sunglasses to protect your eyes and the sensitive skin around them,” said Perez.

“Avoiding the sun altogether isn’t a realistic option for most of us, but getting in the habit of wearing sunscreen every day is your second line of defense,” said Dr. Perez. “Be sure to read labels and fully understand the strength and limitations of the sunscreen you’re using. Applying a sunscreen/ sunblock with an SPF of at least 30 provides the best protection. It is also important to select a product that blocks both UVA and UVB light such as Titanium Dioxide with Oxxybenzone.”

Dr. Perez reminds us that even waterproof sunscreens should be reapplied after taking a dip. While sunscreen doesn’t block all UV rays, do your skin and overall health a favor and slather it on before you head outside.

There is no 100 percent fool-proof way to avoid melanoma. Unfortunately, even the most vigilant can receive a diagnosis. But, by taking steps to protect your skin all year, and especially in the summer, you can greatly reduce your chances of a melanoma diagnosis.

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