Many people, especially redheads with freckles, blondes and those with a fair complexion who burn easily or tan poorly on sun exposure should be warned about the dangers of damage to the skin from sun exposure. Many people who fit into this category have Scotch-Irish-English or Scandinavian ancestry. Unfortunately, these warnings often come only after considerable damage has already been inflicted on the skin.

The effect of sunlight over the years is to weather or to prematurely age the skin. While the brown splotches, thinning, wrinkling, drying, and exposure of many prominent tiny blood vessels at the surface in these sun exposed areas are of primarily cosmetic importance, certain scaling red spots, called ACTINIC KERATOSIS, are in some cases, of more serious significance. These can, in a small number of cases, become skin cancers.

An actinic keratosis can be said to be "going to college" to learn to become a skin cancer. Fortunately, natural skin defense mechanisms assure that the "drop out rate" is high. If they look like they are going to graduate and become skin cancers, they will have to be treated with local destructive techniques. These techniques may include surgery, freezing with liquid gases, certain acids, electrosurgery, and recently through the applications of certain externally applied medications containing anticancer drugs such as 5-fluorouracil.

When an area of sun damaged skin forms a skin cancer (such as a BASAL CELL OR SQUAMOUS CELL SKIN CANCER), they are usually only invasive into the local area where they are growing. For this type of cancer to spread to other areas of the body by the blood stream or lymph channels is unusual. Just like a "bad spot" on an apple, they can be cut off and the rest of the fruit is still good. Because of the mild character of these cancers in early stages, they are the form of cancer best able to be cured by early diagnosis and treatment.

SUNLIGHT IS A FORM OF X-RAY

The damage to the skin which results from sun exposure, like x-ray, will accumulate with exposure over the years. The effect is forever stored in the memory of the skin and cannot be erased. The effect of sun damage today is only seen in years to come.

IF YOU STOP ALL FURTHER UNNECESSARY SUN EXPOSURE YOU WILL PROBABLY STILL CONTINUE TO DEVELOP SKIN CHANGES IN THE FUTURE. BUT IF YOU CONTINUE TO INSULT THE ALREADY DAMAGED SKIN BY ADDITIONAL IMPROPER SUN EXPOSURE YOU WILL CERTAINLY MAKE MATTERS WORSE.

RECOMMENDATIONS FOR TREATMENT OF SUN DAMAGED SKIN

1. A patient with sun damaged skin should visit his or her clinician at least once a year for a thorough examination of the skin in light exposed areas.

2. A patient who has had a skin cancer with a sun damaged skin should keep all follow-up visits until the cancer is pronounced cured. After that, since he or she has a better than average chance of getting another skin cancer, he or she should be seen at least once a year for a similar examination.

3. Any skin growth in a sun exposed area which does not heal, bleeds, or keeps growing in size should be examined.

4. Avoid needless sun exposure whenever possible. Plan your recreational and nonessential outdoor activities for before 10 in the morning and after 3 in the afternoon. This is especially true in the months from April through October. Between the hours of 10 and 3, even the best sun protective lotion will not give adequate protection against the damaging rays. They are like wearing only underwear to keep you warm in Antarctica.

5. Use a sun protective lotion on all sun exposed areas from April through October.

6. Wear hats and protective clothing whenever possible in addition to using the sun protective lotions to shield the skin from the sun.

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