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Saving Our Skin


With beautiful beaches and outdoor spaces, people in Delaware spend a lot of time in the sun. But too much of a good thing is bad for our skin, contributing to both premature aging and skin cancer. In fact, the First State has the fourth highest skin-cancer rate in America, according to the Centers for Disease Control and Prevention.

Between 1996-2006, the number of skin cancer cases in Delaware leapt 64.4 percent. That’s almost 3.7 times the national increase of 17.2 percent. The good news is that people and their doctors are more aware of the signs of skin cancer, so they are being diagnosed earlier, says Heather Brown, comprehensive cancer program director for the state Division of Public Health in Dover. Our skin is our body’s largest organ, a marvel of natural engineering that works to keep us cool in summer, warm in winter and protected from germs. As if doing its job wasn’t enough, our skin also faces other challenges, ranging from adolescent breakouts to lines and wrinkles.

May is Melanoma/Skin Cancer Detection and Prevention Month, part of a concerted campaign to keep skin safety on the radar. Lawmakers are doing their part, too. As of Jan. 1, no one under the age of 18 is permitted to use a UV tanning bed in Delaware. Use of tanning beds increases the risk of melanoma by up to 75 percent, according to the American Academy of Dermatology.

Children’s skin is especially sensitive to UV light, Brown says. Research shows that even a few bad burns in childhood can increase a child’s risk of developing skin cancer later in life. More than 80 percent of skin cancers are now diagnosed in their earlier, most curable stage. That means fewer people are dying of the disease in Delaware, which is ranked 28th in mortality, an improvement from the 24th spot. Awareness really is paying off, Brown says.

Still, melanoma, the most serious form of skin cancer, is killing people. Among them is Brett Gustafson, a 28-year-old farmer from Harrington who discovered a suspicious mass on his collarbone after returning from a trip to Disney World in 2013. He was diagnosed with Stage 4 melanoma, an advanced cancer that already had spread to his bones and brain. Within six months, the father of two was dead. After Gustafson’s diagnosis, his family members went to the dermatologist. His sister had a suspicious mole removed from her ankle, which turned out to be Stage 1 melanoma. His widow, Samantha, made a video that appears on ProtectYourSkinDE.com, a website launched by the state to educate the public on skin cancer. Early detection is a good start to having a fighting chance, she says.

Not surprisingly, Sussex County has the highest skin cancer rate of Delaware’s three counties. Men are more likely to develop the disease than women, especially if they spend a lot of time outdoors. Brown notes that Delaware’s skin-cancer rate for males is second highest in the nation. For both genders, common risk factors are having fair skin, light hair, blue or green eyes, and freckles. But those aren’t the only characteristics that make individuals more prone to skin cancer. People who are undergoing chemotherapy, teens and women who are menopausal or pregnant also are at greater risk. So are individuals with burn scars, infections or who are taking medications that make their skin more sensitive to sun.

To reduce your exposure to UV rays, stay in the shade when the sun is strongest, 10 a.m.-2 p.m. Wear long sleeves and a wide-brimmed hat. And use a broad-spectrum, water-resistant sunscreen with a SPF of 15 or higher. Reapply every few hours, especially if you have been swimming or sweating a lot. You need to slather it on and don’t forget the back of your neck and your ears,” Brown says. African-Americans and people with dark skin should wear sunblock, too. No one is immune to skin cancer.

On Aging…and Acne

In youth, our skin is smooth and plump, bolstered by abundant collagen, the protein that makes skin firm and elastic. But as time goes on, we produce less collagen. Gravity tugs at our bodies. Our hormones shift. Perhaps the most important factor in skin showing its age is how much and how long it has been exposed to the sun, says Dr. Lori Spencer of Premier Dermatology in Newark.

If you were going to pick one product to use daily, I would say a broad-spectrum sunscreen is the most important, she says. Even if you implement retinoids, anti-oxidants such as Vitamin C, skin brighteners and exfoliants such as glycolic acid, you are essentially canceling out your effort if you are not protecting yourself from the sun.

So, do we need to wear sunscreen in the winter? Absolutely, Dr. Spencer says. “Even if you aren’t at the beach you are still exposed to the detrimental effects of the sun, she says. UVA can pass through window glass, so it is important to wear sunscreen, even if you won’t be outside. New, tinted sunscreens compliment all skin tones and can be worn as a light makeup. I often use a bronzer on top of one of these products to give a safe, sun-kissed glow, she says.

Advanced skin products also are helping to hold back the hands of time, including retinol, a form of Vitamin A. Retinoids can help to slow the loss of collagen. Retinoids can reduce fine lines and wrinkles and give the skin a healthy glow, but they are not recommended for use during pregnancy, she says. I also recommend a vitamin C-containing product each morning to prevent free radical damage and to brighten the skin.

Good habits help, too. Some people develop facial wrinkles from sleeping on their side or stomach rather than their backs. Also, chewing gum, drinking from straws and smoking can contribute to perioral rhytides or lines, Dr. Spencer says. Furrows, wrinkles and sagging aren’t the only signs of aging skin, says Erica Suppa, founder of Fresh Faced Skin Care, clinics that specialize in facial skin care in New Castle and Chadds Ford, Pa.

Acne develops in about 25 percent of adults, especially post-menopausal women. Individuals with celiac disease and polycystic ovarian disease frequently break out, too. Stress and genetics also are factors. “All of a sudden, they are 60 years old and have acne, she says. Women say it isn’t fair. They have acne and wrinkles at the same time. Many already have tried regimens of antibiotics without success and are looking for an alternative to Accutane, a powerful prescription medication whose side effects include joint pain, nosebleeds and peeling skin. Or they have tried medications without success.

Suppa often recommends a regimen that includes an exfoliating serum and an antiseptic peel. People with acne expel dead skin cells at a rate up to five times higher than people who are not acne prone, and the pores fill up very quickly, she says. “Also, acne-prone skin gets used to productsvery quickly. So I change things up with different percentages of benzoyl peroxide and how often we use it. Adult acne also can be a side effect of medication, including lithium, anti-seizure drugs and corticosteroids. If you suspect your acne is related to prescription drugs, don’t stop taking your medicine. Call your doctor for advice.

Photograph by Carlos Alejandro

Dr. Lori Spencer of Premier Dermatology in Newark works with patient Stephanie Gray.

Anti-Aging Arsenal

Time marches on. The goal is to look like time is not marching on our faces. Science, technology and good habits make a big difference. Here are some of the products and practices that can help to keep our skin healthy and youthful.

You need it. No doubt about it. Even in the dead of winter. Choose a product with an SPF of at least 15—and higher if you are traveling closer to the equator.

Retinol products
Retinol, a form of Vitamin A, has been shown to reduce wrinkles and brown spots. Creams, serums and other forms are widely available through doctors, as well as over the counter. G.M. Collin Retinol Advanced + Matrixyl + Q10 is designed to deliver concentrated retinol to the skin to correct wrinkles and fine lines while delaying the development of new lines.

Sleep on your back
Your skin will enjoy sweet dreams if you are facing the ceiling when you are catching ZZZs instead of burrowing into a pillow. But what if you find yourself flipping belly down or onto your side? JuveRest, a sleep pillow, is engineered for proper positioning with the contours, flexibility and density to comfortably support a back sleeper head, neck and shoulders.

Minimize your pores
Enlarged pores are caused by a buildup of excess sebum and dead skin cells. Aging and sun damage also enlarge pores. Products like Kiehl’s Precision Lifting and Pore-Tightening Concentrate focus on making skin more elastic to tighten pores. Also, be sure to completely remove makeup, cleanse skin after a workout and choose a matte, oil-absorbing moisturizer.

Don’t smoke
Smoking contributes to wrinkles in several ways, including repetitive facial motions, such as inhaling and narrowing the eyes to keep out smoke. Smoking also depletes the skin of oxygen and damages collagen and elastin, the fibers that give skin elasticity.

Give up gum
Constant chewing contributes to lines around the mouth. So does drinking through a straw.

Spend less time in the tub
Long baths and showers remove oils that moisturize the skin. Instead of hot water, dial back to warm water.

How do you spell melanoma?

The first five letters of the alphabet—A-B-C-D-E—provide an easy way to remember the warning signs, according to the Skin Cancer Foundation. Look for:

A suspicious mole will have an irregular shape. If you draw a line down the center of it, the two sides will not match.

The edges of a melanoma will be uneven, not smooth and round like a normal mole. The border may even appear jagged, notched or scalloped.

Cancerous moles are often several different colors rather than plain black or brown. Moles also may be blue, green or red.

Melanomas usually grow to be larger than the eraser on a pencil or more than ¼ inch in diameter.

Beware of moles that are changing: growing in size, becoming a different shape, changing in color or bleeding, crusting or itching.