We South Africans love outdoor activities and soaking up the sun, but we also need to be very cautious, as too much sun can cause several benign and malignant skin lesions and premature ageing of our skin.
Interesting fact: our skin is the largest organ in our body, constituting around 16% of our body mass.
In the past, South Africans and Australians of European descent believed that the darker your tan was, the better. Medical research, on the other hand, has come up with irrefutable proof of the potentially harmful effects on our skin of UV A and B rays- directly associating over-exposure to these rays with skin cancers, for example, as well as a host of other types of skin damage.
As a result of this awareness, the market is now flooded with a wide variety of skin protection creams, lotions, barriers and even UV- protection bathing clothes and outdoor sports apparel.
So let’s take a look at some of these common types of skin lesions:
- Solar keratosis: brownspots which appear in sun-exposed areas of skin.
- Actinic keratosis: this condition occurs in skin which has been progressively exposed to the sun over many years. It manifests itself as dry, red, scaly spots on sun-exposed areas of skin such as the neck, face and forehead. Actinic keratoses feel rough and dry. They are slightly raised from the surface of the skin. People with fair skin are most susceptible to actinic keratosis because they have less of the protective pigment melanin than darker-skinned people. It is more common in people over 50, or in younger people who constantly work outside, such as construction or agricultural workers. They are usually harmless but can occasionally be pre-cancerous, so they should be checked by a dermatologist.
- Seborrheic keratosis: These lesions are often brown or tan in colour, slightly raised, and form on the chest, head, back, or neck of older people. They are not caused by sun exposure, but may run in families. They do not develop into skin cancer.
Both actinic and seborrheic keratosis may develop individually or in clusters. They may become itchy and bleed. They can be treated with cryotherapy, creams or excision of the lesions.
- Basal cell carcinoma: this is a type of skin cancer which usually develops as a reaction to exposure over time to harmful UV rays. It appears as a change in your skin, such a sore that won’t heal, or a growth. These lesions will have one of the following characteristics:
- a shiny, skin-coloured bump that can look translucent or pink on white skin; on darker skin, the bump often looks brown or glossy black. The bump may bleed and scab over;
- a brown, black or blue lesion — or a lesion with dark spots — with a slightly raised, translucent border;
- a flat, scaly patch with a raised edge. Over time, these patches can grow quite large;
- a white, waxy, scar-like lesion without a clearly defined border.
Basal cell carcinoma is usually treated by completely excising the cancer to avoid recurrence. This type of cancer rarely metastasizes, but it is important to treat it as early as possible in order to remove it completely. If a doctor suspects that a lesion may be cancerous, the first step is to perform a biopsy, to identify it.
4. Squamous cell carcinoma: this type of cancer forms in the squamous cells – the outer and middle layers of your skin. Lesions can appear anywhere on the body, though they are most common on areas of sun exposed skin. They present as one of the following:
- A firm, red nodule
- A flat sore with a scaly crust
- A new sore or raised area on an old scar or ulcer
- A rough, scaly patch on your lip that may evolve to an open sore
- A red sore or rough patch inside your mouth
- A red, raised patch or wartlike sore on or in the anus or on your genitals
Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Untreated, squamous cell carcinoma of the skin can grow large or spread to other parts of your body, causing serious complications. Depending on the size, it can be treated by excision, or, if smaller or superficial, doctors may use cryotherapy (freezing) or a number of other less invasive forms of treatment.
5. Malignant melanoma: Melanoma, the most serious type of skin cancer, develops in the cells (melanocytes) that produce melanin — the pigment that gives your skin its colour. Exposure to UV rays from the sun or tanning lamps increases your risk of melanoma, and the risk seems to be increasing for people under 40, especially women.
Melanomas can develop anywhere on your body. They most often develop in areas that have had exposure to the sun, such as your back, legs, arms and face, but they can also occur in areas that don’t receive much sun exposure, such as the soles of your feet, palms of your hands and fingernail beds, and even in the retina of your eyes. These hidden melanomas are more common in people with darker skin.
The first signs and symptoms of melanoma are often a change in an existing mole, or the development of a new pigmented or unusual-looking growth on your skin.
Moles are common and usually harmless. Most of us have between 10 and 40 moles on our body. To detect an unusual mole that might be a melanoma, it’s helpful to think of the letters A-E:
- A is for asymmetrical shape. Look for moles with irregular shapes
- B is for irregular border. Look for moles with irregular, notched or scalloped borders
- C is for changes in colour. Look for growths that have many colours or an uneven distribution of colour.
- D is for diameter. Look for new growth in a mole larger than 6mm in diameter
- E is for evolving. Look for changes over time, such as a mole that grows in size or that changes colour or shape. They may also start bleeding or itching.
Melanoma can be treated successfully with early detection, so, as with all types of skin cancer, it is important to see your doctor or a dermatologist if you notice any irregularities. Treatment for a melanoma almost always involves surgery, and, if it has spread, chemotherapy and/or radiotherapy may be used.
Prevention is always better than cure. Self- examination of your skin and regular skin exams by your GP or Dermatologist are the best ways of detecting early lesions.
Taking care in the sun is obvious, but we need vitamin D for our immune systems, so try to get your daily 15-30 minutes in the sun before 11h00 in the morning or after 15h00, avoiding the strongest exposure times, so that the vitamin D can get converted into D3, which is crucial for our immunity, without exposing us to risk of sun-damage.
If you will be taking part in outdoor activities for longer than 30 minutes, or during the hottest part of the day, wear a hat and use a suncream with an SPF of at least 30. Reapply the cream every few hours or after immersion in water.
Enjoy the summer and take care!