Dr. Berman Answers Your Questions About Skin Cancer

Kevin Berman, MD, PhD Health Guide
  • Skin Cancer Questions

    • What causes Skin Cancer

    • How can I best protect myself from the sun?


    What causes skin cancer?

    The hallmark of cancer is the proliferation of abnormal cells. Mutations or defects in the genes on the chromosomes within these cells are responsible for this abnormal growth. The specific genes involved and the types of cells affected determines what type of cancer will develop. The three most common types of skin cancer are:
    • basal cell carcinoma: is derived from “keratinocytes”, which are the cells that comprise the majority of the upper layers of skin.

    • squamous cell carcinoma: this is also derived from “keratinocytes”, which are the cells that comprise the majority of the upper layers of skin.

    • Melanoma is derived from “melanocytes”, which are the pigment producing cells of the skin.
    As stated earlier, cancer arises from genetic mutations or defects. For the above mentioned skin cancers, it is thought that sunlight causes the vast majority of genetic mutations that lead to skin cancer. While not completely understood, it is clear that cumulative sunlight over the course of one’s lifetime is the major cause of basal cell carcinoma and squamous cell carcinoma.
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    However, melanoma seems to be associated with severe episodic sun exposure, as would occur in the person who occasionally gets blistering sunburns. Many of the genetic mutations caused by sunlight are repaired by the cells’ innate ability to correct mutations. The mutated cells that are not repaired may remain in a dormant state and not grow for many years. If they are triggered to grow, then a skin cancer begins to grow. As a result, arising skin cancers tend to be caused by sun exposure in the distant past rather than a recent sun tanning session. While sun exposure is the main culprit causing skin cancer, other chemicals and radiation also have the ability to produce similar mutations. And of course, an individual person may have inherited genetic mutations that will lead to skin cancer.
    How can I best protect myself from the sun?

    Sun protection within reason is the best approach to maintaining healthy skin. While one cannot avoid the sun completely, planning outdoor activities for the early morning or early evening allows one to avoid the peak hours of sun intensity. As a general rule, the sun is most intense between the hours of 10 AM and 3 PM. Avoiding outdoor activities during these hours is advised. However, the sun still has high intensity at other hours and protective clothing and sunscreen are absolutely necessary anytime one is outside in the sun.

    Precautions that can be taken to protect yourself from sun exposer:
    The sunscreens available at your local drugstore. Depending on your duration of the sun here are some suggested routines:
    • For daily use: a sunscreen with at least SPF (sun protection factor) 15 should be applied to the face, ears, neck and the back of the hands.

    • If there are expectations of being out in the sun for a prolonged period of time: then SPF 30 or higher is advised with application every 2-3 hours.
    Sunscreen Ingredients to be aware of:
  • Each sunscreen tends to have several chemicals that protect the skin from the sun .
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    • A zinc oxide or titanium dioxide containing sunscreen is recommended as zinc and titanium protect the skin by reflecting sun light from the skin back into the atmosphere.

    • Most other active sunscreen ingredients protect the skin by absorbing the sunlight before it can affect the skin cells. While this is effective, each ingredient may only absorb sunlight of specific wavelengths.

    • An important ingredient is called Parsol 1789 or avobenzone, which absorbs the longer wavelengths of sunlight.


    Note: Most importantly, one must find a sunscreen that is tolerated well so it is used often. A sunscreen is of no use if it is not used often!
Published On: July 26, 2006