SCRIPT NUMBER 94
SKIN DAMAGE FROM THE SUN
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: SKIN DAMAGE FROM THE SUN
PROGRAM NUMBER:
94
SUBJECT: MECHANISM, CHARACTERISTICS, COMPLICATIONS,
TREATMENT OF SUN-DAMAGED SKIN
KEY WORDS: SOLAR KERATOSIS, SEBORRHEIC KERATOSIS, SKIN
CANCER, MICROSCOPE, SUNSCREEN
DATE OF SCRIPT: JANUARY 11, 2013
AUTHOR: RICHARD YUKL, MD, FACS
There are children who spend countless hours day after day playing in the sun,
and adults who are forced to work in direct sunlight as a routine part of their job.
Often, after years of living this lifestyle, they develop rough, scaly patches on the
exposed skin of their head or arms, and they become worried that their long
exposure to the sun has damaged their skin to the extent that it has now
progressed to skin cancer.
I want to talk today about abnormal growths that can develop on skin following a
long history of sun exposure, and when you need to seek medical attention.
We will discuss two common types of skin growths. Both are patches of change
on areas of skin that have been exposed to the sun - skin on the face, lips, ears,
scalp, arms, or on the back of the hands. The first type of growth is a rough,
scaly patch with the medical name solar keratosis, a name given to skin that has
been directly damaged by the sun. This type of growth can degenerate into skin
cancer. It must be differentiated from the other type of growth, which can develop
on the same areas of skin as a brown, black or pale colored growth. It carries the
name seborrheic keratosis, and it has a waxy, scaly, slightly thickened
appearance that looks as though it is pasted onto the skin. These growths are
painless. Their exact cause is not known, but these growths frequently occur in
certain families, and they do not degenerate into cancer. They require no
treatment and are of little concern except for their appearance.
Skin is a living organ that can regenerate itself if it is damaged or destroyed.
Normally, healthy new skin cells develop in an orderly fashion in the deepest part
of the skin. As these new cells develop, they push older cells toward the skin
surface, where the older cells die and are eventually rubbed off. When skin
becomes damaged by the sun, it is the new cells growing in the depths of the
skin that are damaged, and these damaged cells become the abnormal growths
you can see and feel. Your skin is more likely to become sun-damaged if you live
in a sunny climate, are light-skinned, have red or blond hair, or if your eyes are
blue.
If you have had years of excessive sun exposure and now develop a new
growths on areas of exposed skin, know that skin cancer is the most common
form of cancer, even in developed countries such as the United States, where
3.5 million skin cancers are diagnosed every year. Because skin cancers develop
on exposed areas of the body, they can be identified and treated early, making
them highly curable. The cure rate for these cancers is as high as 98%, even
though treatment may require surgery to remove the tumor, and that can be
disfiguring. The death rate climbs if there is a delay in treatment.
Let me describe the progression of sun-damaged skin growths in more detail.
These growths enlarge slowly. They take years to develop, and they usually
cause no symptoms early on. When symptoms do occur, the growth becomes a
rough, dry or scaly patch of skin, usually less than one inch, or 21/2 centimeters,
in size. As the skin damage progresses, the growth will begin to itch or burn. If it
is rubbed or scratched off, it will return. These growths can sometimes disappear
without treatment, but they return if they are exposed to more sun.
Because it can be difficult for you to tell the dangerous growths from the ones
that will not become cancer, it is best to have any change in sun-exposed skin
checked by a doctor, especially if the growth begins to grow rapidly, or if it begins
to bleed and doesn’t heal. These could be signs that the damaged skin has
degenerated into cancer.
Doctors can usually diagnose pre-cancerous skin damage by merely examining
the skin. If there is any doubt, your doctor may take a small sample of the growth
in the office for examination under a microscope. It is impossible to tell exactly
when a sun-damaged growth finally degenerates into skin cancer, or which of
many growths will become cancerous, so all of the sun-damaged pre-cancerous
growths are usually treated as a precaution before any have become cancerous.
Treatment options may include freezing the growths with an extremely cold
substance, or destroying the damaged skin with a powerful light beam if your
doctor has access to the necessary equipment. Your doctor can also scrape off
the damaged cells completely and stop the skin bleeding with an electric current
once the abnormal skin has been made numb with medication. Or, chemicals
that will kill abnormal cells and allow new, normal cells to form in the deep parts
of the skin can be applied to the pre-cancerous growths.
The easiest way one can protect against suffering the complications of sundamaged skin is to prevent the damage in the first place. Avoid sunburns.
Sunburns increase your risk of developing skin cancer. Set time limits on how
long you will spend outdoors. If you have to be out in the direct sun, apply a
sunscreen to all exposed skin, including your lips. Apply it 20 minutes before
going out, and reapply it every two hours. Also, wear clothing that covers your
arms and legs and a broad-brimmed hat, because a hat provides more protection
from the sun than a cap. Finally, examine your skin regularly, looking for new
skin growths or changes in growths that are already present. With the help of
mirrors, check your face, neck, ears and scalp.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may
differ for your particular health needs. If you need medical advice, please consult
a medical professional in your area.