Skin Cancer | Dr. Forley
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Posts Tagged ‘skin cancer’


Friday, July 5th, 2013



Preventive measures can reduce the chances that you will be one of the 20% of Americans who will develop skin cancer in their lifetime. Although being diligent about taking precautions can be challenging, reducing your exposure to sun beginning at a young age is the single most important step you can take. UVA and UVB radiation causes damage to the DNA of skin cells which results in genetic changes that can produce skin cancer.



Here are some methods to protect yourself from the primary cause of skin cancer, UVA and UVB exposure:

Sunscreen: Physical sunscreens like eltaMD  provide long lasting UVA & UVB protection by utilizing microfine, transparent zinc oxide. Daily use is advised as your skin is subject to the effects of UV rays even on cloudy days in winter.

Limit direct sun exposure –  UV rays are strongest when the sun is high in the sky, usually between the hours of 10am and 4pm. Try to schedule activities to avoid being outdoors for too long during these peak hours.

Cover up – Use protective clothing when you are in the sun at the peak exposure hours. Specialized fabrics by companies like SunDayAfternoons, provide UV-rated protection for your skin.

elta MD skin careWear a hat

Wear a hat – A 2- to 3-inch brim all around will protect areas such as the ears, eyes, forehead, nose, and scalp that are often exposed to intense sun. These are known high risk areas for the development of skin cancer.

Wear sunglasses – UV-blocking sunglasses are important for protecting the delicate skin around the eyes, as well as the eyes themselves. Your chance of developing eye disease is increased by long hours in the sun without protection. 

Avoid tanning beds – The cumulative effect of exposure to the ultraviolet rays used in tanning beds can increase the risk of developing melanoma by as much as 75% when tanning is started before age 35.


If you take the time to become familiar with your skin, you will be able to more easily  identify any changes that occur at an early stage. Many skin cancers can be detected when they first start if the skin is monitored on a regular basis. A self-exam is best done with good lighting and a full-length mirror. You should learn the appearance and pattern of any moles, blemishes, freckles, or other marks on your skin so that any changes will be apparent to you the next time you do a body check. Any area that concerns you should be brought to the attention of your physician. You should also ask your physician if your specific skin type and risk factors warrants an annual body check by a dermatologist.

If skin cancer is suspected, a skin biopsy will usually be performed. An excisional procedure may be all that is needed. A specialized technique called Mohs surgery may be used to examine the tissue at the time of the excision. This enables the removal of all cancer cells while sparing as much uninvolved tissue adjacent to the cancer as possible. Reconstruction is performed to minimize any cosmetic defects as a result of the cancer treatment. For cancers such as melanoma that might be more extensive, tests to determine any spreading of the cancer may be recommended. Chemotherapy, immunotherapy, radiation, or additional surgery might be needed if other organ systems are affected.

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Monday, June 24th, 2013

More than 3.5 million skin cancers are diagnosed each year in the United States, making it the most prevalent of all cancers. It is more common than cancer of the breast, prostate, lung, and colon combined. It is estimated that 20% of Americans will develop skin cancer in their lifetime. Although it is very widespread, there is some good news:


  • Since most skin cancers are caused by excessive sun exposure, prevention measures can significantly reduce your risk of getting skin cancer
  • Awareness of skin cancer warning signs enables treatment at an early stage thereby minimizing the risk of spreading or recurrence




Basal and squamous cell cancers (keratinocyte cancers) are the most common forms of skin cancer. They are found mainly on parts of the body exposed to the sun, such as the head and neck. These cancers rarely spread elsewhere in the body and are much less likely than melanomas to be life threatening. Although they grow very slowly, both of these types of skin cancer can become quite large and affect nearby tissues. Scarring, disfigurement, or even functional loss may be the outcome if they are ignored or left untreated.

Basal Cell Carcinoma

Squamous Cell Carcinoma

Squamous Cell Carcinoma

Basal Cell Carcinoma








Melanomas can occur anywhere on the body but certain locations are at higher risk. Women are most commonly affected on the legs, neck, and face while the chest and back have the highest incidence in men. Melanomas can be much more invasive than basal cell and squamous cell cancers, but are almost always curable in their early stages. Disability and death can result if melanoma spreads to other parts of the body.




Basal cell carcinomas have a range of appearances. They may appear flat, firm, and pale in color but can develop as a small, raised, pink or red growth on your skin. A characteristic translucent, shiny, or waxy surface may be evident. They also may be prone to bleed after a minor injury. Multiple small blood vessels may be apparent on the surface. Sometimes the central portion of the lesion may have a crater-like depression and blue, brown, or black areas may be present. Large basal cell carcinomas may have oozing or crusted areas.

Squamous cell carcinomas typically look like lumps that will gradually increase in size if left untreated. The surface is usually rough, scaly, and crusted. These carcinomas may also appear as flat red patches that grow very slowly.

Melanomas are flat or raised pigmented areas on the skin that appear to change in size, shape, or color over time. They also frequently look different from moles or skin pigmentation present elsewhere on your body.

The ABCD rule is a guide for any signs of change in a pigmented skin lesion that should immediately be brought to the attention of your doctor:

(A) Asymmetry – meaning each half of the skin lesion or growth appears different

(B) Border irregularity – meaning the edge of the lesion is uneven

(C) Color irregularity – meaning the color of the lesion is not uniform and may have several different shades

(D) Diameter – meaning the diameter is relatively large (over 5 mm)

The ABCD rule does not apply in every case, so it is important to be aware of any changes that occur in skin lesions that have been present for a long time. In addition, new skin lesions or lesions that look different from the rest of your moles need to be carefully monitored.

An annual body check by a physician is especially important if you have a history of extensive sun exposure. Any lesions that develop ulcerations and are eroding or enlarging need to be evaluated.

In the next blog, prevention and treatment of skin cancers will be discussed.


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Thursday, June 23rd, 2011

Sun protection is one of the key strategies to help prevent premature aging and skin cancer. A sunburn is your body’s reaction to the damage produced by ultraviolet exposure. Prevention of a burn when your skin is exposed to the sun indicates that the level of harmful UV rays necessary to produce damage was minimized or avoided. Here are a few tips to assist you in making the right choice of a broad spectrum and photostable sunscreen for your skin.

Chemical vs. Physical Sunscreens

Chemical sunscreens use chemical UV filters, such as Avobenzone, to absorb or scatter the harmful UV rays of the sun. Many of the chemical filters can absorb into the skin increasing the chance of skin irritation or an allergic reaction. They also can be unstable and start to breakdown after exposure to the sun. This reduces their efficacy and requires frequent reapplication to maintain an adequate level of protection.

In contrast, physical sunscreens, such as zinc oxide, remain on the surface of the skin and deflect or block the sun’s rays by forming a natural protective layer. They are very photostable meaning that they don’t breakdown when exposed to light and can remain effective for an extended period of time if properly applied. The chances of an allergic reaction are reduced since the physical filters are not absorbed into your skin.

Broad Spectrum and SPF: What Do They Mean?

According to Philadelphia dermatologist, Dr Franziska Ringpfeil, broad spectrum means blocking the widest range of UVB and UVA rays.  “An easy way to remember the risks of ultraviolet exposure is to think of UVB as the burning rays and UVA as the aging rays because of deeper penetration without burning. Both can cause skin cancers,” says Dr. Ringpfeil. This is an important factor to consider in selecting your sunscreen because inadequate coverage leads to accumulated damage over time.  New rules, recently announced by the FDA for 2012, specify that designating a sunscreen product as broad spectrum must signify that equal UVA and UVB protection is provided.

SPF spreadsheetSPF or Sun Protection Factor measures how long a sunscreen will protect you from burning and is not an indicator of the strength of the protection. For example, if it takes you 20 minutes to get a sunburn, an SPF 15 will allow you to stay out in the sun 15 times longer, or 5 hours, without burning. The higher the SPF number, the longer the time period of protection against the sun’s harmful burning rays and the less frequently you will need to reapply. Products with an SPF15 block 93% of UVB rays and products with SPF30 block 97%.

Unfortunately, there is no standardized UVA sunscreen protection rating system as yet. Both short and long UVA rays are most reliably blocked by a physical sunscreen such as zinc oxide or titanium dioxide. Chemical sunscreens such as oxybenzone don’t protect against long wave UVA rays.

EltaMD®Dr. Forley recommends the non-comedogenic, fragrance-free, and paraben-free EltaMD® physical sunscreen product line. Each sunscreen incorporates microfine, transparent zinc oxide that leaves no white residue on the skin’s surface while providing broad-spectrum protection.


Proper Application Techniques

Once you have chosen a sunscreen it is important to apply it correctly and regularly. It is recommended to use one ounce of sunscreen for the entire body 15-30 minutes prior to sun exposure making sure to reapply after swimming or heavy perspiration. It should go on after using moisturizer but prior to makeup. Even water resistant sunscreen products should be reapplied as skin oils can negatively affect the adequacy of coverage. The new FDA rules will require the amount of time a sunscreen product remains water resistant to be specified on the label.

Sun-Protective Clothing

Combining a daily sunscreen regimen with sun protective hats and clothing offers another way to protect skin from the harmful effects of the sun. Sun-protective fabrics differ from typical summer fabrics in several ways: they have a tighter weave or knit and are usually darker in color. Ultraviolet Protection Factor (UPF) measures the level of protection the garment provides from UV rays. For example, if clothing has a value of UPF 20 the fabric will reduce your skin’s UV radiation exposure by 20 times.


Additional Tips:

  • UV rays penetrate clouds and glass so apply sunscreen daily and not just when the sun is shining
  • If you are using any type of exfoliating skin care products, such as Retin-A or glycolic acid, you may be more sun sensitive and you should be certain to apply sunscreen daily
  • Don’t forget sunscreen on your neck, chest, and hands as they are also subject to the damaging effects of UV exposure
  • Avoiding the peak sunlight hours of 10am-4pm only reduces UVB exposure. UVA rays are present at equal intensity throughout all daylight hours.

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