Monday, July 28, 2014

Changing moles? Get in QUICK!

April 2013

Sometimes I will go 6 months without seeing a melanoma but I have had three in the last month that I wanted to tell you about. I try to tell my patients " this is a partnership my eye will hopefully pick up anything unusual, but I need you to tell me if anything starts changing".

Anyway, three women, all between early 40's and early 50's, came to me with a lesion or mole that was changing. All had been there about 6 weeks. All were biopsied and found to be melanoma. What gives me goose bumps and the message I want to convey is, if you believe a mole is changing or even have a new lesion you are worried about, try to see me in a week or two because these things can grow quickly. Basal cell carcinomas are a different story we can watch something possibly suspicious over several months before we decide to biopsy and it only grows locally. As you know, as a rule of thumb, basal cells don't metastasize and kill. So, what can I do to help? I usually have openings within the next two weeks, although it may not be at our preferred time. However, even if I have a full schedule, if you are concerned about one changing mole or new lesion, I would rather see you at the end of the day thank think you waited because you could not get in. Just tell the front desk you have a changing mole and to schedule you at the end of the day! Now that I have said that, if you have a list of other issues, I may make you reschedule for those, BUT if I am suspicious about a mole, I will take it off that day.... After seeing these three cases, I just wanted to get this off my chest. Fortunately, these three cases I talked about are in the early stages and I think all will be well. I am not trying to make you paranoid or scared; I would just hate to see you blow something off for months. I did speak to the 2 of the women already about writing this to you, and they thought it was a good idea. Pass it on to a friend if you want.

Getting back to sunscreens. Find one you actually like putting on in the am even if it is a few dollars more and you will most likely really do it. If the skin cancer threat doesn't get you to wear it, maybe vanity will! In the Times Picayune 6/5/2013 and USA today of the day prior, there is an article which shows that after 4 years of daily sunscreen use on the hands , participants were 24% less likely to show signs of increased aging.

For example, today I look out the window and it is raining. I realize my facial tinted sunscreen is on 'rain or shine'. We all really do get ultraviolet exposure (and therefore damage) all day long, through the windows as we are driving or while we're walking the dog after work.

Wearing sunscreen everyday is a habit that I developed in my 20's and have practiced since. Some people only put sunscreen on when they are at the beach or before playing tennis, etc., but so much of the harmful UV exposure is during the little times when you aren't even realizing it.

So find a sunscreen that you really like ... one that you look forward to putting on, whether it is tinted or not. Even the mineral powders have sunscreens in them. So if you are using powder, be sure to find out if it does have sunscreen protection in it and how much.

Some patients I talk to use a drugstore product (such as Neutrogena), others use something more high end ( such as Laura Mercier) in my office. In the office, we have some sunscreen products by Elta MD that I love! A while back I was interviewed on TV about sunscreens; I talked about how I actually visited stores like Earthsavers and found some sunscreens that I liked.

The key is, like your favorite shampoo, you may have to try some different sunscreen products before you find one that fits all your criteria. It is helpful if the place you are shopping lets you actually try some on or gives you samples to make sure you love it before you buy.

So what do you look for? I personally like ones with the micronized zinc oxide that disappears into my face quickly but also gives me at least a 30 SPF. The American Academy of Dermatology used to recommend a 15 SPF but increased it to a 30 when they realized that few of us put on the amount that we really need for that protection, so it kind of equals a 15!

Also, be careful in that one you like in the winter may be too moisturizing for you in the summer; you don't want to break out, do you? Its OK to have different ones for different climates. Lastly, the advantages of doing this form an early age are multifold. Your face will be a more even color with less splotchiness from the sun. If you have a problem like melisma, it is really mandatory for you to be diligent about sunscreen. Medically, you should have less of  chance of skin cancers.

Do you feel it is too late to start this now? It is never too late, but this should also be a wake up call to teach your children the basics of skin care.

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