What causes melanoma?
Anyone can get melanoma. Most people who get melanoma have light skin, but people who have brown and black skin also get melanoma. Your risk of getting melanoma increases if you seek the sun, tanning beds, or sunlamps: These all emit ultraviolet light (UV), and scientists have proven that UV light can cause skin cancer in people. Using indoor tanning beds before age 35 can increase your risk of melanoma by 59%, and the risk increases with each use. Living close to the equator and failing to protect your skin also puts you at an increased risk. You are also at an increased risk if you have had 5 or more blistering sunburns as a child or teenager. Even if you haven’t had a sunburn in recent years, the sunburns that you got as a child still put you at risk for melanoma in your older years.
While exposure to UV light greatly increases your risk of developing melanoma, your other characteristics also play a role. These include:
- Fair skin. Having less pigment (melanin) in your skin means you have less protection from damaging UV radiation. If you have blonde or red hair, light-colored eyes, and freckle or sunburn easily, you’re more likely to develop melanoma than is someone with a darker complexion. But melanoma can develop in people of all races and those with darker complexions, including Hispanics and blacks.
- 50 or more moles
- Large or atypical moles
- Had melanoma or another type of skin cancer
- Had another type of cancer, such as breast or thyroid cancer
- A disease that weakens your immune system, or taking medicines to quiet your immune system, such as taking life-saving medicines to prevent organ rejection after transplant surgery
Scientists have also found that some people inherit genes that increase their risk of getting melanoma. Therefore if a close blood relative — such as a parent, child or sibling — has had melanoma, you have a greater chance of developing it too.
In order for early detection it is recommended to have your skin checked by a dermatologist once a year, or if you notice any mole changing.
All women have facial and body hair, but the hair is usually very fine and light in color. Excessive or unwanted hair that grows on a woman’s body and face is the result of a condition called hirsutism.
The main difference between typical hair on a woman’s body and face (often called “peach fuzz”) and hair caused by hirsutism is the texture and location. Hirsutism is when usually fine hair is coarse or if it grows in areas where hair is not usually present.
Women develop excessive body or facial hair, called hirsutism, may be due to higher-than-normal levels of androgens, including testosterone. All females produce androgens, but the levels typically remain low. Certain medical conditions such as polycystic ovarian syndrome (PCOS), can cause a woman to produce too many androgens and, as can normal life events such as pregnancy. Hair growth or hirsutism in pregnancy is usually due to hormonal fluctuations — an increase in secretion of male hormones or androgens from the ovaries and placenta.
Waxing, shaving, and depilatories: If you have hirsutism, you may need to be more proactive about waxing, shaving, and using depilatories (topically applied creams lotions or foams that remove hair). These are all pretty affordable and take effect immediately, but they require continual treatment.
Laser hair removal: Laser hair removal involves using concentrated light rays to damage your hair follicles. Damaged follicles can’t produce hair, and the hair that’s present falls out. With sufficient treatments, laser hair removal can provide permanent or near-permanent results.
Electrolysis: Electrolysis is the removal of hair using an electric current. It treats each hair follicle individually, so the sessions can take longer.
It’s important to keep an eye on your skin and any changes that may occur. Patients are recommended to take a good look at their own skin once a month. So put a reminder in your phone and spend 5 minutes doing a good check:
- Examine your face, especially your nose, lips, mouth and ears — front and back. Use one or both mirrors to get a clear view.
- Thoroughly inspect your scalp, using a blow-dryer and mirror to expose each section to view. Get a friend or family member to help, if you can.
- Check your hands carefully: palms and backs, between the fingers and under the fingernails. Continue up the wrists to examine both the front and back of your forearms.
- Standing in front of the full-length mirror, begin at the elbows and scan all sides of your upper arms. Don’t forget your underarms.
- Next, focus on the neck, chest and torso. Women should lift breasts to view the undersides.
- With your back to the full-length mirror, use the hand mirror to inspect the back of your neck, shoulders, upper back and any part of the back of your upper arms you could not view in step 4.
- Still using both mirrors, scan your lower back, buttocks and backs of both legs.
- Sit down; prop each leg in turn on the other stool or chair. Use the hand mirror to examine the genitals. Check the front and sides of both legs, thigh to shin, ankles, tops of feet, between toes and under toenails. Examine soles of feet and heels.
Refer to the ABCDE’s when monitoring a spot on your skin:
Asymmetry: when the shape of the lesion is not even;
Border: if the border is uneven or not well-defined;
Color: if there is more than color in the lesion;
Diameter: bigger than the size of a pencil eraser;
Evolving: if the lesion has been changing in any way over time, either slowly or quickly.
There are two ingredients that you have probably seen listed as active ingredients of acne products at your local pharmacy are: benzoyl peroxide and salicylic acid. These two ingredients have dominated the market for years– here’s how they work:
- Benzoyl Peroxide: Benzoyl peroxide unclogs skin pores by stopping bacteria from growing and causing an acne pimple. It acts as an antiseptic against Propionibacterium acnes, the bacteria that causes acne. In addition to killing bacteria, benzoyl peroxide makes some prescription antibiotics more effective in their fight against acne causing bacteria. Furthermore, benzoyl peroxide can prevent resistance from developing to antibiotics. Benzoyl peroxide is available in many forms: soap, lotion, cream, gel, liquid, pad and foam. Although it is available in strengths ranging from 2.5% to 10%, more is not always better! Once you get above 5%, the benzoyl peroxide doesn’t work any better to kill bacteria, it just will make your skin more dry. One caution with using benzoyl peroxide as it can bleach your towels or clothes so apply with caution!
- Salicylic Acid: Salicylic acid has the ability to break down sebum that clogs pores. Because salicylic acid can unclog pores, it can help reduce blackheads and whiteheads. Salicylic acid does not reduce the acne causing bacteria. It is also available in many different forms and strengths over the counter. There are also chemical peels available to treat acne that contain salicylic acid.
Both benzoyl peroxide and salicylic acid are tried and true ingredients that can help clear acne. Recently, a new acne-fighter has been introduced to the pharmacy: Differin
. Up until a few months ago, Differin was a prescription-only medication. It has recently been approved for over the counter use and has kept its original strength of 0.1%. This is a different mode of treating acne than benzoyl peroxide and salicylic acid, as it is a retinoid product. Retinoids are a form of vitamin A. They also reduce acne outbreaks by preventing dead skin cells from clogging pores. Talk to your dermatologist about which topical may be right for you.
Isotretinoin, formerly known as Accutane, is the most effective medication for the treatment of severe acne. Other medications may or may not help severe acne or moderate versions that can be unresponsive, but isotretinoin is known to clear up most people’s acne. Around 80% of those who use isotretinoin are cured of their acne. Isotretinoin pills remain the most efficacious treatment for severe acne as well as many cases of more moderate acne that are unresponsive to other treatments. Some other conditions such as rosacea and folliculitis may also be treated with isotretinoin.
Isotretinoin is a version of high dose vitamin A that blocks processes in the body that lead to acne, such as shrinking the skin’s oil glands, reducing acne-causing bacteria on the skin, and changing the way that you shed skin cells. One course of treatment takes about 5-7 months on average; the course of treatment can take less time or a bit more depending on the individual, as dermatologists tailor the treatment to each patient. It is a medication that is usually given after other acne medicines or oral antibiotics have been tried without successful treatment of breakouts. This is a medication that requires monitoring so monthly check ups with your dermatologist are required while on this medication.
Mohs surgery is a specialized treatment for skincancer treatment on delicate skin areas or “high real estate areas” of the body like the face. Mohs surgeons are dermatologists who have performed additional fellowship training to become experts in Mohs micrographic surgery. Fellowship-trained Mohs surgeons are highly skilled in all aspects of this technique, including surgical removal of the tumor, pathologic examination of the tissue, and advanced reconstruction techniques of the skin.
It is a very precise, highly detailed method whereby the skin cancer is excised and then stained and examined under the microscope immediately. Repeated saucer-shaped layers of tissue are removed and examined until no more skin cancer can be microscopically visualized in the sample.
Mohs is scheduled with the understanding that the patient may be spending the entire day in the office depending on the number of levels necessary to clear the tumor. General anesthesia is not required for Mohs micrographic surgery. Most of these procedures are performed with the patient in the waiting room awaiting the verdict from the Mohs surgeon. The procedure uses frozen sections of skin that are then stained with special dyes. The dyed frozen pieces of skin are examined under the microscope and a tumor map showing the sites of any residual cancer cells is drawn by the Mohs surgeon. The process permits an examination of the entire tumor’s margins simultaneously while the patient is waiting in the office. If more cancer cells are seen under the microscope, tissue is removed at the site of involvement. Each skin layer that is removed is called a “level”. If no more cancer cells are seen at a particular level, then it is deemed “clear” (no more tumor) and the surgeon can begin on closing the excised area. Some tumors that appear small on clinical exam may have extensive invasion underneath normal appearing skin, resulting in a larger surgical defect than would be expected. It is therefore impossible to predict a final size until all surgery is complete. Cure rates typically exceed 99% for new cancers, and 95% for recurrent cancers.
By removing only tissue where cancer is known to be present, the technique combines a very high cure rate with excellent preservation of normal skin. Once the cancer has been fully removed, the surgeon will determine the type of repair for the best cosmetic result. The surgeon may refer patients to another physician for wound closure, may close the wound immediately, or may let the wound heal on its own.
Parabens are used in pharmaceuticals and skin care products as antifungal agents. In fact, parabens are the most widely used preservatives in the cosmetics industry. They’re often used in makeup, hair care products, moisturizers and shaving products. There are several types of parabens, the most common being methylparaben, probylparaben and butylparaben. They are used to maintain the integrity of the product, as they protect against the growth of fungus and bacteria, and have been used in products since the 1950’s. Yet while they do lower the chance of you developing a skin infection from a compromised product, they can still be irritating to some people’s skin.
The controversy comes from when in the 1990s, parabens were found to be xenoestrogens ― agents that can mimic the body’s natural estrogen. Additional sources of exogenous estrogen has been linked to organ system toxicity, reproductive and fertility problems, birth and developmental defects, and hormone disruption. As a result, experts in many countries have recommended limits on paraben levels in cosmetic products. What’s more, watchdog organizations worry that if parabens can be stored in the body, over time they could have a cumulative effect and pose a health risk.
This remains controversial, as other studies have shown parabens to have a very weak estrogenic effect and it is unknown if cumulative effects could pose a health risk. Currently the USDA and WHO consider the chemicals safe at low levels, as the amount of parabens in any product is typically quite small.
There’s reason to be mindful, but no reason to have an all-consuming concern about these chemicals. If it helps you rest easy, use a paraben-free body lotion. Today there are a number of formulas available from paraben-free brands. Epionce® is a botanical based brand created by a board-certified dermatologist that is completely paraben free.
A scar is the body’s natural way of healing and replacing lost or damaged skin. A scar is usually composed of fibrous tissue and can form for many different reasons anywhere on the body. The look and feel of the scar and the composition of a scar may vary – sometimes appearing flat, lumpy, sunken, colored, painful, or it can be itchy. The final look of a scar depends of many factors, including the skin type and location on the body, the direction of the wound, the type of injury, and age of the individual.
We don’t know why some patients with acne scar very badly and others don’t. Even patients with mild acne can develop scars, while there are patients with severe acne that don’t get scars. Picking at or popping acne lesions can definitely increase the likelihood that you could get scars from your acne.
Acne scars can be classified as many different types: atrophic, hypertrophic, or dyspigmented scars. Atrophic scars look like little indents or dimples in the skin and may be further classified as icepick (deep and narrow), rolling (broad with sloping edges) or boxcar scars (broad with sharp edges).
On the other side of the spectrum, hypertrophic scars are thickened raised acne scars. Discolored acne scars are sometimes referred as post-inflammatory hyperpigmentation (brown discoloration) or post-inflammatory erythema (red discoloration). The treatment of acne scars is dependent on the type of scars you have.
There are many different types of treatments for acne scars including: lasers, steroid injections, chemical peels, dermabrasion, microneedling, and fillers. Speak to your dermatologist about which treatment type would be best suited for you.
Acne is listed as a side effect of IUDs that contain progesterone, specifically the Mirena and Skyla implants. This is because this hormone is an androgen that can over-stimulate your oil glands and contribute to acne. What causes the acne is the hormone imbalance caused by more progestin in the body and not enough estrogen to balance it out. However, it is not a certainty that any type of birth control actually causes acne directly, just that certain ones will not help with it if you’re prone to outbreaks. If you were taking the birth control pill right before switching to an IUD and find that you start breaking out, more often than not that is behind what is going on with your skin.
Medications such as spironolactone can help counteract the effects that the IUD has in the skin and can control IUD-related breakouts. Originally formulated to treat hypertension and a few other cardiovascular conditions, spironolactone is a drug that can also help with hormonal acne at lower doses. It works as an anti-androgen (therefore only given to female patients) by blocking the entry of androgen hormones into cells. Overall, it limits the hormonal fluctuations that can lead to breakouts. While spironolactone has been used for hormonally regulated breakouts for over 30 years, it is considered off-label use for acne.
Pre-gym: Before heading out to the gym, cleanse the skin with a mild, non-irritating cleanser if you’re wearing a heavy base layer of makeup, and apply a lightweight, oil free moisturizer. Tinted moisturizer or mineral powder are fine to wear if you choose. Applying an oil-free formula is perfect to use pre-workout, as it won’t cause the skin to feel greasy, yet will work to hold water in the skin while you perspire. As much as it might feel like it, sweat sessions are not exactly quenching your skin with moisture. Moisturizer is especially important to apply because sweat evaporates water out of the skin, leaving it dehydrated unless protective steps are taken. If you’re headed outdoors to exercise, use a moisturizer with a sunscreen of at least 30 SPF, remembering to protect your neck, décolleté and arms as well as the face.
During the workout: The machines at the gym may be great for your body, but the sweaty hands of your fellow gym rats mean that they’re also repositories of a lot of germs. Make sure to stay hydrated throughout exercising, to replenish the moisture you are losing as you sweat. During exercise, try to avoid wiping your face with your hands – instead use a towel and pat your face dry.
After You’re Done: A big mistake people make after a workout: being too aggressive with their skin. Resist the urge to over-scrub: even the most killer spin class doesn’t call for major exfoliation. Skin is extra sensitive following a workout, so make sure to gently cleanse your face and avoid applying other products as too many products could irritate the skin and cause redness. Refrain from lounging in your sweaty exercise gear and remove clothing as soon as possible and hit the shower. The dirt and sweat from your clothing will sit on your skin, blocking your pores and potentially causing breakouts.