How to protect the skin you're in

For decades, dermatologists have warned people about the dangers of soaking up the sun. But the appeal of a golden tan has been hard for many people to just say "no" to.

That's starting to change as the incidence of skin cancer soars and more people are taking the warnings to heart.

Still, there are plenty of holdouts who think that they can get by without using a sunscreen or think that skin cancer can never happen to them.

To encourage sun-worshippers to kick the habit, Dr. Diego Marra, a Fort Worth dermatologist, answers common questions concerning skin cancer and what people can do to protect themselves.

Have you seen the incidence of skin cancer increasing in your practice?

I am seeing more skin cancers in general, and also more cancers in younger patients. A recent study shows there are more than 3 million cases of skin cancer each year and that the number continues to grow. Experts have called that an epidemic of skin cancer in the United States.

Are you seeing more melanoma in younger people?

Unfortunately, yes. In fact melanoma is the most common form of cancer in young adults 25-29 years of age.

Are you seeing more baby boomers who lived in the sun as children and now have skin cancer?

Absolutely. We know that skin cancers are caused by cumulative sun damage. In other words, it's not the sun we got yesterday, but the sun we got while we were growing up. Back then we didn't know as much as sun protection as we do now.

What should adults who lived in the sun as children do to protect themselves now?

Even if someone has had extensive sun exposure earlier in life, it is never too late to start protecting yourself from the sun, and that may help prevent the development of skin cancer. It is important to remember that there is no such thing as a "healthy tan." A tan is the body's reaction to UV radiation damaging skin cells, so it is, by definition, unhealthy. To protect yourself, avoid prolonged exposure in the sun during peak hours from 11 a.m. to 3 p.m. Wear sunscreen and protective clothing, especially hats. I tell my patients to wear both anytime they plan on being outdoors for more than a few minutes.

How much UV protection does an adult need in a sunscreen?

The higher the better. Although an SPF of 30 screens out 97 percent ultraviolet rays, that assumes "perfect" application in terms of how much and how evenly one applies the product. In the real world, that is often not the case and going to a higher SPF compensates for that. I use an SPF of 80, and there are products that go even higher. It is important to remember that the SPF number only refers to protections about UVB, the main cause of sunburns. There is another type of sunlight called UVA, which causes premature aging such as wrinkled and age spots. When purchasing a sunscreen, one should look at the SPF number and also make sure the products lists UVA protection on the label.

Are the sunscreens found in cosmetic products such as foundations enough, or should women add a layer of sunscreen?

There are many cosmetic products with SPF values of 15 and some that go up to 30. These are excellent for daily activities that don't involve prolonged exposure to the sun. If, however, one anticipates being outdoors for several hours, then sunscreen and protective clothing should be considered.

Do hats, shirts and other products touted as having a sunscreen in them really help?

Yes. The main difference between these products and regular clothing is how tightly the fabric is woven, which in turn allows less sunlight to pass through. Most T-shirts have an average SPF of 7 and that drops to 3 if the fabric is wet. Sun-protective clothing is designed with SPF values in the 30s.

Most of us know the signs of melanoma, but what should we watch for in terms of other skin cancers?

The most important thing is change. I tell all of my patients who have had skin cancer to examine their skin at least once a month and get to know their spots. Many times, our eye can tell something has changed before we can pinpoint exactly how it has changed. And if that's the case, patients should then contact their dermatologist, who may perform a small biopsy procedure to check the cells under the microscope.

If you got a lot of sunburns as a child is there anything you can do as an adult to reduce your risk of getting cancer?

Absolutely. Make the use of sunscreen and protective clothing a regular habit. Pay attention to your skin. Develop a good relationship with your dermatologist and the moment you notice a change, make an appointment. Also monitor areas we don't frequently see -- behind the ears, on your back and the top of the scalp.

If someone develops skin cancer, what is the treatment like?

There are many ways to treat skin cancer, and some are actually nonsurgical. For cancers on the critical areas such as nose, eyelids and other parts of the face, Mohs surgery offers the benefit of real-time microscopic analysis, which helps maximize a cure and minimize scarring. Based on the various features of each cancer, your dermatologist can help guide you in deciding the best treatment. Although the word "cancer" can be scary, if caught and treated early, the vast majority of skin cancers have an excellent outcome.