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... have been in the sun, including the face, scalp, ears, lips or around your mouth. ... sensitive areas such as your lips, nose, and palms of the hands ... – PowerPoint PPT presentation

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  • Florida Department of Environmental Protection
  • Central District Office

What is skin cancer?
  • Skin cancer is a disease in which cancer
    (malignant) cells are found in the outer layers
    of your skin.

Skin Cancer
  • This year more than one million Americans will
    develop one of the three most common forms of
    skin cancer.
  • Over 90 percent of these cancers will appear on
    sun-exposed skin, usually on the face, neck,
    ears, forearms, and hands.
  • Every hour an American dies from skin cancer.

What causes skin cancer?
  • Sunburn and Sunlight
  • Heredity
  • Environment

How it happens
  • Overexposure to ultraviolet UVA and UVB rays
    ravages skin cells. The top layer, or epidermis,
    is the most vulnerable. Too much sun prompts
    visible damage (like sunburn or tanning) as well
    as invisible, cellular-level damage that adds up
    over the years.

Layers of Skin
  • Epidermis
  • Dermis
  • Subcutis

  • Top layer of skin.
  • Contains three kinds of cells
  • flat, scaly cells on the surface called squamous
  • round cells called basal cells and
  • cells called melanocytes, which give your skin
    its color.

  • The middle layer of skin.
  • Contains blood vessels, nerves, and sweat glands.
  • The hair on your skin grows from tiny pockets in
    the dermis, called follicles.
  • The dermis makes sweat, which helps to cool your
    body, and oils that keep your skin from drying

  • The deepest layer of skin.
  • The subcutis keeps in heat and has a
    shock-absorbing effect that helps protect the
    body's organs from injury.

Three Most Common Forms of Skin Cancer
  • Basal Cell Carcinoma
  • Squamous Cell Carcinoma
  • Malignant Melanoma

Basal Cell Cancer - What is it?
  • Most common type of nonmelanoma skin cancer.
  • Affects the skins basal layer, or 5th layer of
  • Onset most commonly occurs after the age of 40
    however, an increasing number of younger adults
    are developing this from of cancer.

Basal Cell Cancer - What causes it?
  • Skin damage from the sun that has occurred over
    many years.

Basal Cell Cancer - What does it look like?
  • Often appears as a small raised bump that has a
    smooth, pearly appearance.
  • Another type looks like a scar and is firm to the
  • It could also be a small lesion or sore that does
    not heal and has other specific characteristics.

Basal Cell Cancer - Where does it usually occur?
  • On areas of your skin that have been in the sun,
    including the face, scalp, ears, lips or around
    your mouth.
  • May spread to tissues around the cancer, but
    usually does not spread to other parts of the

Basal Cell - Is it curable?
  • Early treatment results in a cure rate of more
    than 95. However, new growths can occur. Stay

Squamous Cell Cancer - What is it?
  • A malignant growth of the epithelial layer of the
    skin, or the external surface.

Squamous Cell Cancer - What causes it?
  • Overexposure to x-rays
  • Excessive exposure to the sun

Squamous Cell Cancer - What does it look like?
  • Often appears as a firm red bump.
  • Sometimes the tumor may feel scaly or bleed or
    develop a crust.

Squamous Cell Cancer - Where does it usually
  • Occur on areas of your skin that have been in the
    sun, often on the tip of the nose, forehead,
    lower lip, and hands.
  • May also appear on areas of your skin that have
    been burned, exposed to chemicals, or had x-ray
  • Squamous cell tumors may spread to other parts of
    the body if not treated.

Squamous Cell Cancer - Is it curable?
  • Yes, early treatment results in a cure rate of
    more than 95.
  • As with basal cell, new growths can occur. Stay

Melanoma - What is it?
  • Type of skin cancer that starts in the
    melanocytes, the cells that give your skin color.
  • Not as common as basal cell or squamous cell skin
    cancer, but much more serious.
  • Nearly 48,000 Americans will develop it this
  • Accounts for about 4 of skin cancer cases, but
    causes about 79 of skin cancer deaths.

Melanoma - What are the risk factors?
  • Moles
  • Fair Complexion
  • Family History
  • Immune Suppression
  • Too much UV radiation exposure
  • Age

Melanoma - What does it look like?
  • Melanoma usually begins as a dark brown or black
    patch with irregular borders and is characterized
    by the uncontrolled growth of pigment-producing
    tanning cells.

Melanoma - Where does it usually occur?
  • It may appear anywhere on the body without
    warning or start near a mole.
  • Men most often get melanoma on the trunk (the
    area between the shoulders and hips).
  • Women most often get melanoma on the arms and
  • It has a tendency to spread, making it essential
    to treat it right away.
  • Since melanoma is often linked to a change in one
    of your moles (most of us have 100 or so), you
    should inspect them regularly and look for any
    changes in their size and color, such as the
    appearance of a bump or the spreading of pigment
    around the border.

Identifying Melanoma
  • The Skin Cancer Foundation and the American
    Academy of Dermatology recommend using the ABCD
    method (see photos) to help detect melanoma.

  • Most early melanomas are asymmetrical.

  • Borders of melanomas are uneven.

  • color varied shades of brown, tan, or black are
    often the first sign of melanoma.

  • Diameter early melanomas tend to grow larger
    than common moles.

Skin Signs and Changes to Watch For
  • SizeSudden or continuous growth especially if it
    is bigger than a pencil eraser.
  • ShapeIrregular borders (not symmetrical).

Skin Signs and Changes to Watch For
  • ColorA mole that darkens or develops a dark spot
    in its center. Pearly, translucent, tan, brown,
    black, pink or multi-colored.

Skin Signs and Changes to Watch For
  • ElevationSudden elevation of a flat freckle
  • Surface CharacteristicsBleeding, itching,
    oozing, hurting, crusting, and/or scabbing.

Skin Signs and Changes to Watch For
  • Surrounding SkinRedness, swelling, or spots of
    color, especially near a mole.
  • ConsistencyAny softening, hardening, or
    crumbling of skin.

Skin Signs and Changes to Watch For
  • Sensation
  • Itching, tenderness, or pain.
  • Open sore that lasts for more then 4 weeks, heals
    and then reopens.
  • Scaly or crusty bump that is dry and rough, and
    that may produce a prickling or tender sensation.

How can I determine my personal risk?
  • One serious sunburn can increase the risk by as
    much as 50.
  • The effect of UV light has on your skin is
    dependent on
  • the intensity and the duration of your exposure
  • your genetic background
  • http//

Are there precautions that will reduce my risk?
  • Yes! Six steps recommended by the American
    Academy of Dermatology and the Skin Cancer
    Foundation to help reduce the risk of sunburn and
    skin cancer.

Six Steps to Reduce Your Risk
  • Minimize your exposure to the sun at midday and
    between the hours of 1000AM and 300PM.
  • Apply sunscreen with at least a SPF-15 or higher,
    to all areas of the body which are exposed to the
  • Reapply sunscreen every two hours, even on cloudy
    days. Reapply after swimming or perspiring.

Six Steps to Reduce Your Risk
  • Wear clothing that covers your body and shades
    your face. (Hats should provide shade for both
    the face and back of the neck.)
  • Avoid exposure to UV radiation from sunlamps or
    tanning parlors.

Six Steps to Reduce Your Risk
  • Protect your children. Keep them from excessive
    sun exposure when the sun is strongest (1000AM
    and 300PM), and apply sunscreen liberally and
    frequently to children 6 months of age and older.
    Do not use sunscreen on children under 6 months
    of age. Parents with children under 6 months of
    age should severely limit their children's sun
    exposure. Most people receive 80 of their
    exposure to the sun by age 18.

Should everyone use sunscreen?
  • Yes! Even if you rarely sunburn, sensitive areas
    such as your lips, nose, and palms of the hands
    should be protected.
  • The FDA (Food and Drug Administration) and the
    American Academy of Dermatology (AAD) recognize
    six skin categories Skin Type (I-VI)

Skin Type I
  • Sun History Always burns easily, never tans,
    extremely sun sensitive skin
  • Example Red-headed, freckles, Irish/Scots/Welsh

Skin Type II
  • Sun History Always burns easily, tans minimally,
    very sun sensitive skin
  • Example Fair-skinned, fair-haired, blue-eyed,

Skin Type III
  • Sun History Sometimes burns, tans gradually to
    light brown, sun sensitive skin
  • Example Average skin

Skin Type IV
  • Sun History Burns minimally, always tans to
    moderate brown, minimally sun sensitive
  • Example Mediterranean-type Caucasians

Skin Type V
  • Sun History Rarely burns, tans well, sun
    insensitive skin
  • Example Middle Eastern, some Hispanics, some

Skin Type VI
  • Sun History Never burns, deeply pigmented, sun
    insensitive skin
  • Example African-Americans

  • The AAD suggests that regardless of skin type
    a sunscreen with an SPF of at least 15 should be
    used year-round.

When should a sunscreen be used?
  • Every day if you are going to be in the sun for
    more than 20 minutes.
  • When on or around reflective surfaces such as
    water and snow. Snow can reflect up to 80 of
    the suns rays!
  • On cloudy days too!

How do I choose a sunscreen?
  • Choose a sunscreen that has an appropriate sun
    protection factor (SPF).
  • Consider allergic reactions. Some people are
    sensitive to PABA (para-aminobenoic acid) and its
  • Sunscreens come in ointments, creams, gels,
    lotions, oils and wax sticks.

What is an SPF?
  • Sun Protection Factor
  • Typically range from 2 to 60
  • Rating is calculated by comparing the amount of
    time needed to produce a sunburn on protected
    skin to the amount of time needed to cause a
    sunburn on the unprotected skin.

  • If a sunscreen is rated for SPF 2 and a
    fair-skinned person who would normally turn red
    after 10 minutes of exposure uses it, it would
    take twenty minutes of exposure for their skin to
    turn red. Subsequently, if that person used a
    sunscreen with SPF 15, it would take 15 times
    longer to burn, or 150 minutes.

Does SPF 30 have twice as much protection as SPF
  • No! The SPF protection does not increase
    proportionately with the designated SPF number.
  • In higher SPFs such as SPF 30, 97 of rays are
    absorbed however, an SPF of 15 indicates 93
    absorption, and an SPF of 2 indicates 50

Does the SPF give the protection rating for UVA
or UVB rays?
  • SPF rates protection for UVB - there is no rating
    system for UVA protection.

What is the difference between UVA and UVB light
  • UV-B ranges in wavelengths between 280 and 320
    nm. The wavelengths of UV-A radiation range
    between 320 and 400 nm.
  • While UVB rays are the primary cause of sunburn
    and skin cancer, UVA rays, which penetrate deeper
    into the dermis, also contribute to sunburn and
    skin cancer.

Sunscreen Selection Note
  • Some sunscreens only protect against UVB rays.
    Examples Products using PABA, PABA esters, and
  • If you want protection from UVA rays, you must
    select a broad-spectrum sunscreen that uses
    products like benzophenones, oxybenzone,
    suilisobenzone, titanium dioxide, zinc oxide and
    Parsol 1789.

How much sunscreen should you use?
  • Enough to liberally cover the exposed skin,
    approximately one ounce.

How often should you apply?
  • Apply to dry skin 15 to 30 minutes before going
  • Reapply after swimming or perspiring heavily.
    Remember that water-resistant sunscreens may lose
    their effectiveness.
  • Reapply according to the SPF factor selected.

What is the difference between a sunscreen and a
  • Sunscreens absorb UV rays Sunblocks deflect UV

What should I do to protect myself from the sun?
  • Use sunscreen or sunblock.
  • Use wide brimmed hats, protective clothing such
    as long-sleeved shirts, long pants, etc.
  • Avoid sun exposure as much as possible.

How do I know at what level to protect myself?
  • Use the UV Index as a guide.
  • The UV Index is a publication provided by the
    Climate Prediction Center (CPC), National Centers
    for Environmental Prediction (NCEP), National
    Weather Service (NWS), National Oceanic and
    Atmospheric Administration (NOAA), and U.S.
    Department of Commerce (DOC).

How do I access the UV Index web site and obtain
the current UV Index for my area?
  • http//

Protective Measures based on UV Index
  • Note If you are aware that you are extremely
    sensitive to UV exposure or have a skin condition
    that is worsened by UV exposure, more stringent
    measures are probably required.

Estimate Minutes to Skin Damage using UV Index
How do I treat a sunburn?
  • The two most common sunburns are first and
  • second degree burns.
  • First degree sunburns use cool baths and
    moisturizers or over-the-counter hydrocortisone
    creams. Caution your use of -caine products.
  • Second degree sunburns May need medical
    attention. If the burn is severe, accompanied by
    a headache, shills or a fever, seek help right

Are tanning booths a safer way to tan?
  • Although no direct linkage has been proven,
    tanning booths emit UVA radiation. UVA is known
    to cause cataracts, sunburns, skin cancer and
    premature aging of the skin.

  • American Academy of Dermatology
  • American Cancer Society
  • Climate Prediction Center (CPC),
  • National Cancer Institute
  • National Centers for Environmental Prediction
  • National Oceanic and Atmospheric Administration
  • National Skin Centre
  • The Skin Cancer Foundation
  • South Seas Trading Company