Ask Dr. Barber

Q. I was recently diagnosed with a malignant melanoma on my shoulder. My husband found it and I unfortunately just watched it for a few months before going to the dermatologist. She biopsied it and ultimately removed it. I was lucky because it was called a superficial melanoma and the only treatment recommended was close follow up for the next five years. I was advised to use sun screen regularly, but I am wondering if there is anything else that I can do and how do I protect my children from this terrible skin cancer?

A. Yes, you are very lucky. Malignant melanoma is now almost epidemic in the sun belt of the United States and I have witnessed over my 30-year career a dramatic rise in the diagnosis of this often aggressive and potentially fatal skin cancer. Part of the problem has been the rise in the use of tanning beds in the last 25 years and part of the problem is the failure of our population to be serious about sun screen when exposed to the sun for longer than about 15-30 minutes. Melanoma usually presents as a dark mole, typically about the diameter or larger of a pencil eraser, it can be flat or raised, irregular borders and can have black, brown or even some red color within the mole. If you are someone who is out in the sun for extended periods of time (more than 15-30 minutes) on a regular basis, it is advisable that you inspect your own skin every 6 months for any suspicious growths or moles. Since it is impossible to inspect your backside accurately, have a significant other look for anything suspicious, or have your dermatologist or primary care physician do the examination.
As for your situation, I am afraid your days in the sun without sunscreen protection and a coverup is probably over. That does not mean that you cannot get into the pool or ocean, but not for long periods of time. When not in the water, reapply sunscreen and put your coverup back on. Melanoma is serious business and you have demonstrated a susceptibility to the disease. Why chance another melanoma?
As for protecting your children, sunscreen and protective clothing is still the only proven protection from sunburn (which can lead to melanoma). Sunscreen is recommended for any child over the age of 6 months. For children younger than six months, protective clothing, hat and sunglasses are recommended. Sunglasses are also recommended for children and adults of all ages when out in the sun for long periods of time, say at the beach, the pool, or hiking. UV radiation is bad for the eyes and melanoma can occur on the retina in the back of the eye, although it is rare. Teach your children the importance of sunscreen, so that as they get older the application of this vital skin protection is ingrained in their habits. Good luck and remember that sunburns are very bad for adults and children, and excessive tanning either in a tanning bed or naturally is also something to avoid. Protect your skin like you protect any other organ in your body.

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