The ABCs of healthy skin lie in knowing when to see a dermatologist, staying protected from the sun’s rays and catching cancers early. Dr. Mitchell Bressack of Dermatology Center of Northwest Indiana has spent 30 years helping patients monitor the body’s largest organ.
When should individuals begin skin checkups?
The time to start checkups is when you have something you are not sure about. Keep an eye on yourself and have your spouse help check your back. When you go in for a routine physical, your primary doctor should also look at your skin as part of the standard exam and advise you when to see a dermatologist. Around 50 years old, it is worth it to have a baseline exam and then every three to five years if nothing pops up.
What concerns should prompt a visit to the doctor?
The American Academy of Dermatology ABCDE guidelines include watching for differences in asymmetry, border and color within a mole and the diameter as well. E (evolving) was added five years ago and basically involves changes. The problem is everything changes as we get older—it’s like gaining and losing weight. Over the course of six months on a day-to-day basis you don’t see the change, but six months later you are 15 pounds heavier. You don’t see the change because it happens gradually. Photos will help with this. Keep skin close-ups around as a basis for comparison. This is something you can do yourself.
What are the different types of skin cancers and treatments?
Skin cancers are divided into melanoma and non-melanoma types, which have a very small chance of spreading. Basal cell carcinoma, which is the most common, is found in the deepest layers of skin. Squamous cell carcinoma is found in the skin’s surface. Both can be treated with creams, burned or frozen off, surgically removed or there is Mohs surgery for larger tumors. This method combines removal with review under a microscope to ensure all of it is eliminated and as much healthy tissue as possible is preserved. Finding these at an early stage saves the amount of surgery needed. There is also keratosis actinic, which can turn into squamous cell carcinoma if left untreated.
Melanoma can spread if it is left alone. The chances of it spreading are related to how thick it is, which also indicates how long it has been there. The problem with melanoma is there is no good therapy. The goal is to catch it as early as possible. The lesion is taken off plus additional tissue depending upon the thickness—it is not a minor procedure. Lymph nodes are also tested to see if it has spread. The difference between big and small in non-melanoma is a big and small scar. The difference between big and small in melanoma could be life and death.
Is skin cancer more prevalent?
My first year of practice I saw one case of melanoma. Now I see two or three a month on average. Is it because there really are more cases or are we more aware? I don’t think there is any way to prove an answer. There have been changes in society. With more money and free time, more people are going on spring break vacations and over the years, we started wearing less at the beach. Then tanning beds were created and that has added to it.
What is key for sun protection?
Common sense: use sunscreen and wear long sleeves and big hats—you have to protect the scalp. If you can see light through the fabric, it is not going to protect you from the sun. The tighter the weave the better, and the darker the color the fewer ultraviolet rays get through as they are absorbed by the material. You can still do what you love. If you golf, you can golf, if you garden, you can garden—just try not to do it between 11 a.m. and 2 p.m. In winter months, there are not as many ultraviolet rays, but you should still make it part of your daily routine to wear sunscreen and be covered.
What can we pass along to our children to curb skin cancer cases in the future?
Kids do what they are taught when they are young. If they are taught to put on sunscreen, it will be part of their natural routine like brushing their teeth.
Dr. Bressack works with Drs. Melanie Griem and Ruchik Desai as well as physician’s assistant Heather Upchurch at their offices, 70 West 94th Place in Crown Point. He is on staff at Methodist Hospitals and Franciscan St. Anthony Health in Crown Point. For more information, visit dermatologynwi.com.