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Is a Deadly Terrorist Lurking on Your Skin?
By Dr. Kenneth Dickie
Aug 12, 2008 - 2:48:16 PM

Melanoma is a serious skin cancer that can affect anyone staring in the preteens and is much more common than you may realize. Among 25 to 29 year olds it is the most prevalent cancer and it is the leading cancer killer among women of ages 30 to 35. But it is easy to find early while it is thin and curable to simple, painless removal in a doctor’s office. Waiting can be fatal. Melanomas may develop from pre-existing moles or start in clear areas of the skin, including areas not exposed to sunlight. The first step in checking your skin is to learn about normal and atypical moles. Normal moles have round or oval shapes, are less than 1/4 inch wide, have uniform color and shade, and sharp, even borders. Atypical moles usually have one or more of these properties:

Width 1/4 or more
Irregular shape
Two or more shades or colors
Fussy or notched borders
Raised “fried egg” center
Pebbled surface

The average lifetime risk of melanoma in the white population is about 1 and 56 but may be much higher if you have any of these risk factors:

Any atypical moles, even one.
More than 50 normal moles.
Light complexion
Blonde or red hair, light eyes, freckles.
History of any blistering sunburns under the age of 20
Personal or family history of any type of skin cancer.

The risk is about 15 times less among African Americans. Check your skin using a wall mirror in a well-lighted room, a hand mirror with ling handle, flashlight, hair brush or dryer for parting hair, and two small chairs or stools. Using the wall mirror, hand mirror, and flashlight check all areas of hands, arms, face, ears, neck, underarms, and chest. Women should also check under breasts. Using a brush or dryer to part hair, check scalp and behind ears (or have a family member help). Check upper and lower back thoroughly, then check buttocks and genitals including hidden areas. The back is the most common site of melanoma in males. While sitting on a chair of stool, check all sides of legs and feet including ankles, between toes, and under toenails. Legs are the most common sites of melanoma in females

Surgical excision should be carries out immediately if you find a color, size, shape, border, or surface appearance of an existing mole, freckle, birthmark, or other pigmented spot. Likewise if you see a new mole or suspicious spot or growth you hadn’t noticed before. Typical characteristics are jagged uneven borders, asymmetry (a line drawn down the middle would not produce matching halves), two or more colors, and large size. The more “atypical” a mole looks the more likely it is to be melanoma. And if a mole is growing faster than you, have it checked no matter what it looks like.

Decreasing the risk of melanoma: minimize exposure to sunlight from 10 a.m. to 4 p.m., avoid tanning beds, wear protective clothing including a wide-brim hat. Use sunscreen with an SPF rating of 45 rated fro both UVA and UVB. Apply it heavily and reapply it at least once every two hours. There is no such thing as a “healthy” tan. Have a doctor check your family member’s skin. Consider having atypical moles removed if you (or your children) are not likely to notice them routinely.

Dr. Kenneth Dickie is certified by the Royal College of Physicians and Surgeons of Canada in Plastic Surgery. He specializes in Cosmetic Plastic Surgery as well as Plastic, Reconstructive, and Hand Surgery. Dr. Dickie has been in clinical practice since 1984, and is currently a member of the Canadian and American Societies of Plastic Surgery, and the Canadian and American Societies of Aesthetic Plastic Surgery. For a consultation, please contact the Bahamas Institute of Plastic Surgery at (242) 351-1234 or toll-free 1(242)300-1235.