SUN SAFETY

1. SUN SAFETY Florida Department of Environmental Protection Central District Office

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

3. 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. Skin Cancer

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

5. 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. How it happens

6. Layers of Skin • Epidermis • Dermis • Subcutis

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

8. Dermis • 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 out.

9. Subcutis • 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.

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

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

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

13. 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 touch. • It could also be a small lesion or sore that does not heal and has other specific characteristics.

14. 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 body.

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

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

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

18. 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.

19. Squamous Cell Cancer - Where does it usually occur? • 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 therapy. • Squamous cell tumors may spread to other parts of the body if not treated.

20. 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 vigilant!

21. 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 year. Accounts for about 4% of skin cancer cases, but causes about 79% of skin cancer deaths. Melanoma - What is it?

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

23. 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 - What does it look like?

24. 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 legs. 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. Melanoma - Where does it usually occur?

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

26. Most early melanomas are asymmetrical. Asymmetrical

27. Borders of melanomas are uneven. Borders

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

29. Diameter; early melanomas tend to grow larger than common moles. Diameter

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

31. 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

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

33. 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

34. 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. Skin Signs and Changes to Watch For

35. 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://www.aad.org/skinrisk.html How can I determine my personal risk?

36. 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.

37. Six Steps to Reduce Your Risk • Minimize your exposure to the sun at midday and between the hours of 10:00AM and 3:00PM. • Apply sunscreen with at least a SPF-15 or higher, to all areas of the body which are exposed to the sun. • Reapply sunscreen every two hours, even on cloudy days. Reapply after swimming or perspiring.

38. 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.

39. Protect your children. Keep them from excessive sun exposure when the sun is strongest (10:00AM and 3:00PM), 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. Six Steps to Reduce Your Risk

40. 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) Should everyone use sunscreen?

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

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

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

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

45. Sun History: Rarely burns, tans well, sun insensitive skin Example: Middle Eastern, some Hispanics, some African-Americans Skin Type V

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

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

48. 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!

49. 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 esters. Sunscreens come in ointments, creams, gels, lotions, oils and wax sticks.

50. 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.