Helpful Reminders from Tara Lawless, FNP During Healthy Skin Month

By Tara Lawless, FNP
Lexington Regional Health Center

Skin is the body’s largest organ, and skin cancer is the most common cancer in the U.S. About 1 in 5 Americans will develop skin cancer by age 70, but it is also one of the most treatable cancers when caught early. Melanoma caught early has about a 99% 5-year survival rate.

Why It Matters Here

Nebraskans spend a lot of time outdoors, whether working, farming, coaching, or watching games, and UV damage adds up over a lifetime.

Up to 80% of UV rays get through clouds, and sun reflects off snow in winter, so exposure isn’t just a summer concern.

Who Is at Higher Risk?

Those at higher risk include people with:

• Fair skin that burns easily
• Lots of moles
• A family history of skin cancer
• A history of bad sunburns, especially in childhood
• Jobs or activities that involve spending a lot of time outdoors
• When Should You Start Getting Skin Checks?

There are two different kinds of checks, and they start at different times:

• At-home skin checks (self-exams): Start doing these monthly in your 20s. The point is to learn what your own skin normally looks like, including your moles, freckles, and spots, so you notice when something is new or changes.
  • Use a mirror or ask someone to help check areas that are difficult to see, such as your back and scalp. Use the ABCDEs to evaluate anything that looks different or concerning.
• Dermatology provider visits: Get a baseline professional skin exam in your 20s or 30s. Start earlier if you have risk factors such as a family history of melanoma, lots of moles, fair skin that burns easily, a history of blistering sunburns, or a weakened immune system.
  • After the baseline visit, about once a year is typical for most adults, and more often if you are high risk or have had skin cancer before.
  • If you ever spot something new or changing, don’t wait for your annual visit. See your dermatology provider.

Why Reapplying Sunscreen Matters So Much

• Every sunscreen, no matter the SPF, has to be reapplied every two hours.
• SPF measures how much UVB it filters, not how long it lasts. SPF 30 blocks about 97% of UVB and SPF 50 about 98%, but neither one keeps working longer than the other.
• All sunscreen wears off from sweat, swimming, toweling off, rubbing your face, and normal breakdown over time.
• Reapply more often than every two hours after swimming, heavy sweating, or toweling off.
• Most people also apply only about half the recommended amount, so reapplying helps make sure you are actually covered.

Why Sunscreen Still Matters in Winter

• UV does not take the winter off.
• UVA rays, the ones tied to aging and deeper skin damage, stay fairly constant all year, pass through clouds, and can even come through window glass.
• Snow reflects up to 80% of UV back at you, which can significantly increase your exposure, especially if you are outside for a while.
• People often skip sunscreen in winter because they don’t feel the heat, but UV is not heat. The damage is cumulative over a lifetime.
• Cold, dry winter air can also dry and crack the skin barrier, which is another reason moisturizer matters during the winter months.

What About Visible Light?

• Beyond UV, there is high-energy visible light, which is the blue-violet part of sunlight, roughly 400–500 nm.
• It penetrates deeper into the skin than UVB and has been shown to trigger and worsen dark spots and melasma, especially in medium to deep skin tones. It can also contribute to photoaging through oxidative stress.
• Regular chemical or mineral sunscreens do not block visible light particularly well. Iron oxides, which are pigments found in tinted sunscreens, can help absorb and scatter visible light.
• That is why dermatologists often recommend a tinted sunscreen containing iron oxides for people dealing with melasma or stubborn dark spots.

Good Reminders

• Wear broad-spectrum SPF 30+ sunscreen every day, even when it’s cloudy. Use about a nickel-sized amount for the face alone, and don’t forget your ears, neck, and hands.
• Skip tanning beds. They significantly raise skin cancer risk.
• Do a monthly self-check. Look for new spots or any mole or spot that changes in size, shape, or color.
  Know the ABCDEs of melanoma:
  A: Asymmetry: One half is unlike the other.
  B: Border: Irregular or blurred edges.
  C: Color: Varied colors or shades.
  D: Diameter: Larger than a pencil eraser.
  E: Evolving: Any change in size, shape, color, or symptoms such as itching or crusting.
• See your dermatology provider promptly for anything that bleeds, itches, crusts, is a sore that doesn’t heal, or simply looks different from your other spots.

• Take care of your skin barrier heading into winter. Moisturize daily, especially after showering, and use fragrance-free products if your skin gets irritated easily.

  Bottom Line

• If something on your skin changes, grows, or just doesn’t look right, don’t wait on it. A short visit can help catch problems early, when treatment is often simplest.