Beauty Is Skin Deep, So Is Skin Cancer


By: Dr. Francesca Lewis, MD, FAAD Special to the Boca and Delray newspapers

Skin cancer is the most common form of cancer in the United States! One in five Americans will develop a type of skin cancer in their lifetime. Florida with its inviting beaches and warm climate lends itself to enjoying the outdoor weather, often times without appropriate sun protection, whether at the pool, golfing, playing tennis or just walking outdoors. Unfortunately, chronic sun exposure and intermittent sunburns accumulate damage to our skin, leading to the eventual formation of pre-cancers, termed “actinic keratoses,” and eventually skin cancer.

The two most common forms of skin cancer, Basal cell carcinoma and Squamous cell carcinoma, are collectively termed “Non-Melanoma Skin Cancer.” More than 3.5 million non-melanoma skin cancers are diagnosed in the US annually. These are very treatable by surgery and unlikely to metastasize if identified early. Although non-melanoma skin cancer spreads slowly, if left untreated, it can lead to disfigurement and even invasion into muscle and bone. Basal cell carcinoma often appears as a slow growing, pink or skin colored lesion that may bleed. Squamous cell carcinoma may arise more quickly and appears as a crusty or warty growth.

Melanoma, on the other hand, is the most deadly form of skin cancer, contributing to more than 75% of deaths from skin cancer. On average one American dies from Melanoma every hour. Melanoma most often manifests as an irregular dark lesion that may be flat or elevated. It is the most common form of cancer in 25-29 year olds and the fastest growing cancer in young women. Caucasians and men older than 50 are at a higher risk of developing melanoma than the general population. Early detection is key to Melanoma survival. If detected early, the 5-year prognosis for Melanoma is 95-98%, however, if detected late, can be as low as 16%. It is important to know and look for the ABCDEs of melanoma when doing self-skin examinations at home. A stands for Asymmetry, B for irregular Borders, C for Color variation (dark or multiple colors), D for a Diameter greater than 6 mm, and E for Evolution or change in a lesion (color, size, bleeding, itching).

So, who should see a Dermatologist for a skin examination? The risk factors for skin cancer include a family history, chronic sun exposure (golfing, tennis, cycling, walking, gardening) or intermittent sunburns, fair skin, light colored hair and eyes. UV exposure is most important modifiable risk factor. Having five or more blistering sunburns between the ages of 15-20 increases the risk of Melanoma by 80%! Indoor tanning bed usage even just a few times can increase Melanoma risk by upwards of 60%. Because of these significant percentages, the American Academy of Dermatology recommends using a Broad Spectrum SPF sunscreen of at least 30 on exposed areas such as face, neck, chest and arms on a daily basis. Sunscreen should be reapplied every 2-3 hours and sun protective clothing should also be utilized. Anyone with these risk factors should be screened yearly and if a personal history of skin cancer exists, twice yearly. I unfortunately find many skin cancers in patients starting as early as their 30s, both melanoma and non-melanoma skin cancers alike, due to childhood sun exposure, genetics, and past tanning bed use.

As May is Skin Cancer Awareness Month, educate yourself on the signs and consequences of developing a skin cancer and make an appointment with a Dermatologist Certified by the American Board of Dermatology and who is a Fellow of the American Academy of Dermatology for a skin examination!

To reach Dr. Francesca Lewis, MD, FAAD at  Delray Dermatology + Cosmetic Center, visit or call 561-440-8020.