A Skin Cancer Guide For Surfers
Protection, Prevention, and Identification
Skin cancer is the most common form of cancer with an estimated 1 out of 5 Americans being diagnosed with some form of it by age 70. The major risk factor of skin cancer is UV damage, and by being out in the sun for extended periods of time surfers can be in a higher risk group – in fact in one Australian study they are three times more likely to get melanoma than non-surfers. However many of the most avid surfers I know have never even been to a dermatologist.
After being diagnosed with two basal cell carcinomas on my nose at age 31 and 35, I have been on a mission to educate my friends about prevention, detection, and most of all going to a dermatologist at least once a year.
Most people are on the lookout for Melanoma, but many people still don’t know the dangers, or what to look for as far as other skin cancers are concerned.
The first basal cell carcinoma I had was a small white bump the size of a pimple. But it didn’t go away. I did not think skin cancer at all. In fact I was hyper worried about melanoma at the time as I had another odd mole I was more concerned about.
I had it removed via Moh’s surgery, but despite how fast I caught it and how small it was, the roots extended under the skin “iceburg” style and they actually had to do a second pass. I feel slightly strange posting this photo (I’m fully awake in it, just had my eyes closed), but I’d rather show people that it’s no joke. I just want people to go get their skin checked.
Thankfully my plastic surgeon was excellent–19 stitches, one bilobe flap, and several years later you cannot see that this was done unless you look very very hard. But it sucked, and it gave me a lot of anxiety at the time which took me a good while to bounce back from. The C word is shocking.
The second basal cell carcinoma I had on my nose was almost invisible save for the fact that it bled a teeny tiny bit once or twice, tipping me off to something unusual. At first I thought it was a tiny pimple that I might have rubbed too hard drying off after a shower. But given my case history and my knowledge of what to look for, it was biopsied and determined to be a BCC. At an unrelated visit my primary care doctor took a look at the area and exclaimed with shock “how in the world did you find that?”
Knowing what to look for and just being aware can really go a long way in treatment. Skin cancer is scary, but knowledge is power. A bit of awareness could save your life – that’s the goal of this article.
Why Don’t Surfers See Dermatologists?
I am not sure of the answer to this one. All I know is that my mother took me to dermatologists yearly ever since I was a young child – perhaps because of our family history of skin cancer and the fact that I had a few extra moles on my body. So to me, a yearly dermatologist skin cancer screening was a no-brainer.
I was seeing a dermatologist yearly when I had a tiny white pearly bump appear on my nose. It didn’t look like anything really – maybe a zit – but I was curious what it was. It just so happened my yearly checkup was coming up, and my dermatologist didn’t even know what it was – she couldn’t tell just by looking at it. It was biopsied and determined to be basal cell carcinoma.
Getting an annual skin cancer screening at a board certified dermatologist (not just a primary care doctor) is an important thing for people who are in the sun a lot. A lot of surfing friends mention to me that they have random spots or moles they are wondering about. The easy fix? See a dermatologist. Then you’ll know you absolutely have your skin health under control.
Skin Cancer Risk Factors
There are some definite risk factors when it comes to developing skin cancer. These are:
- Family history of skin cancer
- Fair skin, light eyes, blond hair
- History of sunburns
- Having many moles
- Having had skin cancer in the past
- Extent of UV damage
Some of these things you really can’t do anything about. It just means you’ll have to be extra vigilant.
Darker skinned people are not as likely to get skin cancer but it can still happen, and I urge those people to watch their skin carefully and stay educated on skin cancer signs.
Types Of Skin Cancer
Basal Cell Carcinoma
The most common form of skin cancer, basal cell carcinoma can take on a few appearances. Some appear as a pearly white bump. Others as a patch of red skin. Any area of skin that appears like this and repeatedly bleeds should be suspect and biopsied. However, some BCCs never bleed.
Basal cell carcinoma rarely spreads to the lymph nodes and stays in the skin. However, in some cases where the cancer is left untreated it can spread. Death from BCC is rare, but the longer the cancer is left the more destructive it can be to local healthy skin. On the face this can mean cosmetic damage.
Squamous Cell Carcinoma
The second most common form of skin cancer, Squamous cell carcinoma usually appears as a defined scaly red patch on the skin. They may bleed or flake.
Squamous cell carcinoma is treatable when detected early, and is slightly more likely than basal cell carcinoma to spread to the rest of the body.
Melanoma is the skin cancer most people are aware of. Melanoma is dangerous but has an excellent prognosis when treated early. You want to catch Melanoma when it’s “in situ” which means it’s in the top layers of skin. Any unusual new moles or changing moles should be evaluated. Melanoma is known for the ABCDE method of self evaluation at home:
- A: Asymmetry – is the mole asymmetrical?
- B: Border – does the mole have an uneven, blurry, or ragged border?
- C: Color – is the mole multi-colored?
- D: Diameter – is the mole larger than 6mm? Melanomas can be smaller, though, so don’t use this to rule out suspicious moles.
- E: Evolving – is the mole changing?
Melanoma doesn’t just limit itself to sun exposed areas. You can develop melanoma anywhere on your body – on the soles of your feet, under your nails, and even on your genitals (how fun!). Bob Marley had what’s known as an acral lentiginous melanoma, which appears on the soles of the feet, hands, or mouth. People of dark skin (Asian and African) usually develop the acral lentiginous subtype of melanoma.
Merkel Cell Carcinoma
This one is very rare, and appears on sun exposed parts of the body as a painless and firm skin colored or reddish colored bump. The bump usually grows quickly over the course of a few weeks.
This is not a skin cancer but is considered a form of “pre” skin cancer. Actinic keratoses are areas on the skin that flake or scab repeatedly. Sometimes they can resemble basal cell carcinomas. They can be very small, but you’ll notice the scabbing. Dermatologists will often freeze these off. They can eventually become Squamous cell carcinomas if left untreated.
Skin Cancer Prevention
This one is obvious. I use super high percentage zinc oxide sunscreens now. Check out my article all about sunscreens to use for surfing for more information.
Keep an eye on your skin. YOU are your own best advocate for skin health. Push for biopsies if something is really bugging you but your primary care doc brushes it off. Tell your partner to mention if there are any changes or new moles on your back. Check the bottoms of your feet and in between your toes. Tell your hair dresser or barber to let you know if they see any moles on your scalp.
No Tanning Beds
Do people still use tanning beds? I’m not sure – but suffice it to say these are the worst things for your skin ever. Just don’t do it.
Full Suits, Hats, and Rash Guards
I know a lot of you want a nice even tan, but I have taken to wearing full suits or at least short sleeve full wetsuits year round in order to ensure my skin is protected from the sun for the hours and hours I’m surfing. Many people have begun using trendy leggings and other accessories to aid in sun protection. Hats can help too although I still can’t figure out how to comfortably wear a hat while surfing. It really messes with me but some people do it all the time.
See A Dermatologist
I already wrote about this at the beginning of the article, but catching skin cancers early is the best thing you can do for your skin and your health.
You can get skin cancer in your eyes, not to mention a host of other UV related damages. Wear sunglasses at all times when out of the water (get good ones, don’t trust drug store cheapies for UV protection). If you can, wear em in the water!
Tint Your Car Windows
I wish I had done this a long time ago. Auto glass on passenger and side windows only blocks about 50% of UV rays. Usually the windshield protects more, but not always. You can get clear or tinted UV blocking film on your car windows to ensure that you’re not baking on long drives. Some state regulate tints on windows so check with what’s allowed in your area (and let’s be honest, not everyone follows those rules but it could leave you open to getting pulled over).