The Sun Will Come Out Tomorrow – Protect Against Melanoma Today

Dr. Janet Zand
February 22, 2019


We talk a lot about avoiding UV radiation. It’s easy to appeal to vanity to convince people to avoid damage from the sun. After all, UV radiation ages the skin. It’s a major contributor to wrinkles, spots, and collagen loss. However, the most concerning thing about UV radiation is the threat of skin cancer. Concerns about appearance typically go out the window when we receive a cancer diagnosis.

But many people don’t know exactly what to look out for when it comes to skin cancer – or how they can take steps to avoid it even when they’re out of the sun. Here’s what you need to know.

You may know that melanoma is the deadliest form of skin cancer. In the U.S., there were approximately 178,560 melanoma diagnoses in 2018 alone. On average, over 9,000 people die from melanoma every year in the US. That’s a big price to pay for a suntan.

Melanoma forms when cells called melanoyctes start growing out of control. Melanoyctes are responsible for producing melanin. The more melanin you have, the darker your skin. That’s why moles are so dark – they are chock-full of melanin. And that’s why they’re a key place to watch for unchecked melanocytes.

Because of the connection between melanin production and melanomas, people with lighter skin are more susceptible. The more additional melanin the body has to produce in response to UV radiation, the more chances there are for things to go wrong. A suntan is actually a signal that you’re sustaining damage.

How to Find Melanoma

The most common place melanoma shows up for women is on the legs. For men, it’s the back, so keep an eye on your partner. I recommend seeing a dermatologist for a skin check every year, as melanoma can show up anywhere on the skin and even elsewhere in the body, such as the nasal passages. It’s great to have an expert set of eyes checking everything out thoroughly.

However, if you notice a change in a mole, you need to get to a doctor right away – even if you were just there last month. Time is of the essence when it comes to cancer, especially melanoma.

You should also have a doctor check your fingernails and toenails. Melanoma can appear as a dark spot under a nail. Many people ignore these spots, assuming they’re a fungus. But if you ignore melanoma for too long, having the finger or toe amputated may end up being the best-case scenario. So check your nails carefully any time you change your polish, and go ahead and remove the polish altogether before your skin exam.

Another surprising place melanomas show up is on the soles of the feet. This is of course a less common place for us to have sun exposure. But damaged DNA can manifest anywhere on the body.

Interestingly, a study of 54 men and 69 women plotted out where melanomas occurred on these patients’ feet. While 40% were toward the back of the foot, only 2.4% were in the arch. The melanomas seemed to be more likely to show up in places that got the most pressure. Mechanical stress may increase your risk.

In a moment, we’ll give you some strategies to reduce that risk beyond just staying out of the sun. These strategies will help protect your feet better than sunscreen. But make sure your doctor looks at the soles of your feet at your skin check.

Australian researchers are actually in the process of developing a blood test that will make it easier for doctors to identify melanoma. This could certainly make early detection easier. But of course, prevention is the best strategy.

How to Prevent Melanoma

Many people don’t realize that they can do more to reduce their melanoma risk than just staying out of the sun and tanning beds. However, one of the best strategies might seem somewhat counterintuitive: you need to make sure you get enough vitamin D.

Of course, you can get vitamin D from the sun. And it’s possible to get enough vitamin D from the sun without getting a sunburn. But that’s a difficult balance to strike. And it’s hard to do every day.

Interestingly, people who work outside get fewer malignant melanomas than people who work indoors. Yet the indoor workers have UV exposure three to nine times lower than the outdoor workers. Especially if the outdoor workers are avoiding sunburns, the vitamin D they get might be protective. It seems to help balance out the UV rays.

Still, researchers say that one of the worst combinations for risking melanoma is high levels of UV radiation with low levels of vitamin D. (Think getting a sunburn once or twice a summer but rarely getting sun the rest of the year.) To avoid this combination, yes, you should wear sunscreen and minimize your sun exposure to about 10-20 minutes a day, avoiding mid-day sun. But you also should supplement with vitamin D.

In fact, the National Institutes of Health funded a study to examine links between melanoma and vitamin D levels. They found that patients with the lowest levels of the vitamin were 30% more likely to die from the cancer than those with the highest levels.

Get enough vitamin D to keep your levels between 50 and 80 ng/ml. You can ask your doctor for a blood test to see where you’re at. If you work outdoors, you may be ok – unless you live in the north. Otherwise, chances are you’re going to need a supplement. I recommend 1,000 to 5,000 IU a day for many of my patients. If you have very fair skin or burned a lot as a child, this is especially important for you. Also, consider vitamin K if you’re 50 years old or more. As we age, we’re more likely to be vitamin K deficient. Vitamin D taken with vitamin K helps to reduce and prevent vascular calcification.

Protection Against the Sun

To avoid sunburn when you are outside, sunscreen and protective clothing are the way to go. But there’s a lot of debate about what kinds of sunscreen are safe. I don’t like putting chemicals on my body. So I prefer sunscreens that provide a physical barrier between my skin and UV rays.

Micronized zinc oxide and titanium dioxide are two of your best bets. Look for products that offer an SPF of 30 or more. And put it on every two to three hours. Set an alarm on your phone to remind you.

These physical blocks are likely to turn your skin a bit white.

Finally, keep in mind that what UV rays are ultimately doing is causing oxidative stress to your DNA. So eating an antioxidant-rich diet can help you combat this. The standard American diet can partner up with UV exposure to damage your DNA further. So dietary changes really can make a difference.

Fruits and vegetables aren’t a substitute for sun protection. But they sure aren’t going to hurt. And we’ve talked quite a bit about how they can enhance your skin’s appearance. They’ll give you a healthy glow that’s better (and much safer) than a suntan.

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