Many of us have had the occasional sunburn. You forget to put the sunscreen over the back of your knees, the underside of your forearms, or you underrate the amount of ultraviolet rays that come through the clouds on a cool day. But is there anything you can do to prevent or at least decrease the risk of developing a skin cancer if you have a history of sunburns?
There are two basic types of skin cancer – melanoma and non-melanoma skin cancers such as basal cell skin cancer or squamous cell skin cancer. Melanoma is by far the most dangerous type. It’s said that only a few severe sunburns in the course of your life increase your risk of developing melanoma significantly. Examining your skin with the ABCDE’s of melanoma in mind will not prevent a melanoma from developing, but these steps will help you catch a melanoma early while it is still curable (http://en.wikipedia.org/wiki/Melanoma). Any suspicious findings should be reviewed by your dermatologist.
What about non-melanoma skin cancers? For patients who suffer from Xeroderma Pigmentosum, a relatively rare skin disorder in which the damage from ultraviolet light cannot be repaired by the body, a drug called Dimericine is available. This lotion helps the body repair the damaged DNA and thus reduces the risk of skin cancer development in these patients, a risk that is 1000 times greater than that of the general population and shortens their life expectancy by 30 years. Investigators are also looking at Dimericine for use as a “morning after” lotion for anyone who has just suffered a severe sunburn in an attempt to reduce the DNA damage and the risk of future skin cancer, although further study is still required before FDA approval.
The same Retin-A cream that is commonly used for wrinkle reduction can also be of use in any patient with a history of sun exposure so as to minimize their risk of future skin cancers. Retin-A, a derivative of Vitamin A, acts in the skin to repair the DNA damage caused by ultraviolet light. One of its major cosmetic benefits is its thinning out of the outer dead layer of the skin which gives a smoother look and feel to the skin, but that also makes you more prone to sunburn. For this reason, if you are using Retin-A be sure to always apply a sunscreen, avoid peak hours of sun exposure, wear protective clothing and a hat, and stop the Retin-A a week or so before a trip when you anticipate lots of sun exposure.
For those patients who develop actinic keratoses in response to sun exposure – those rough, scaly red spots that may ultimately develop into squamous cell skin cancer – Efudex cream can be used under a physician’s supervision to control or eliminate the keratoses and thus decrease the chance of squamous cell cancer. It also acts by encouraging the repair of UV-damaged DNA. It must be applied daily for several weeks and produces some redness and irritation of the skin during treatment that may be cosmetically undesirable.
On a final note, chemical peels and laser resurfacing may be of benefit in the prevention of skin cancers. The outer layer of skin cells can be removed and the new cells that cover the skin surface come from deep inside the hair follicles where they have not been as exposed to the harmful effects of ultraviolet radiation. In theory they should be less inclined to become cancerous.
Should you desire further information, please speak with your dermatologist.