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Health Beat

A fAvorite pastime as a child was to draw faces on the thumb and index finger, so that when we

shaped our hands into fists, they formed a face with a mouth, which we could make talk by moving the thumb up and down. occasionally, the artwork would move beyond the hand and include a drawing on the arms or feet, or a to-do list scrawled on the inside of the palm of the hand. one friend’s mother, outraged whenever we would write on ourselves, despite her warnings not to, would inevitably grab a damp paper towel and some soap, and start scrubbing the ink off of us, saying the same thing every time, “Your skin is your most precious organ. Would you write on your liver or your heart? Don’t write on your skin!”

Skin is the most visible of our organs. According to a National Geographic research report, “Skin is our largest organ—adults carry some eight pounds (3.6 kilograms) and 22 square feet (2 square meters) of it. This fleshy covering does a lot more than make us look presentable. in fact, without it, we’d literally evaporate

Skin acts as a waterproof, insulating shield, guarding the body against extremes of temperature, damaging sunlight, and harmful chemicals. it also exudes antibacterial substances that prevent infection and manufactures vitamin D for converting calcium into healthy bones. Skin additionally is a huge sensor packed with nerves for keeping the brain in touch with the outside world. At the same time, skin allows us free movement, proving itself an amazingly versatile organ.”

With all that your skin does for you, it is essential to take care of it so that you can maintain good skin throughout your life. Good skin doesn’t simply mean striving to be wrinkle free and looking twenty years younger than you are (although, if someone’s figured out how to swing that, let

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us know!). Good skin care means protecting your skin from damage, like sunburns or skin cancer, and caring for the skin problems that inevitably will show up, like acne, eczema or psoriasis. With the proper care though, your skin can be one of your most beautiful and hard working organs.

Skin cancer is one of the greatest risks for your skin, and it is, unfortunately, not a rare one. More than 1 million new cases of skin cancer will be diagnosed in the United States this year, which is more than any other form of cancer. Although the

majority of skin cancers diagnosed are nonmelanoma skin cancer, including basal cell carcinoma and squamous cell carcinoma, the incidence of melanoma, the most deadly form of skin cancer, has been steadily increasing for the past 30 years. it’s not just those in sunny locations like florida and California

who are at risk. the Centers for Disease Control and Prevention’s analysis of data from 2001 to 2005 showed Washington ranked fifth in the nation for melanoma incidence, and idaho ranked seventh. for melanoma deaths, Washington ranked 16th, but idaho ranked first. Something must be done to drive home the seriousness of this disease.

As we are wrapping up another beautiful summer in the inland Northwest, there are many out there who are enjoying a post-summer glow of the skin; rich bronze tans that give that coveted healthy glow. is it really healthy though?

According to the Skin Cancer foundation, “tanning is the skin’s reaction to ultraviolet (Uv) radiation. When skin is exposed to Uv rays, cells called melanocytes produce the brown pigment melanin, which darkens the cells of the epidermis. this darkening of the skin cells is the skin’s natural – if imperfect – defense against further

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damage from Uv radiation. “the sun’s Uv rays damage the

DNA of the skin’s epidermal cells, triggering enzymes that race to repair the damage; however, these enzymes do not always repair the DNA successfully, and all this unrepaired damage can lead to mutations that increase the risk of skin cancer. Also, repeated unprotected sun exposure can cause photoaging – wrinkles, sagging skin, and spots associated with sun damage.”

So while the golden glow of a tan may make you look fantastic in your white sundress, and puts some invigorating color in your face, it may also be doing damage to your skin, whether it is putting you at risk for skin cancer, or drawing up blueprints for wrinkles and visible aging.

“People are always asking about the ‘silver bullet’ for aging,” says Dr. Staci Ward-Hestdalen, a dermatologist at Advanced Dermatology & Skin Surgery, in Spokane. “i would really like to impress upon your readers that aging and the incidence of skin cancers are directly related to sun exposure. i ask that your readers have an honest discussion with their providers about reasonable ways to minimize their skin’s exposure to the sun. Minimizing skin cancers and solar aging are very easy if people

will take early preventative measures and teach their children good sun avoidance habits.”

totally avoiding the sun is impossible, unless you live in Alaska during the winter, or an underground bio-sphere. Considering most of our readership does not fall into these two categories, we’ll assume you are going to get sun exposure throughout the year, which means you need to take precautions.

“Sunscreen is still the top tip,” says Dr. Ben Hsu, of Spokane’s Northwest Dermatology. “Most people may not be aware that not all sunscreens are created equally. All sunscreens block UvB fairly well, the higher the SPf, the better. UvB is a shorter wavelength (280 to 320 nm) of light, which causes sunburns and skin cancer. Not all sunscreens block UvA equally well. UvA is a longer wavelength (320 to 400 nm), which causes skin cancer and photoaging (i.e. wrinkles and age spots). i always recommend sunscreens which contain a good UvA blocking ingredient, such as zinc oxide, titanium dioxide, mexoryl or photo-stabilized avobenzone (Helioplex).”

A new wrinkle has surfaced in the sunscreen debate, and it involves vitamin D. Some researchers argue that people are not getting enough

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Stephanie Combs Dmd, Msvitamin D because of the overuse

of sunscreen in the quest to prevent damage from the sun. So is it better to use less sunscreen or forgo it and soak up some of that vitamin D, or is it better to always use sunscreen? it seems like a difficult balance to strike.

“the majority of the medical community agrees that adequate quantities of vitamin D can be obtained by exposing the arms and legs to direct sunlight for approximately fifteen minutes, three times weekly,” says Ward-Hestdalen. “therefore it is not necessary to completely forgo or even use less sunscreen in order to maintain adequate vitamin D levels.” She says a greater detriment to vitamin D levels in our region and climate are the extended periods of cold and low levels of sunlight and the more sedentary/ indoor lifestyles that many lead. “for these reasons, i recommend that my patients take vitamin D supplements on a daily basis (at least 1000 mg), wear sunscreen regularly, and when the weather allows expose arms and legs to the sun three times weekly for approximately fifteen minutes.”

Another debate that won’t die down is whether or not it is okay to use tanning beds to achieve that summer glow. Some argue that tanning beds provide a source of vitamin D, and are a healthy alternative to basking in the sun, because you are able to achieve a tan in visits as little as 10 to 15 minutes, as opposed to soaking up rays for a full day. it has also been argued that tanning beds help increase people’s confidence and lift

Health Beattheir spirits.

According to the Livestrong foundation, “According to the U.S. food and Drug Administration (fDA), tanning in a tanning bed increases the risk of cancer. tanning beds have been associated with squamous cell carcinoma and melanoma, which are skin cancers, as well as ocular melanoma, which is an eye cancer. According to the fDA, the international Agency for research on Cancer considers tanning beds carcinogenic to humans, which means that they cause cancer.”

taking the pros and cons into consideration, the smartest and safest bet is to avoid much time spent in tanning beds. Dr. Hsu takes it one step further. “Never use a tanning bed. Never let your kids use a tanning bed,” he says, citing the fDA’s recently issued warning against the use of tanning beds because they increase the risk of skin cancer.

Having the tools to plan for the future ensures you can take great care of your skin, and work to prevent skin cancer. What if the damage is already done? for anyone who has spent a day on the beach, marinating in cocoa butter and using reflective shields to draw more sun onto them, or for those who used to flock to the tanning beds to get them through the long, cold winters, only to discover years later the damage they have done, what is the next step?

first and foremost, be vigilant about checking your skin for any changes or concerning spots. A self-exam of your skin can easily be done in less than 10 minutes, once a month. this is a good way to follow-up from an all over skin exam done by your doctor, who can give you a baseline from which to start, and help you to know the changes for which to look. A step-by-step self-examination guide may be found at www.skincancer.org/Self-examination.

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While skin cancer is an increasingly occurring cancer, in part because of our lifestyles, it is also one of the easiest to cure, if diagnosed and treated early. “i love being able to use the state-of-the-art surgical treatments to cure skin cancers,” says Dr. Nick Countryman, a new arrival at Northwest Dermatology. Having just completed a fellowship under the direction of two national experts studying Mohs surgery, an advanced surgical technique for the removal of skin cancer, and complex reconstruction, he says, “i enjoy being able to repair the wounds left from the cancer removal. it is incredibly rewarding to be able to help patients who have been given a diagnosis of skin cancer, often a very difficult time for patients and their families. they are really appreciative of the care that we are able to give them during this time in their life.”

With proper care and maintenance, your skin can be healthy and something to write home about – just don’t write it on your skin; it’s one of your most precious organs!

If found, the following should be brought to your doctor’s attention right away:

A skin growth that increases in size and

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• is irregular

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A spot or sore that continues to itch,

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An open sore that does not heal within

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