With Dr. Rankin

My wife recently made asked me get a skin body scan by the dermatologist. Her motivation stemmed from a co-worker who recently lost her battle with skin cancer (much too young). We cyclists spend a lot of time outside. In fact cycling tan lines are a point of pride for us (Rule #7). After spending 5+ hours on the saddle last Saturday I came away with some pretty good ones! But the older I get the more I think about health and wellness and the more I know people dealing with difficult health issues. I’m running this piece again about skin health with Dr. Rankin. Hope you find it helpful as the summer riding season nears.

OCA: Dr. Rankin, am I going to be a wrinkly old man before my time because I don’t use sunscreen?
JR:  Maybe, but maybe not.  We all get wrinkles as we get older, and it’s a normal part of aging. The dermis layer of the skin becomes thinner which leads to decreased skin elasticity, or stretchiness.  Genetics and ethnicity certainly contribute to the rate at which wrinkles become more apparent.  However, getting too much sun does contribute to an acceleration of skin damage which can increase the onset and severity of wrinkles.

OCA: How important is it to protect the skin from sun damage?
JR:  Given that most but not all skin cancers arise in sun exposed skin believed to have suffered damage from the sun’s harmful UV rays, protecting the skin either through covering it or using sunscreen is paramount in the prevention of said skin cancers as well as early wrinkling of the skin.

OCA: Ultraviolet radiation does the most damage. Is there a time when that is reduced during the day?
JR: Yes UV radiation from the sun and even tanning beds does the most DNA damage.  During the day, the early morning hours (up to about 10:00 AM) and the evening hours (after about 5:00 PM) are the hours when UV radiation is lowest.

OCA: What causes skin cancer?
JR:  Skin cancer is the uncontrolled growth of abnormal skin cells. It occurs when unrepaired DNA damage to skin cells triggers mutations, or genetic defects, that lead the cells to multiply rapidly and form malignant tumors. In some types of skin cancer (most notably squamous cell carcinoma and malignant melanoma), these cells can metastasize to other areas of the body leading to cancer at many sites.

OCA: Who is at risk for skin cancer?
JR:  Persons with fair (light) skin are at an increased risk.  Also there is some genetic component so if you have a family history of skin cancer, you are at an increased risk.  People with excessive skin exposure (like those who work outside all the time), people who have been sunburned many times, and also people with a lot of moles are at an increased risk as well.

OCA: Any tips for checking the skin for damage or potential cancer?
JR: It’s a good idea to take a good look or have someone else (physician, spouse, supper good buddy) take a good look at your skin on a regular basis.  That way, you/they are familiar with your skin and realize when a new lesion, lump, or mole has shown up.  Any new lesion/lump/bump/mole that arises and does not go away over a few weeks should be looked at by a physician. In fact, a yearly body scan by a dermatologist is highly recommended especially for those at higher risk.  Also, any mole or older skin lesion that seems to have recently changed can be worrisome. (Take a photo of the questionable spot, then compare it later to see if it changes. – edition OCA) With regard to malignant melanoma (the worst type of skin cancer), it’s important to remember the ABCD’s of melanoma: A) asymmetry, B) border irregularity, C) color variation, and D) diameter greater than 6mm.

OCA: What are your sunscreen habits? Especially for long events.
JR: Typically, if I expect to be outside on the bike or just by the pool for more than an hour or so especially between 10:00 and 4:00, I’ll try to apply sunscreen (SPF 30 or higher) to the sun exposed areas of my skin prior to heading out.  My personal preference is one of the spray-on variants just for ease of use.  If I’m not on my TT bike, I’ll wear a typical cycling kit with sleeves so that as much of my skin as possible is at least partially covered.  Most of my kits also have at least some built in SPF protection. During a triathlon, however, it gets a little tricky especially if it’s a wetsuit legal swim.  If it’s a longer distance like 70.3 or more, I’ll take a few seconds in T1 to get some sunscreen from a volunteer and apply some at minimum to my head and neck.  Of course, it’s always recommended to also wear sunglasses preferably with 100% UVA and UVB absorption to protect your eyes, eyelids, and surrounding skin.

OCA: Thanks Dr. Rankin, that was very helpful. Check your skin regularly and use that sunscreen!  

To see the previous post on first aid for cyclists with Dr. Rankin click here.

Looking for a doctor who understands the athletes’ lifestyle? Check him out, click here.

Dr. Joshua Rankin
FirstCare Family Doctors – Tontitown, a MANA Clinic
171 N. Maestri Rd.
Springdale, AR 72762
479-361-1020