Think About Environmental Insult
While counseling patients about the dangers of UV radiation and risk of skin cancer is important, it may not tell the full story. According to Arianne Shadi Kourosh, MD, MPH, “Certain gases such as nitrous oxide and ozone gas and certain particulates in our environment—particulate matter like smog—can actually age the skin, cause premature wrinkling, cause dyspigmentation and dark spots...we should be counseling our patients to select products that will protect against that as well.” Physical or mineral sunscreens are most effective for protecting against environmental pollution. Combined with the use of antioxidants and layering of products, sunscreens can help protect the skin from both UV and environmental insult.
Get Better Dermpath Intel
An important tool in the treatment of skin cancers may be the dermatopathology report. The intimate but sometimes complex relationship between the dermatologist and the dermatopathologist may be taken for granted, observes Abel Jarrell, MD. It’s important to maintain communication with your dermatopathologist and understand the steps that take place from specimen collection to final report. An adequate history should be included with every sample sent to the dermatopathologist. “Try to avoid misleading terms,” Dr. Jarrell says.
Consider Sunscreen Delivery Options
When it comes to daily sun protection, “I think women do a much better job in terms of my practice,” says Joel L. Cohen, MD. Women may have SPF in the make-up or moisturizer they use every day, he says. Pay special attention to endurance athletes, and educate about different delivery vehicles, such as sticks, that may be convenient for these individuals. In any event, “Emphasizing the importance of using sunscreen and reapplying sunscreen is really critical,” Dr. Cohen says.
On the Horizon: Lasers for BCC
Lasers can be an important tool for the management of superficial basal cell carcinomas (BCC), a growing body of research shows. Treatments work by “targeting the vasculature of these tumors in order to treat them specifically without causing unnecessary damage to surrounding structures,” Mathew Avram, MD says. While the approach is still investigational, laser treatment may be appropriate for patients with multiple BCCs or BCCs in cosmetically sensitive areas.
Bonus: Burning Topic
“Official Dermatologist of Burning Man” Erin Gilbert, MD, PhD talks about keeping UV safe in the desert sun.