On the occasion of World Cancer Day , we spoke with Doctor Nicole Ménard, a dermatologist in Quimper, France, who is faced with the screening and treatment of skin cancers, which are particularly common in her area. She shares her expertise and advice to better protect our skin and adopt good habits on a daily basis .
Why is prevention essential in the fight against skin cancer?
Dr. Ménard:
Skin cancers pose a real public health problem. According to Santé Publique France, each year, between 141,200 and 243,500 cases (carcinomas and melanomas combined) are diagnosed in France , making them the most common cancers. The number of melanomas has increased fivefold over the last thirty years.
Attributable in more than 80% of cases to excessive exposure to natural or artificial ultraviolet (UV) rays, they could be avoided through reasonable sun exposure .
The danger of the sun is often underestimated: however, ultraviolet (UV) rays have been recognized as carcinogenic by the IARC (International Agency for Research on Cancer) since 1992. As soon as the skin is exposed to UV rays, the DNA of the skin cells is altered and requires repair. Solar capital corresponds to the amount of UV rays absorbed by the skin and against which it has the capacity to repair itself.
All skin types need protection.
All skin types must be protected because each skin has a solar capital that gradually decreases according to the frequency and intensity of sun exposure. Light-skinned subjects have less solar capital than dark-skinned subjects and long-term UV damage (sun spots, aging and skin cancers) may appear earlier.
Children, especially under the age of 3, and adolescents, due to their thin and immature skin , must be particularly protected because sunburn and prolonged sun exposure before puberty have a direct impact on the risk of developing skin cancer later.
What are the main risk factors for skin cancer?
Dr. Ménard:
The main risk factor is exposure to ultraviolet (UV) rays : 4 out of 5 skin cancers in adults are linked to sun exposure since childhood.
Sunburn in childhood and adolescence is frequently found in patients with melanoma. People with fair skin, whose marker is the presence of freckles, are particularly susceptible to sunburn and have an increased risk.
Chronic sun exposure promotes the development of carcinomas and melanomas in areas exposed to sunlight on a daily basis.
Chronic sun exposure, particularly among outdoor workers (farmers, construction workers, gardeners, sailors, etc.), promotes the development of carcinomas and melanomas in areas exposed to the sun on a daily basis.
A family history of skin cancer is a risk factor for other family members who must be vigilant and protect themselves well.
The presence of numerous moles (more than 50) or atypical moles is a risk factor for melanoma.
Immunosuppression (people who have had transplants, are taking immunosuppressive treatments) promotes the appearance of skin cancers, which makes sun protection essential to limit the risk.
What are the best ways to protect yourself from the sun on a daily basis?
Dr. Ménard:
We are all actors in the health of our skin . Taking the time to protect it effectively from the harmful effects of UV rays will help keep your skin healthy.
Here are the recommended reflexes to protect yourself effectively from the sun:
- Limit sun exposure when UV rays are at their most intense between 12pm and 4pm (11am-5pm for sensitive skin), even if the weather is cloudy. Watch the size of your shadow! If it is smaller than you (the UV index is then higher than 5), protect yourself!
- Stay in the shade whenever possible , but remember that trees or umbrellas do not offer complete protection due to UV reflections on the ground.
- Wear covering clothing and wide-brimmed hats or caps with flaps, which will protect the nape of the neck, neck and ears. UV-protective items certified as UPF 50+ offer optimal protection and are particularly suitable for water activities or prolonged exposure.
- Wear wraparound sunglasses , category CE 3, and even CE 4 for activities on water or snow.
- Apply a broad-spectrum sunscreen (with the UVA logo) generously and regularly to areas not covered by clothing. Preferably use an SPF of at least SPF 30. Remember that total sunscreen does not exist and that using sunscreen should not encourage you to stay out in the sun for longer. The environmental impact of sunscreens encourages you to use protective clothing instead.
- Following the UV index on weather sites or on the UV Weather app allows you to be aware of the UV risk on a daily basis and to know how long it takes to get sunburn depending on your skin type. Let's be vigilant, especially for children, whether the sky is sunny or cloudy because clouds do not stop UV rays.
Many people associate sun protection with summer vacations, but should we protect ourselves all year round ?
Dr. Ménard:
Sun protection should be a daily habit , not just at the beach in the summer.
I often hear patients say that they do not expose themselves even though they have multiple outdoor activities...
In fact, we are all exposed to the sun daily involuntarily without being aware of it as soon as we are outside and even through the windows of our cars...
It is recommended to protect yourself from March to October when the UV index is greater than or equal to 3 , but also in the event of sun exposure in the mountains during winter, where the reverberation of UV rays on the snow is particularly intense.
As early as April, UV indexes are recorded as high as in the middle of summer. However, we think more about protecting ourselves in July-August than in April-May, while UV rays are just as intense in a schoolyard, on a football pitch or on a construction site.
Remember to protect yourself and your children from UV rays by adopting a “ sun routine ” from a young age, which will limit the occurrence of the majority of skin cancers.
What are the warning signs?
Dr. Ménard:
Knowing your skin well and looking at it regularly allows you to be alert in the event of the appearance or change of a skin lesion.
A skin carcinoma may appear as a sore that does not heal, a pimple or a scab that persists and becomes painful.
A mole that increases in size and changes color or a new mole that changes over a few months and does not resemble other moles on the skin should attract attention.
The ABCDE rule allows us to suspect a melanoma : a pigmented lesion with asymmetrical contours, irregular edges, a non-uniform color, a diameter >6mm as well as its progressive nature.
If in doubt, it is advisable to seek the advice of your doctor who will decide whether a specialist opinion is in order.
What messages do you want to convey?
Dr. Ménard:
Only by raising awareness of the risk of UV rays at an individual level and at the level of communities and public authorities will it be possible to reduce the incidence of skin cancers.
There is no such thing as a healthy tan.
The promotion of tanning through the media encourages some people to expose themselves to the sun without sufficient protection or to artificial UV rays, leading in the long term to an increased risk of skin cancer and premature aging of the skin. Indeed, tanning reflects the damage suffered by the skin attacked by UV rays: THERE IS NO HEALTHY TAN.
Sun prevention for children and adolescents allows them to acquire good photoprotection habits and avoid cancers in adulthood.
Finally, whatever your age, it is never too late to protect your skin to save your solar capital. Patients who have developed skin cancer will thus limit the risk of new lesions appearing if they protect themselves effectively.
Giving testimony after having been affected by skin cancer helps to raise awareness and encourage sun prevention among those around you.
To learn more about the UV index, visit:
www.soleil.info
Or download the UV Weather app:
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