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UV Safety - Skin Cancer Protection
In light of UV Safety Month, Dr. Ali Lashgari explains the importance of looking after your skin, protecting yourself from the sun, and the warning signs to look out for.
Featuring:
Dr. Lashgari received his Bachelor’s degree with honors from Caltech in Pasadena and did his medical training at University of California, San Diego (UCSD). After completing his internship at Yale New Haven Hospital, he returned to UCSD for his dermatology residency training, which he finished in 1996. After working a few years with other doctors, Dr. Lashgari started his own practice in Encinitas, CA in 1999. He had his practice until December 2016 and has been working strictly in the city of Ridgecrest since then.
Dr. Lashgari’s goal is to provide the best dermatologic care in the most caring atmosphere to the Ridgecrest community.
Ali Lashgari, MD
Dr. Ali Lashgari is a board-certified dermatologist who’s been practicing at Ridgecrest Regional Hospital for the past 3 ½ years. He treats dermatologic conditions of skin, hair, and nails for all age groups, does dermatologic surgery including Mohs Micrographic Surgery, and some cosmetic procedures such as Botox®, fillers, and lasers.Dr. Lashgari received his Bachelor’s degree with honors from Caltech in Pasadena and did his medical training at University of California, San Diego (UCSD). After completing his internship at Yale New Haven Hospital, he returned to UCSD for his dermatology residency training, which he finished in 1996. After working a few years with other doctors, Dr. Lashgari started his own practice in Encinitas, CA in 1999. He had his practice until December 2016 and has been working strictly in the city of Ridgecrest since then.
Dr. Lashgari’s goal is to provide the best dermatologic care in the most caring atmosphere to the Ridgecrest community.
Transcription:
Prakash Chandran (Host): It’s important to practice safe protection measures when spending time in the sun. Being outdoors, may come with consequences unless we are actively protecting our body from skin cancer. We’re going to talk about it today with Dr. Ali Lashgari, a Board Certified Dermatologist at Ridgecrest Regional Hospital.
This is a podcast from Ridgecrest Regional Hospital. I’m Prakash Chandran. So, first of all, Dr. Lashgari, it’s great to have you here. Why exactly is it so important for us to keep our skin protected?
Ali Lashgari, MD (Guest): Well there are multiple reasons why it’s important to keep your skin protected. First of all, it’s been proven that sunburn and chronic sun damage are the causative factors for two types of skin cancer: basal cell carcinoma and squamous cell carcinomas. It is also a very important factor in melanoma development. Although, melanomas are also – genetics is also an important factor for melanoma development.
The other important reason to keep your skin protected is that 80% of aging is due to chronic sun exposure. Signs of aging such as lentigines, wrinkles, texture change which is that leathery skin look, and looseness of skin have all been attributed to chronic sun exposure. Furthermore, skin gets thinner due to sun damage which can cause bruising. For example, those purple spots that we see in older skin on the forearms; that’s due to chronic sun exposure.
Host: When you say sun exposure, I’m sure a lot of us listening to this are wondering what exactly that means. like right now, for me, for example, I may go outside a couple of times a day but at what point does it become harmful to my skin and are there best practices that I should be following?
Dr. Lashgari: Sure. So, of course, when you get sunburns, that’s the one thing everyone needs to prevent. Because sunburns are the one thing that causes the most damage to the DNA in the skin cells which then causes, over time, can cause skin cancers. So, the most important thing one can do is prevent or limit exposure during those times of the day from 10 o’clock in the morning to four o’clock in the afternoon when the sun is most intense. So, things like sun avoidance, staying in the shade as much as possible, applying sunscreen, sun blocks and wearing protective clothing are things you can do to limit the sun exposure.
Host: So, speaking of sunscreen, or sun block, I think most of us believe that if we apply enough of it, especially with a high enough SPF; we should be okay. Is that true?
Dr. Lashgari: Well it’s partially true. It does matter how much sunscreen you put on. So, you need to put on a significant amount to cover the skin that’s exposed to the elements completely but the type of sunscreen that you use is also very important. Ideally, you want to use a sunscreen that has ingredients zinc oxide and titanium dioxide. And the SPF should be SPF 30 or higher. And in addition, when you apply the sunscreen is important. You want to apply the sunscreen at least 20 to 30 minutes prior to exposure to the sun.
Host: Okay. That’s a really good tip because I know for a fact, that me and most of my friends as soon as we go to the beach, we are already in the sun, we apply it and we think we are ready to go. So, is there anything else that we need to know about sunscreen and how we should be applying it?
Dr. Lashgari: Yes. So, beyond the 30 minutes prior to exposure application, it’s really important to also know what the active ingredients of the sunscreen should be. The two best ingredients are zinc oxide and titanium dioxide. So, you need to look on the back of the sunscreen and look for those ingredients as the main ingredients. Furthermore, is someone is outdoors for long periods of time, they need to reapply the sunscreen every two hours. And finally, wearing a wide brimmed hats and some protective clothing are also important.
Host: Okay, great. And just before I get into the next question here, we’re talking about getting sunburn and there’s that direct correlation with that UV radiation. Can you talk a little bit about UV radiation and the relationship that it has with our bodies and then how it leads to potential skin cancer?
Dr. Lashgari: Sure. So, UV radiation or ultraviolet rays, basically, as I mentioned before, damage the DNA within the nucleus of the skin cells. This then results in, over time, results in precancer formation which are these rough spots that develop on the skin that are persistent. And they are referred to as actinic keratoses. These actinic keratoses then can develop into skin cancer over time. Of course, repeated sun exposure may augment how quickly those turn into skin cancer. And as I mentioned previously, the sun exposure UV rays also then cause premature aging.
Host: So, you mentioned those actinic keratoses. What are the early symptoms or signs that those are developing into skin cancer?
Dr. Lashgari: Right, so the thing about skin cancer unfortunately, is that there may not be any early symptoms. So, you may not have itching, burning, pain or anything like that associated with skin cancer. But there are signs and one of the signs is what I mentioned that you get these rough, peeling spots that just persist and eventually may thicken into what we call cutaneous horns which are these really rough, raised spots. And those are the precursors for basal cell and squamous cell carcinomas. In regards to melanoma, there really is no symptom. What you need to look for are irregular moles. So, irregular moles can look or feel exactly the same as normal skin textures, but they are irregularly pigmented, irregularly shaped, asymmetrical larger in size and so those are the signs of what we need to look for. Unfortunately, there may be no symptoms though.
Host: I see. Okay. That’s good to know so, how – for someone that spend a lot of time in the sun, what’s the best way to just monitor themselves so they are constantly on the lookout for some of these potential developments on the layer of their skin?
Dr. Lashgari: Right so, the most important thing is regular skin checks that one can give to himself or herself. So, monthly skin checks in front of the mirror is important. Same way as one would, women especially, but men should do a self-breast exam. They should also do self-skin exams. So, you stand in front of the mirror and look at your skin to see – to become familiar with the moles that you have. Of course, melanomas are the most serious types of skin cancer. They are the ones that can metastasize or spread to other body parts. So, the most important thing to recognize are changing moles. So, again, you are looking for a mole that becomes more irregular, has different colors, is asymmetrical looking. So, that’s one way. And then the other thing is feel the skin for these rough spots. And most of the time, these develop on sun exposed skin so on the face, arms, if you feel a spot that just persists and doesn’t go away, you want to have that checked.
Host: Okay. So, I want to move into diagnoses and treatment. So how exactly is skin cancer diagnosed and then eventually treated?
Dr. Lashgari: Well the diagnosis is usually of course by – if you do notice some kind of a change or something that doesn’t feel right or look right; you go see your physician and many times if you are initially seeing your primary care physician, they may be able to diagnose it or if not they refer you to a dermatologist who can then of course diagnose any lesion that you have as to whether it’s just a early precursor to skin cancer or maybe it’s a benign thing. But seeing your physician is the most important thing. They would usually – if it’s something that’s suspicious, would do a biopsy on the lesion and determine if it’s skin cancer. If they know that it’s not a skin cancer and it’s a precursor like actinic keratosis that I was mentioning, that can then be treated with either liquid nitrogen which is called cryotherapy or there are creams that can treat precancers or actinic keratoses.
In regards to the precursor to melanoma, which are atypical moles, those would need to be excised first of all to make sure they are not melanomas yet and also to prevent them from turning into melanomas.
Host: Got it. So, just as we wrap up here, one thing that I always like to ask is, you as a board-certified dermatologist have seen many different cases and cases obviously related to skin and skin cancer; what is one thing that you might share with people who are worried about their skin health, something that you have learned over seeing all of the hundreds of patients that you’ve helped serve?
Dr. Lashgari: Okay. So, one thing that I want people to realize that skin cancer is very treatable in general. The majority of skin cancers are basal cell and squamous cell carcinomas. And those are very treatable. As I mentioned previously, the cure rate is quite high with those types of skin cancer and even if there is recurrence, they can be treated again and re-excised and the prognosis is very good. The other thing is that people can be involved in their skin health by taking care of their skin, being careful with sun exposure and that can make a big difference in having healthy skin. And one of the most important things that I want especially younger people to know, that tanning beds are really very unsafe. So, the type of UV light that tanning beds provide are UVA radiation, ultraviolet A radiation and that actually penetrates deeper into the skin and can cause more damage and if there is repeated use during adolescence and early adulthood; it increases risk of developing melanoma. So, I think that’s an important thing to realize especially for the younger individuals to be very careful with that and people think that okay, if I’m going to the tanning bed, I’m getting vitamin D formation and that’s completely false as well.
Host: Okay. Yeah, that’s a really good point. I did not know that. And just as we close here, you mentioned vitamin D; I’m sure people in this country, they kind of always or they are aware that they’re vitamin D deficient. So, do you have a recommended amount of time they should be spending in the sun to get that vitamin D?
Dr. Lashgari: So, it’s really thought that the amount of sun exposure that we get through routine exposure, being outdoors, getting in and out of our cars or just going to shopping or things like that is all the amount of sun that one needs for vitamin D formation. I always tell my patients as long as you get 15 minutes a couple of times a day at different times, that’s probably adequate sun exposure. Now that doesn’t mean that you don’t become vitamin D deficient because sun is not all that’s needed for vitamin D formation. And there are plenty of people who are very tan and get plenty of sun and they are still vitamin D deficient. So, we need to make sure our nutrition, our diet is adequate, has enough vitamin D in it and sometimes that’s not enough. As we get older, we need to have vitamin D supplementation. So, all of that is important.
Host: Well Dr. Lashgari, this has been hugely informative, and I really appreciate your time today. That’s Dr. Ali Lashgari, a Board-Certified Dermatologist at Ridgecrest Regional Hospital. Thanks for checking out this episode of Ridgecrest Regional Hospital Podcast. Head to www.rrh.org/podcast for more information. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.
Prakash Chandran (Host): It’s important to practice safe protection measures when spending time in the sun. Being outdoors, may come with consequences unless we are actively protecting our body from skin cancer. We’re going to talk about it today with Dr. Ali Lashgari, a Board Certified Dermatologist at Ridgecrest Regional Hospital.
This is a podcast from Ridgecrest Regional Hospital. I’m Prakash Chandran. So, first of all, Dr. Lashgari, it’s great to have you here. Why exactly is it so important for us to keep our skin protected?
Ali Lashgari, MD (Guest): Well there are multiple reasons why it’s important to keep your skin protected. First of all, it’s been proven that sunburn and chronic sun damage are the causative factors for two types of skin cancer: basal cell carcinoma and squamous cell carcinomas. It is also a very important factor in melanoma development. Although, melanomas are also – genetics is also an important factor for melanoma development.
The other important reason to keep your skin protected is that 80% of aging is due to chronic sun exposure. Signs of aging such as lentigines, wrinkles, texture change which is that leathery skin look, and looseness of skin have all been attributed to chronic sun exposure. Furthermore, skin gets thinner due to sun damage which can cause bruising. For example, those purple spots that we see in older skin on the forearms; that’s due to chronic sun exposure.
Host: When you say sun exposure, I’m sure a lot of us listening to this are wondering what exactly that means. like right now, for me, for example, I may go outside a couple of times a day but at what point does it become harmful to my skin and are there best practices that I should be following?
Dr. Lashgari: Sure. So, of course, when you get sunburns, that’s the one thing everyone needs to prevent. Because sunburns are the one thing that causes the most damage to the DNA in the skin cells which then causes, over time, can cause skin cancers. So, the most important thing one can do is prevent or limit exposure during those times of the day from 10 o’clock in the morning to four o’clock in the afternoon when the sun is most intense. So, things like sun avoidance, staying in the shade as much as possible, applying sunscreen, sun blocks and wearing protective clothing are things you can do to limit the sun exposure.
Host: So, speaking of sunscreen, or sun block, I think most of us believe that if we apply enough of it, especially with a high enough SPF; we should be okay. Is that true?
Dr. Lashgari: Well it’s partially true. It does matter how much sunscreen you put on. So, you need to put on a significant amount to cover the skin that’s exposed to the elements completely but the type of sunscreen that you use is also very important. Ideally, you want to use a sunscreen that has ingredients zinc oxide and titanium dioxide. And the SPF should be SPF 30 or higher. And in addition, when you apply the sunscreen is important. You want to apply the sunscreen at least 20 to 30 minutes prior to exposure to the sun.
Host: Okay. That’s a really good tip because I know for a fact, that me and most of my friends as soon as we go to the beach, we are already in the sun, we apply it and we think we are ready to go. So, is there anything else that we need to know about sunscreen and how we should be applying it?
Dr. Lashgari: Yes. So, beyond the 30 minutes prior to exposure application, it’s really important to also know what the active ingredients of the sunscreen should be. The two best ingredients are zinc oxide and titanium dioxide. So, you need to look on the back of the sunscreen and look for those ingredients as the main ingredients. Furthermore, is someone is outdoors for long periods of time, they need to reapply the sunscreen every two hours. And finally, wearing a wide brimmed hats and some protective clothing are also important.
Host: Okay, great. And just before I get into the next question here, we’re talking about getting sunburn and there’s that direct correlation with that UV radiation. Can you talk a little bit about UV radiation and the relationship that it has with our bodies and then how it leads to potential skin cancer?
Dr. Lashgari: Sure. So, UV radiation or ultraviolet rays, basically, as I mentioned before, damage the DNA within the nucleus of the skin cells. This then results in, over time, results in precancer formation which are these rough spots that develop on the skin that are persistent. And they are referred to as actinic keratoses. These actinic keratoses then can develop into skin cancer over time. Of course, repeated sun exposure may augment how quickly those turn into skin cancer. And as I mentioned previously, the sun exposure UV rays also then cause premature aging.
Host: So, you mentioned those actinic keratoses. What are the early symptoms or signs that those are developing into skin cancer?
Dr. Lashgari: Right, so the thing about skin cancer unfortunately, is that there may not be any early symptoms. So, you may not have itching, burning, pain or anything like that associated with skin cancer. But there are signs and one of the signs is what I mentioned that you get these rough, peeling spots that just persist and eventually may thicken into what we call cutaneous horns which are these really rough, raised spots. And those are the precursors for basal cell and squamous cell carcinomas. In regards to melanoma, there really is no symptom. What you need to look for are irregular moles. So, irregular moles can look or feel exactly the same as normal skin textures, but they are irregularly pigmented, irregularly shaped, asymmetrical larger in size and so those are the signs of what we need to look for. Unfortunately, there may be no symptoms though.
Host: I see. Okay. That’s good to know so, how – for someone that spend a lot of time in the sun, what’s the best way to just monitor themselves so they are constantly on the lookout for some of these potential developments on the layer of their skin?
Dr. Lashgari: Right so, the most important thing is regular skin checks that one can give to himself or herself. So, monthly skin checks in front of the mirror is important. Same way as one would, women especially, but men should do a self-breast exam. They should also do self-skin exams. So, you stand in front of the mirror and look at your skin to see – to become familiar with the moles that you have. Of course, melanomas are the most serious types of skin cancer. They are the ones that can metastasize or spread to other body parts. So, the most important thing to recognize are changing moles. So, again, you are looking for a mole that becomes more irregular, has different colors, is asymmetrical looking. So, that’s one way. And then the other thing is feel the skin for these rough spots. And most of the time, these develop on sun exposed skin so on the face, arms, if you feel a spot that just persists and doesn’t go away, you want to have that checked.
Host: Okay. So, I want to move into diagnoses and treatment. So how exactly is skin cancer diagnosed and then eventually treated?
Dr. Lashgari: Well the diagnosis is usually of course by – if you do notice some kind of a change or something that doesn’t feel right or look right; you go see your physician and many times if you are initially seeing your primary care physician, they may be able to diagnose it or if not they refer you to a dermatologist who can then of course diagnose any lesion that you have as to whether it’s just a early precursor to skin cancer or maybe it’s a benign thing. But seeing your physician is the most important thing. They would usually – if it’s something that’s suspicious, would do a biopsy on the lesion and determine if it’s skin cancer. If they know that it’s not a skin cancer and it’s a precursor like actinic keratosis that I was mentioning, that can then be treated with either liquid nitrogen which is called cryotherapy or there are creams that can treat precancers or actinic keratoses.
In regards to the precursor to melanoma, which are atypical moles, those would need to be excised first of all to make sure they are not melanomas yet and also to prevent them from turning into melanomas.
Host: Got it. So, just as we wrap up here, one thing that I always like to ask is, you as a board-certified dermatologist have seen many different cases and cases obviously related to skin and skin cancer; what is one thing that you might share with people who are worried about their skin health, something that you have learned over seeing all of the hundreds of patients that you’ve helped serve?
Dr. Lashgari: Okay. So, one thing that I want people to realize that skin cancer is very treatable in general. The majority of skin cancers are basal cell and squamous cell carcinomas. And those are very treatable. As I mentioned previously, the cure rate is quite high with those types of skin cancer and even if there is recurrence, they can be treated again and re-excised and the prognosis is very good. The other thing is that people can be involved in their skin health by taking care of their skin, being careful with sun exposure and that can make a big difference in having healthy skin. And one of the most important things that I want especially younger people to know, that tanning beds are really very unsafe. So, the type of UV light that tanning beds provide are UVA radiation, ultraviolet A radiation and that actually penetrates deeper into the skin and can cause more damage and if there is repeated use during adolescence and early adulthood; it increases risk of developing melanoma. So, I think that’s an important thing to realize especially for the younger individuals to be very careful with that and people think that okay, if I’m going to the tanning bed, I’m getting vitamin D formation and that’s completely false as well.
Host: Okay. Yeah, that’s a really good point. I did not know that. And just as we close here, you mentioned vitamin D; I’m sure people in this country, they kind of always or they are aware that they’re vitamin D deficient. So, do you have a recommended amount of time they should be spending in the sun to get that vitamin D?
Dr. Lashgari: So, it’s really thought that the amount of sun exposure that we get through routine exposure, being outdoors, getting in and out of our cars or just going to shopping or things like that is all the amount of sun that one needs for vitamin D formation. I always tell my patients as long as you get 15 minutes a couple of times a day at different times, that’s probably adequate sun exposure. Now that doesn’t mean that you don’t become vitamin D deficient because sun is not all that’s needed for vitamin D formation. And there are plenty of people who are very tan and get plenty of sun and they are still vitamin D deficient. So, we need to make sure our nutrition, our diet is adequate, has enough vitamin D in it and sometimes that’s not enough. As we get older, we need to have vitamin D supplementation. So, all of that is important.
Host: Well Dr. Lashgari, this has been hugely informative, and I really appreciate your time today. That’s Dr. Ali Lashgari, a Board-Certified Dermatologist at Ridgecrest Regional Hospital. Thanks for checking out this episode of Ridgecrest Regional Hospital Podcast. Head to www.rrh.org/podcast for more information. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.