Dr. Jim O’Toole Shows Us How to Stay Smart in the Sun
By Rachel Jones | Photograph by Michael Fornataro
As the warmer weather invites us to take our workouts and other activities outside, we’re delighted to bask in the sunshine that abandoned us during the winter months. But don’t overdo it. “Sun exposure is essential for Vitamin D absorption,” says Dr. Jim O’Toole, double board certified plastic surgeon and owner of O’Toole Plastic Surgery. “But we need to be careful about it.”
According to the Skin Cancer Foundation, one in five Americans will develop skin cancer in their lifetime and one in 50 will develop melanoma. There are 400,000 cases of skin cancer yearly in the U.S. alone directly related to tanning bed exposure. Dr. O’Toole is an expert in melanoma care, removing the most dangerous form of skin cancer from patients with an effective and minimally scarring method that prevents greater problems from developing down the road.
“The thing that makes melanoma problematic is the cell lineage it comes from,” O’Toole explains. “It comes from neuroendocrine cells, which is the same kind of tissue that your brain and spinal cord arise from. It is inherently protected from the immune system. That’s one of the reasons it is so hard to treat. Most people think, ‘Hey, it’s skin cancer. They’ll cut off the skin, and I’m fine.’ But if it gets out of the skin, it’s incredibly difficult to treat.”
Melanoma is one of few tumors that can spread from the skin to other parts of the body. But the more Dr. O’Toole and his colleagues at the Hillman Cancer Center study the cancer, the more they learn about the best ways to prevent it.
The biggest culprit is the tanning bed, which emits UVA rays at least 12 times stronger than the sun. Known to travel deeper into the skin than UVB rays, UVA rays can reach the second layer of skin (the dermis) and mutate the skin’s cells to cause cancers. “The risk of developing melanoma from tanning bed use is more than the risk of developing lung cancer from smoking,” O’Toole states. “The risk goes up anywhere from 50 to 75 percent when you frequent a tanning bed.”
If you believe you are at risk, check your moles for the five main warning signs: Asymmetry or irregular shape; uneven Border; more than one Color; large Diameter; and Evolution in size, shape, color, or elevation over time. Following the A-B-C-D-E method is a simple way to cover all of your bases. Dr. Toole also recommends the standby — “one of these things is not like the other.” “I say that jokingly but with a lot of truth,” he explains. “Regions of the body tend to see the same amount of ultraviolet light, so moles’ shapes, sizes, and pigments should match each other very well. If they don’t or they change, they should get checked out.”
Visible changes in moles are so subtle that it’s often hard to notice any differences over time. To keep track, take photos of any suspicious moles with your cell phone every month to note any alterations. These photos will serve as a physical log of the progression, which can easily be shown to your doctor for better analysis.
“I also recommend people that have a family history of skin cancer get screened by their hairdressers,” O’Toole adds. “Nobody sees your scalp more than your hairdresser, so they might pick up on something you won’t. I see 8 to 10 melanoma cases a year that a hairdresser or barber sent in.”
The good news is a recent study in Australia proved that wearing sunscreen every day for one calendar year significantly decreased the lifetime risk of melanoma. So before you spend the day outside, apply broad spectrum sunscreen — preferably with an SPF between 30 and 50 — and reapply every few hours. Even if it’s cloudy or chilly, the UVA rays are still able to affect your skin. In fact, some of the most damaging sunburns result from popular outdoor activities, such as skiing or participating in water sports because of the secondary exposure of ultraviolet light that reflects off the snow or water.
“You just have to be smart about it,” O’Toole adds, with optimistic expectations for the future. “Nationally, we’ll see a reduction in skin cancer because the use of sunscreen is far more prevalent than it used to be, and the FDA has issued a black box warning for tanning bed use for individuals under the age of 18. It is a consensus that there is no established safe level of tanning bed usage at any age and the younger the individual, the greater the risk.”
O’Toole Plastic Surgery, otooleplasticsurgery.com.