Living in Palm Beach County means sun most days of the year: on the golf course, on the boat, at the beach and walking to the car. That exposure adds up over decades, and many people who moved here later in life also carry years of sunburns from childhood summers. Skin checks are a sensible habit for almost everyone here.

The basics

According to the CDC, skin cancer is the most common cancer in the United States. The three most common types are basal cell carcinoma, squamous cell carcinoma and melanoma. Basal and squamous cell cancers are the most common and can usually be cured, though treatment can leave scars. Melanoma is less common but causes more deaths, because it is more likely to spread if not caught early.

Who is at higher risk

The CDC lists factors that increase the risk of skin cancer:

  • Lighter natural skin color, or skin that burns, freckles or reddens easily
  • Blue or green eyes, or blond or red hair
  • Certain types of moles, or a large number of them
  • A history of sunburns or tanning
  • A family or personal history of skin cancer
  • Older age

Anyone can get skin cancer, including people with darker skin, where it is sometimes found later.

Sun protection in South Florida

The CDC notes that UV rays can reach you on cloudy and cool days, and reflect off water, sand and cement. In the continental United States, UV rays are strongest from 10 a.m. to 4 p.m. during daylight saving time. The CDC advises protecting your skin when the UV Index is 3 or higher, which in South Florida is much of the year. The EPA publishes a daily UV Index forecast by location.

  • Shade and timing. Plan long outdoor activities for early morning or late afternoon when you can.
  • Clothing. A wide-brimmed hat, sunglasses and sun-protective shirts do a lot of the work.
  • Sunscreen. The CDC recommends a broad-spectrum sunscreen with SPF 15 or higher, applied generously to all exposed skin and combined with other protection.
  • On the water. Reflection from the water adds exposure, so reapply after swimming or sweating.

Checking your own skin

The American Academy of Dermatology recommends a regular skin self-exam: look at your body front and back in a full-length mirror, then each side with your arms raised; check forearms, underarms, palms, legs, between the toes and the soles of the feet; and use a hand mirror for the back of your neck, scalp, back and buttocks. A partner can help with places that are hard to see.

The National Cancer Institute describes the ABCDE rule for features of early melanoma:

  • Asymmetry: one half does not match the other.
  • Border: edges that are ragged, notched or blurred.
  • Color: uneven shades of brown, black or tan, sometimes with other colors.
  • Diameter: a change in size, usually an increase.
  • Evolving: a mole that changes over weeks or months.

NCI also notes that the first sign of melanoma is often a change in an existing mole, or a new, unusual spot. The AAD advises seeing a dermatologist about a spot that looks different from the others, or that changes, itches or bleeds. The AAD’s guide to the ABCDEs of melanoma has photos that help.

If you have already had a skin cancer, the CDC lists a personal history of skin cancer as a risk factor for another, so regular checks with a dermatologist matter even more.

What the screening guidance says

The US Preventive Services Task Force concluded that the evidence is insufficient to judge the benefits and harms of routine skin exams by a clinician in adults without symptoms. That conclusion is about screening everyone. It does not apply to a spot that is new or changing, or to people at higher risk, who often benefit from regular checks with a dermatologist. The USPSTF does recommend that clinicians selectively counsel adults with fair skin about reducing sun exposure.

Where your internist fits

Your internist is not a substitute for a dermatologist, but is often the first to see a spot during a physical, and can help decide how quickly it needs attention. If you burn more easily than you used to, ask whether one of your medicines could be the reason.

At Legacy Medical, Dr. Shtern coordinates specialist care, which includes choosing a dermatologist, making the referral and keeping track of what they find, so your records stay in one place. If you split the year between Florida and somewhere else, our guide for seasonal residents covers how to keep care continuous. To meet her, book a complimentary meet and greet, or read more about preventive care at the practice.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.