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From broad-spectrum sunscreens to laser removal for hair, spider veins and tattoos, we bring to light the truth about the sun’s damaging effects and how to make your skin look its best.

Skin Cancer Risks & Prevention

Chris Borelli, 42, of Appleton is no stranger to the great outdoors. As a city of Appleton arborist, his bread and butter are earned outside. Summer is his busiest time of year.

In October 2008, Borelli’s mother noticed a brown, mottled spot on his nose and suggested he get it checked out. He decided to seek the advice of a dermatologist and a biopsy determined he had pre-melanoma. Melanoma is a type of skin cancer that accounts for about 4% of all diagnosed skin cancers.

Borelli was referred to Pawel Stachowicz, MD, a plastic surgeon with extensive experience in melanoma treatment with The Center for Aesthetics & Plastic Surgery in Neenah. Dr. Stachowicz removed the dime-sized piece of skin and replaced it with a skin graft taken from behind Borelli’s left ear.

According to the American Academy of Dermatology (AAD), one in five Americans will develop some form of skin cancer during their lifetime. Skin cancers include melanoma, basal cell, and squamous cell. Basal and squamous cell are common and treatment is very effective. Malignant melanoma, especially in later stages, is serious and treatment is difficult. Sun exposure is the biggest cause of melanoma among other skin cancers.

In Borelli’s case, it was detected early and treatment increased his survival rate.

While dermatologists agree that the sun is certainly a source of vitamin D, they are uniquely aware it is also a source of harmful ultraviolet radiation resulting in thousands of skin cancers each year.

The AAD recommends an adequate amount of vitamin D should be obtained from a healthy diet that includes foods naturally rich in vitamin D, foods/beverages fortified with vitamin D, and/or supplements. Vitamin D should not be obtained from unprotected exposure to ultraviolet radiation.

“A daily total dose of 1,000 IU (international units) of vitamin D is recommended for those in certain at-risk groups, including those with limited sun exposure,” says Michele Holder, MD, a dermatologist with Affinity Health.

Like many Midwesterns, Borelli fits the bill (half Irish, half Italian) for having the common risk factors for skin cancer. Skin cancer also runs in his family. “Those of central northern European descent, having light colored hair and blue eyes, put someone at greater risk of developing skin cancer,” says Dr. Stachowicz.

A factor such as the number of sunburns one receives, especially during the teenage years, matters. Characteristics such as having multiple, darkly colored birthmarks and moles also put individuals at risk.

And while it may seem obvious, climbing into a tanning bed is the absolute worst thing to do, even if you are going on vacation to a warm, sunny climate. “There is a dramatically higher rate of skin cancer in patients who use tanning beds,” says Brian Kiesnowski, MD, from Appleton Plastic Surgery Center. “Just like people know smoking causes lung cancer, extensive sun exposure increases your risk of skin cancer.”

Providers recommend using sun blocks with SPF 30 or higher and reapplying every 10-15 minutes. “Sun blocks with the least amount of ingredients are typically the best,” explains Dr. Stachowicz. “Look for sun blocks containing zinc oxide or titanium dioxide.” He also suggests avoiding the sun’s harmful ultraviolet rays during peak times, especially from 10am– 4pm. If you must be outside, he advises to cover up with hats, long-sleeved clothing and sunglasses.

There are also new products on the market to help protect you during the summer months. Refine MD in Menasha carries a new mineral sun block that is endorsed by the American Cancer Society called Sunforgettables by Colorescience. “We also carry Revision Intellishade products, which are tinted moisturizers that contain SPF 45 and offer great hydration without the need for heavy makeup,” said Lori Buss, an aesthetician with Refine MD.

Biopsies & Treatments

A punch biopsy is typically the simplest way for your physician to determine whether a suspicious skin legion may be cancerous, explains Dr. Kiesnowski. “The instrument looks like a tiny cookie-cutter and a small piece of skin is taken to a pathologist for examination,” he says.

Other methods are shave biopsies, which are the least invasive, and great for basic skin lesions. The drawback is that this procedure can result in scarring if not done well. Dr. Kiesnowski adds that an excisional biopsy also may be done to remove the entire lesion. If a large area is biopsied, a flap of normal skin may be used to replace the skin that was removed. An incisional biopsy is the least used method in which only a sample of the suspicious tissue is cut into (incised) and removed for purposes of diagnosis.

There are also laser and destructive methods such as liquid nitrogen or topical creams such as Effudex or Aldara.

What to Look For

“Self examinations are key to finding a suspicious spot that may be skin cancer,” says Dr. Kiesnowski, adding that early detection is important. “Look for anything new, such as a new bump, mole or area that the size, color or border has changed or become irregular,” he says. “It’s a lot easier to take care of a small problem early.”

Premature Aging

Is there anything you can do to treat sun damage?

Michele Holder, MD, a dermatologist with Affinity Health says that some patients benefit from using a prescription called Tretinoin, an active ingredient in Retin-A. It can help with the appearance of sun-damaged skin. “Retinol, a pure and active derivative of Vitamin A, can also help and can be purchased over-the-counter but it is not as strong as Retin-A,” she says. “Other Alpha Hydroxy creams and Vitamins E & C can timprove the look of skin, along with dermabrasion and laser treatments.”

Refine MD also offers ViPeel, a cosmetic chemical peel that can be done before the summer months to take off dead layers of skin. “It also helps eliminate the need for makeup and reduces fine lines and wrinkles,” says Buss.

Laser Treatments

There’s been much ado about the use of lasers in treating spider veins, tattoos and unwanted hair.

Richard Parfitt, MD, a Facial Plastic Surgeon with AestheticA Skin Health Center in Appleton, says the best laser for removing tattoos is called Q-YAG5. This treament breaks up the ink particles and effectively removes unwanted tattoos. “Some types of inks respond better to the laser,” he says. “For some, one to two treatments can effectively remove the tattoo; in other cases, it may take 10 treatments.”

AestheticA also offers state-of-the-art lasers that eliminate small reddish “broken capillaries” and “spider veins,” red moles and spots. During treatment, the laser light is absorbed by oxyhemoglobin, or bright red blood cells carrying oxygen, causing decomposition by heat of the unwanted cells.

“Another common procedure for the summer is hair laser treatments, which are good to get done before you go out and get a tan as the laser is attracted to the brown pigment in your skin,” explains Dr. Parfitt. “The treatment uses Intense-Pulsed Light (IPL) to injure the hair root.”

No matter what your skin goals are this summer, the Fox Cities has an abundance of resources to help your skin look its best and stay healthy for years to come.