More Than Skin Deep

Can you spot the warning signs of melanoma on your clients’ skin?

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More than one million skin cancers are diagnosed each year in the United States, according to the American Cancer Society, and that number is rising. Melanoma rates in the U.S. have increased by at least 3% each year for the past decade, say statistics appearing in the Journal of Investigative Dermatology. Yet, despite widespread efforts to educate and raise awareness of the problem, a recent survey conducted by the Consumer Reports National Research Center reveals that 31% of Americans still don’t use sunscreen.

Although it isn’t the purview of spa professionals to diagnose or treat skin cancer, it’s certainly a skincare therapist’s responsibility to advise clients on skin cancer prevention—and to recognize potential signs of trouble on the skin. May is Melanoma Awareness Month, a perfect time to re-educate yourself, your staff and your clients about detection and prevention of this potentially deadly disease.

Did You Know?
The survival rate for patients whose melanoma is detected early—before the tumor has penetrated the skin—is about 99%. For those whose melanoma is in advanced stages, the survival rate is 15%.

Types of Skin Cancer

The three types of cell carcinomas referred to as skin cancers are, in order of severity, basal, squamous and melanoma. Dr. Richard Kaplan, a Memphis, Tennessee-based dermatologist describes each type:

Basal cell carcinoma “This is the most common skin cancer. It can be locally destructive, causing a person to lose parts of his or her nose, for example.”

Squamous cell carcinoma “The second most common type. In rare cases, it can metastasize and get into the nerves of the skin.”

Melanoma “This is the most rare and deadly form of skin cancer. Melanoma gets into the skin, but then, if not caught early, it gets into the blood cells and spreads throughout the body. There’s no cure for melanoma, though some patients get better with chemotherapy.”

Did You Know?
Skin cancer can originate on any part of the body, but some of the most common areas are the upper backs of men and women and the legs of women because of the high incidence of sunburns in these areas.

What to Look For

All skin cancers are curable if detected early, reminds Dr. Kaplan, and a full-body examination by a medical professional is the best way to ensure that early detection takes place. However, he adds, skin therapists can do their part by being on the lookout for:

• Moles, blemishes or birthmarks that change in size or color
• Shiny pink or red lesions that appear suddenly, or grow slowly in a cluster
• Hard, flat or concave lesions
• Sores that won’t heal
• Any area that bleeds

Early signs aren’t always obvious, especially when they turn up in unexpected places on the body. A brown or black vertical streak on a fingernail or a seemingly harmless freckle could signify early trouble. Pay close attention as you perform body treatments, facials and even manicures and pedicures, and don’t hesitate to advise clients to see a doctor if you notice anything suspicious. Let them know that there are free skin-cancer screenings available through the American Academy of Dermatology. Information on local screenings is available at www.aad.org/public/exams/screenings/index.html.

Did You Know?
One or more blistering sunburns in childhood or adolescence more than doubles a person’s chance of developing melanoma later in life.

Safe Tanning

The $5-billion-per-year tanning industry experienced a hard hit after the May 2010 release of a study showing that indoor tanners are 74% more likely to develop melanoma than non-tanners. A 10% tax was recently levied on tanning salons, and some states have started to require parental consent for children under the age of 18 to tan. Moreover, The Federal Trade Commission (FTC) approved a final settlement banning the Indoor Tanning Association (ITA) from making misleading or unsubstantiated health and safety claims about indoor ultraviolet (UV) tanning.

The result of these actions is a boon to the providers of sunless tanning products and services. Self-bronzers and spray tans are not only safe alternatives for clients who crave that just-returned-from-Hawaii look, but they can also help boost day spas’ retail and service revenues.

Did You Know?
Until age 39, women are almost twice as likely as men to develop melanoma; starting at age 40, melanoma incidence in men exceeds that in women, and the trend becomes more pronounced with each decade.

Prevention at the Spa

Treatment rooms aren’t only for treatments; they’re where skincare education takes place. Don’t just end each facial with an application of sunscreen—tell the client what you’re doing and why. “We make it a point to discuss sunscreens that will benefit their skin, and we carry several of these products in our spa,” says Nancy Neiderer, an esthetics nurse at The Medical Spa at Nova in Ashburn, Virginia. “I advise clients that the three most important places to apply sunscreen are the face, décolleté and tops of hands.”

Signage is another effective way to make sure that clients are getting the message about prevention. Request a poster about skin cancer warning signs from the American Academy of Dermatology, or make one of your own. The popular “ABCs of Skin Cancer” resonates with most people:

Asymmetry Healthy moles are usually symmetrical, so the sides should mirror each other.
Border If the outer edge of a mole is irregular, it may be a sign that something’s wrong.
Color Varying shades of brown, tan or black in one spot may signal that cells aren’t functioning properly. Unusual colors such as white, red or blue are also cause to investigate further.
Diameter Watch for moles that exceed the size of a pencil eraser (though smaller moles can also be cancerous).
Evolving If the characteristics of a mole have changed recently, it’s time to see a dermatologist. •

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