Hawaiʻi Experts Spread Awareness about Sun Exposure Safety this Summer

With summer approaching, skin cancer specialists across the state are urging residents to pay closer attention to their skin, sun exposure and proper treatment.

“Skin cancers are the most common and most preventable type of cancer,” said UH Cancer Center Researcher Kevin Cassel.

UV rays are a major risk factor for cancer in Hawaiʻi––particularly because “our close proximity to the equator means our sun rays are more direct, which puts Hawaiʻi residents at a year-round risk for skin cancers,” Cassel added.

Every year, 10,000 people in Hawaiʻi will be diagnosed with skin cancer, according to the UH Cancer Center.

To lower the incidence of skin cancer, Hawaiʻi experts have set out to educate people on the types of skin cancer, risk categories, and preventative measures.

Types of skin cancer

The three major types of skin cells that can become cancerous are:

• Squamous cells: Thin, flat cells located in the basal layer of the skin between hair follicles.
• Basal cells: Round cells under the squamous cells located in the mid-epidermis.
• Melanocytes: Cells that make melanin, the pigment in moles that give skin its color.

The world of skin cancer is divided into non-melanoma skin cancer (NMSC) and melanoma, said George Martin, M.D., of Maui.

The basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) make up the majority of non-melanoma skin cancer (NMSC), which is the most common type of cancer in the United States.

BCC rarely metastasizes and causes death while SCC does so more readily with 7,000 to 12,000 people dying with SCC annually and nearly 2 million new SCC developing annually in the United States, said Martin.

Martin of Dr. George Martin Dermatology Associates said he sometimes finds squamous and basal cell lesions in high-risk people as early as their 20s and 30s.

Most basal and squamous cell skin cancers can be treated easily if detected early, according to the UH Cancer Center.

Melanoma is less common (4% of all skin cancers detected annually) but potentially the most deadly.

In 2021, over 7,000 people in the United States will die due to melanoma while over 100,000 new melanomas will be detected during that time, Martin said.

Melanoma, cancer formed in melanocytes, is more aggressive and becomes harder to cure if the tumor has spread from the epidermis (the upper layer of skin) to the dermis (the lower layer of skin).

Approximately 400 cases of melanoma are diagnosed each year in Hawaiʻi, according to the UH Cancer Center.

Risk categories

Martin described high-risk patients as fair-skinned individuals with a family history of skin cancers, and low-risk patients as darker-skinned individuals with no family history of skin cancers.

While skin tone with more melanin has a natural SPF of about 13 that protects from sun exposure, it does not amount to immunity and may only delay tumor growth, according to Martin.

Many experts take a cautious approach to risk categories because the notion can cause underestimations and neglect of the issue by certain individuals.

“Multiethnic and multi-complexion populations may underestimate their risk for skin cancer,” echoed Cassel.

Martin said he has seen melanoma in individuals in their teens and younger, although those instances are scarce.

Still, Martin and other experts have stressed looking for skin cancer in younger individuals.

“Our studies have found that adolescents and young adults in Hawaiʻi are not aware of their risk for skin cancer,” Cassel said.

Martin recommended that “patients should be screened for melanoma skin cancer as early as 12-years-old, particularly if they are at risk.”

Skin cancer prevention

Hawaiʻi’s experts believe skin cancer can be managed by staying on top of the preventative measures, looking for unusual developments on the skin, and scheduling regular appointments with a dermatologist.

The UH Cancer Center released the following recommendations to reduce skin cancer risks within the daily routine:

• Seek shade during peak sun brightness (10 a.m. to 4 p.m.).
• Avoid tanning and getting sunburned. Do not use UV tanning beds.
• Wear broad-spectrum sunscreen (SPF 30 +) every day.
• Cover up with UV-protective clothes, a wide-brimmed hat and UV-blocking sunglasses.
• During extended outdoor activity, apply sunscreen (30 SPF +) 30 minutes before going outside and reapply every 2 hours.
• Examine your skin each month for any unusual red patches or moles, and see a dermatologist at least once a year for a professional exam.

Martin reflected this statement as the general guidelines for Hawaiʻi residents.

“Slip on a shirt. Slap on a hat. Slop on some sunscreen,” Martin mentioned, saying, “we’ve added sunglasses to that,” as a preventative measure against cataracts, skin cancer around the eyes, and other issues that may arise as a result of sun exposure to that region.

Along with being a dermatologist on Maui, Martin is an avid waterman who wants to spread awareness of healthy practices and spending long periods outdoors when conditions are best before 10 a.m. or after 4 p.m..