Monthly Archives: July 2014

Slather Sunscreen Again and Again

Bottle of Suncreen

In the summer months, we’re all in need of a bit of rest and relaxation. Whether you choose to sit on the grass at your local park or enjoy a Caribbean vacation, there are some things you need to consider while you’re having fun—SPF protection. Sun exposure is a year-round concern. But it is especially dangerous when you’re skin is exposed for prolonged hours to the blazing sunlight during summer months. Our relationship with the sun is a complex one: we need the sun because it’s the best source of vitamin D, yet too much sun exposure leaves telltale signs of skin damage such as wrinkles, sallowness, and age spots. Over time, however, prolonged UV light exposure causes skin cell damage that leads to cancer.

There are three main types of skin cancers, which are based on the cell type that is affected by sun exposure: basal cell skin cancer (common in fair skin people), squamous cell skin cancer (common in dark skin people), and melanoma. Of these types of skin cancer, melanoma is the most aggressive form of skin cancer and the most difficult to treat.

Melanoma develops in pigment cells called melanocytes. People are at an increased risk for developing melanoma if they’ve had a history of blistering sunburns or had intense sun exposure. While melanoma commonly shows up on chest, back, and extremities, melanomas can also be found under the nail bed, on the palms of the hand, or on the soles of the feet. Melanomas also begin to develop in moles or pigmented skin areas such as birthmarks or freckles.

The diagnosis of melanoma is not an easy task because these skin changes can be easily missed, especially when the focus of your doctor’s visit may be related to something else altogether. With limited time to discuss your most pressing concerns with your physician, it’s likely that a skin exam won’t make it on the roster of things to evaluate during a physical exam. So it’s important that you look at your skin and bring up any changes you notice to your doctor. Some things to look out for include noticeable changes in an existing mole, the development of a new mole, or the formation of an unusual growth or pigmented patch of skin. Is the mole oozing or bleeding? Does your mole itch? Has the growth changed color? Does it have an irregular border? Is your mole asymmetrical in shape?

Despite the characteristic changes of moles and pigmented areas of skin, it is still very difficult to identify the changes, especially if the occur in hard-to-see areas like your scalp or back. For areas that are hard to see, ask a family to help or use a handheld mirror.

With all cancers, it’s better to prevent it from occurring in the first place, then to treat it.  Since melanoma develops due to sun exposure, SPF protection makes sense, right? Well new research says that sunscreen doesn’t completely shield you from UV light damage. This may come as quite a surprise given that SPF protection has been rigorously supported as a preventive measure against skin cancer.

Slather Sunscreen Again and Again

Wait! Before you throw out your SPF, don’t because you still need it. The study identified TP53, which is a tumor suppressor gene that corrects the UV ray damage done to DNA in skin cells. Researchers looked at the protective impact of SPF-50 creams used on mice. In spite of the use of the heavy-duty sunscreen, the mice still developed tumors albeit fewer tumors than the mice who were not given SPF protection.

To protect against skin cancer take the following precautions:

  • Stay out of the sun during peak hours (10 a.m. to 2 p.m.)
  • Wear clothing that protects your skin from the sun (e.g., brim hat, sunglasses)
  • Request a annual mole check
  • Check your skin for new moles, abnormal changes in existing moles, and suspicious lesions
  • Use a sunscreen with an SPF ≥ 30 when you’re outdoors (during intense sun exposure reapply SPF every 2 to 3 hours and if you are swimming or sweating a lot reapply it every 1 to 2 hours)

Skin cancer is the most common cancer among Americans, and melanoma is an aggressive cancer that carries a poor prognosis the farther away it migrates from skin to organs and bones in the body. If it’s found early, before metastasis, it is highly treatable. Protect yourself this summer and throughout the year because UV light can damage DNA at any time.

Lyme Light: Understanding the Tick-Borne Bacteria

Deer Tick in Glass Vial

Borrelia is the genus name for the bacterial spirochete that causes Lyme disease. The disease is caused by the bacterium Borrelia burgdorferi in the United States; the European relatives of the bacteria are Borrelia afzelii and Borrelia garinii. The origin of Lyme disease dates back about 40 years when in the mid-70s children living in Lyme, CT were diagnosed with rheumatoid arthritis (RA), which is a disease most commonly seen in older adults, although there is a juvenile rheumatoid arthritis (JRA) form. However, it’s highly unlikely that a group of children living in the same city would develop cases of JRA. Once the children’s parents brought their story to the attention of researchers, further studies led to the 1982 discovery of the cause of the inflammatory condition in these children—bacteria found in the stomach of a deer tick (Ixodes scapularis). These ticks serve as vectors and carry Borrelia burgdorferi in their stomachs until they bite someone and transfer the bacterium to a person. The fifty states have all reported cases of Lyme disease; however, the northeastern part of the U.S. tends to have the most cases.

Interestingly, Oregon State University researchers found ticks fossilized in 15- to 20-million-year-old amber that was located in the Dominican Republic; the ticks were infected with spirochete bacteria that closely resemble Borrelia, which is commonly found in present-day ticks. With this new evidence, it’s clear that ticks have been around well before they were first identified in ‘82. During warmer months, people enjoy spending more time outdoors, which is a good thing as it relates to the health benefits of getting vitamin D from the sun (but don’t spend all day without putting on your SPF), such as improving bone strength, boosting immune function, and even preventing cancer. Unfortunately, spending time outdoors exposes you to a host of other dangers too like tick bites.

It Starts With a Bite
Once you’ve been bitten by a deer tick the bacteria moves into your skin.  Within a few days Lyme disease’s classic bull’s-eye rash develops, which is an expanding pattern of rings forming around the bite mark. However, the rash called erythema migrans doesn’t always develop in everyone and in people with darker skin tones it may be hard to identify the rash. Nonspecific symptoms are also present (e.g., headache, fatigue, muscle and joint stiffness). A rash can be missed, symptoms can be nonspecific, and patients may not even recall getting bit by a tick. After all a tick bite is tiny and difficult to spot. Within days or weeks, the rash will resolve itself and at that time the bacteria continue to spread undetected to cause disease in the heart (arrhythmias, heart failure), nervous system (confusion, Bell’s palsy), and joints (pain, swelling, stiffness, particularly in the knees).

Diagnosing Lyme disease
The classic bull’s-eye rash is helpful in diagnosing Lyme disease. However, when this sign is missing, doctors often rely on history (e.g., the patient was in an area in which Lyme disease is common). If the patient is showing signs of joint pain or heart disease, then running a series of test is required to exclude diseases that may present with similar findings. In the later stages of Lyme disease, the bacteria trigger the production of antibodies to fight off the infection. A lab test is used to confirm Lyme disease; however, it’s reliable within four weeks of a tick bite. Lab testing in patients suspected of Lyme disease is most helpful when (1) there is a 4-week history of a tick bite or (2) there are inexplicable disorders affecting the heart, joint, or nervous system.

Treating Lyme Disease
Antibiotics are used to treat Lyme disease. The type of treatment a patient receives is determined by the stage of the disease: earlier stages are usually treated with oral antibiotics, later stages with intravenous drugs. For swelling and joint pain, an anti-inflammatory drug such as Motrin can be used.

Because Lyme bacteria can lead to disorders of the heart, joint, and nervous system, it’s important that you recognize the symptoms of Lyme disease, especially if you’ve been camping, hiking, or walking in woody, grassy areas. Borrelia burgdorferi, it appears with the latest research, has been around for many more years than what was previously thought. Recognize the symptoms of this tenacious microbe so you can bring concerns of Lyme infection to your physician sooner rather than later.