Top 5 Tips For Clinicians Regarding UV exposure
By: Terri Schmitt PhD, APRN, FNP-BC, FAANP
One: Ultraviolet radiation contributes to more than just melanoma, including basal cell and squamous cell cancer, cataracts, pterygium, premeature aging, and immune suppression of the skin.
Two: In primary care practice include a quick 5-minute dermatology exam with each wellness visit. The following areas are more common areas of exposure– Face, neck, ears, scalp, arms, shoulders, upper chest and back, hands, lower leg, and feet. Remember ABCDE criteria to evaluate lesions: Asymmetry, Border irregularity, Color variation, Diameter >6 mm (though smaller lesions can also be melanoma), Evolving appearance.
Three: Be aware of medications that increase photosensitivity like doxycyline, minocycline, sulfonylureas and sulfonamides, hydrochlorothiazide, furosemide, Isotretinoin, and others. Check medication warnings and remind patients of appropriate clothing and minimizing exposure when outside.
Four: Help educate on myths such as “Sunscreen prevents me getting vitamin D” or “I don’t need sunscreen on a cloudy day"
Five: Have important facts to keep in mind like
- One blistering sunburn during childhood nearly doubles the lifetime risk of melanoma.
- Skin cancer is the most common cancer diagnosed in the United States.
- Broad-spectrum sunscreens protect against both UVA (aging) and UVB (burning) radiation.
References
US Preventive Services Task Force (USPSTF) (2018). Behavioral Counseling to Prevent Skin Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Mar 20;319(11):1134-1142. doi: 10.1001/jama.2018.1623. PMID: 29558558.
Pérez, LL & Bashline, B. (2019). Skin Cancer: Prevention. FP Essentials. 481:28-31. PMID: 31188550.
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