As temperatures rise, and tank tops and shorts become the daily uniform, the medical community shines a light on the damaging effects of sun exposure – namely, skin cancer. May is observed as Skin Cancer Awareness Month by numerous health care entities, including the American Academy of Dermatology (AAD).
Additionally, May 6 has been designated “Melanoma Monday,” specifically calling on individuals to begin a lifelong habit of examining their skin for signs of skin cancer.
UTMB dermatologist Anthony Linfante, MD, agrees this is good practice. Melanoma is the most serious type of skin cancer, with the AAD estimating that 200,340 melanomas will be diagnosed and about 8,290 people will die of melanoma in 2024.
“Melanomas are basically asymptomatic. They don't really cause you any discomfort, pain, bleeding until they're relatively advanced,” Dr. Linfante says. “But really, what you're looking for is a dark brown or black spot that's growing in diameter, not height, and getting darker at the same time.”
A self-exam guide developed by dermatologists uses “ABCDE” – asymmetry, border, color, diameter, evolving – to determine if a mole or pigmented spot may be melanoma. In addition, Dr. Linfante encourages patients to look at their family history to understand their risk.
“There are two major families of melanomas. There is the chronic sun exposure that you will see in 70, 80-year-olds’ faces or ears, and that has to do with progressive sun exposure over a very long period of time. That really doesn’t have much of a genetic predisposition,” he says.
“And then there's another type of melanoma that has a really high genetic predisposition, that will have people in their 30s, 40s and 50s getting melanoma on areas that that rarely see the sun, like on their back or their thighs.”
A younger patient with a first-degree relative that has had melanoma, or has had many abnormal moles removed, should share that history with their primary care provider and begin the discussion about skin cancer risk. Those with first-degree relative history might also consider being seen by a dermatologist in their 20s or 30s for an initial exam.
Dr. Linfante also points out that non-melanoma skin cancers, like basal cell and squamous cell carcinoma, are far more common. Limiting sun exposure is key in prevention of these types of skin cancers. This means covering up with clothing and wearing hats or visors, and wearing sunscreen routinely.
Chemical sunscreens, which make up the majority of those sold, break down in the sun and need to be reapplied every two hours – something the majority of wearers forget to do. For more effective protection, Dr. Linfante recommends mineral-based sunscreens.
“If you’re going to use a sunscreen for places that see the sun every day, like your face and ears and neck, use a tinted sunscreen or just a plain zinc or titanium sunscreen, because those will last a lot longer,” he says.
Prior to joining UTMB’s Dermatology faculty, Dr. Linfante completed a dermatopathology fellowship. His practice includes treatment for all types of skin cancers, beginning with a biopsy to diagnose a potential anomaly.
Melanoma is graded on thickness, and even a very thin melanoma that has not broken through the second layer of skin must be excised. Dr. Linfante typically performs these procedures in office under local anesthesia. In cases where the cancer has spread to the lymph nodes, he refers to surgical oncology.
“So the goal is to catch them when they're very, very early, and they just require a relatively small excision,” Dr. Linfante says.
Although most people will never have a melanoma, he notes that individuals who have a lot of sun exposure – especially those who are fair-skinned and living in a sunny area like the Houston-Galveston region – are likely to develop a precancer by the time they reach 50 or 60.
“Getting a skin check around 50 years old without any risk factors or concerning features is a good idea, and then we'll be able to kind of stratify at that point, do I need to see you back in six months, 12 months, two years?” he says. “Generally as you get older, you start accumulating more sun damage so the interval for follow-up becomes shorter.”
Learn more about Skin Cancer Awareness Month from the American Academy of Dermatology.
 | Anthony Linfante, MD, sees patients at UTMB Health Dermatology Clinics at the UHC in Galveston, Stewart Road in Galveston, and at the General and Cosmetic Dermatology Clinics at Town Center in League City. Learn more about Dermatology services at UTMB. |