SAVE YOUR SKIN

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MELANOMA NEARLY KILLED ME and my unborn child. Fortunately, I got to a dermatologist in time, and my doctor was able to deliver my baby early and save my life. These are the lessons I've learned from that frightening experience. Heed them today and you'll…

I Was 33-years-old and seven and a half months pregnant when I found out I had melanoma, the deadliest form of skin cancer. I'd been visiting relatives in 2003 when I absentmindedly scratched a mole on my arm. My sister-in-law noticed. "That looks terrible," she told me. "You should have it checked out right away." I did — and the verdict was melanoma. Things moved fast after that. I had to deliver my baby a month early so I could have the cancer removed in order to save my own life.

Since then, I've had another serious melanoma on my face, and three more pre-melanomas on my face, back, and arm, all of which required surgery. Doctors think my skin is more vulnerable to cancer because of the light treatments I had as a child for psoriasis. My story is scary but it could have been worse. Follow these rules to make sure you stay safe.
Check for Moles

Scan your body for suspicious moles and other skin irregularities (like persistently dry patches) every two to three months after showering. If you have no risk factors (see "Skin Cancer: The Basics," below), have your family doctor check your skin as a part of a complete physical exam (the American Cancer Society does not currently advise screenings by a dermatologist for those at low risk).

Why: "Early detection is the key to surviving," says Susan Boiko, M.D., of the American Cancer Society.

Get started: If you have risk factors, establish a timetable with your doctor for regular screenings, which involve a two- to three-minute visual inspection as well as questions about your sun habits and family history of melanoma. (For do-it-yourself screenings, see "Mole Patrol," opposite.)
Start Young

Limit your children's time in direct sunlight to the morning and late afternoon (before 10 a.m. and after 4 p.m.), apply sunscreen, and dress them in protective clothing, including a hat, in spring, summer, and fall.

Why: Sun exposure in childhood raises the risk of developing skin cancer, including melanoma, as an adult.
Wear Sun-Proof Clothing

If you're at high risk, wear clothing specifically designed to protect your skin from the sun. (See above: sun-proof hats:T2, $69; tilley.com; and sun-protective clothing: Dryflylite sleeveless shirt, $54; exofficio.com; Sun.Life convertible pants, $44.50; landsend.com). For everyday wear, choose tightly woven fabrics, tops in dark colors (they're better at blocking the light), and hats with three-inch brims.

Why: Light-colored (unless designed specifically to block the sun) and loosely woven fabrics offer little sun protection.
SKIN CANCER:THE BASICS

NON-MELANOMA: Basal cell carcinoma and squamous cell carcinomas are the most common forms of skin cancer — affecting more than one million people a year — and can easily be removed with various outpatient procedures.

MELANOMA: This much more serious form of skin cancer affects fewer people — 62,000 people (8,420of whom died) in 2008, according to estimates by the American Cancer Society — but is potentially fatal because it can spread to other organs and can appear anywhere on the body, not just on sun-exposed parts.

INCREASES IN SKIN CANCER: The incidence of melanoma in women under age 40 has jumped by 50 percent since 1980, according to research by the National Cancer Institute. And incidence of non-melanomas has more than doubled among young women in the past 30 years, according to Mayo Clinic data. Experts chalk it up to women dressing more scantily and using tanning beds, which have been shown to increase risk. New research shows that women who undergo Hormone Replacement Therapy (HRT) for menopause symptoms may be twice as likely to develop melanoma.

THE RISKS: Your risk is higher if you are Caucasian and older than 20 and have these factors, according to experts:

* Fair skin, blond or red hair, light-colored eyes, and you freckle or sunburn easily
* Repeated sunburns Excessive sun exposure (e.g., you work outdoors or live in a sunny or high-altitude region) History of using tanning beds, which emit UV rays
* Many moles or abnormal moles (use the ABCD guidelines, opposite) or large pigmented birthmarks, around 20 centimeters in diameter
* A personal or family history of skin cancer or precancerous legions, or breast or ovarian cancer
* A weakened immune system from HIV/AIDS or leukemia, or from taking immunosuppressant drugs
* Fragile skin (e.g., skin burned, injured, or treated for psoriasis or eczema)
* Frequent exposure to industrial chemicals

If you're at high risk for skin cancer, limit your overall time in the sun, especially between 10 a.m. and 4 p.m., when UV rays are strongest.
MOLE PATROL

When screening for moles, follow this ABCD system from the American Cancer Society:

ASYMMETRY: one side looks different from the other

BORDERS: irregular, notched, scalloped, or otherwise indistinct

COLOR: more than one shade

DIAMETER: larger than a pencil eraser

Plus: Note changes in the texture of a mole (scaly, oozing, crusty, or bleeding), changes in the skin around the mole (redness, swelling), or any moles that start itching or feel tender or painful.

Get started: For infants under six months, skip the sunscreen, which hasn't been tested on babies; opt instead for complete shade.
Eat Foods that Fight Skin Cancer

Pile your plate with generous amounts of cooked tomatoes, colorful fruits and vegetables, green leafy vegetables, fatty fish, and dark chocolate.

Why: Studies show that the antioxidants in these foods can heighten your body's natural SPF, says Wilhelm Stahl, Ph.D., of Heinrich-Heine University in Dusseldorf, Germany. "Antioxidants scavenge the free radicals that are formed as a consequence of UV exposure," says Stahl. While this "internal sunscreen" will give you a natural SPF of only about two or three, the cumulative effect may be significant over time.

Get started: Eat at least five daily servings of antioxidant-rich fruits and vegetables (like watermelon, berries, and peppers). Add tomato sauces — cooking tomatoes releases extra lycopene, a powerful antioxidant — to meals. Indulge in one or two squares of dark chocolate, and drink at least one cup of green tea (steeped for three to five minutes) daily. Finally, eat two servings a week (one serving is three ounces) of cold-water fish like salmon, anchovies, or sardines, or take 500 milligrams (or up to .5 grams) daily of a fish oil supplement.
Keep Your Blood Sugar Normal

Avoid white bread, white rice, and processed, foods made with refined sugar, and reduce the amount of saturated fat (found in butter, cheese, and red meats) you eat every day.

Why: A 2007 Swedish study has linked high blood sugar to increased risk of malignant melanoma. In a landmark study, in 1995, at Baylor College of Medicine in Houston, people who'd been treated for non-melanoma skin cancer managed to slash their risk of developing new precancerous skin growths by 75 percent simply by lowering their intake of saturated fat from 36 percent of their total calories to 20 percent.

Get started: Take a quick blood test at. your doctor's office to find out if your blood sugar levels are high, and talk to your doctor about ways to bring those levels down if necessary. Replace high-fat dairy products with low-fat options, and choose lean meat and fish over red meat.
Exercise to Boost Immunity

Partake in physical activity (run, walk, cycle, swim, practice yoga or martial arts) every day.

Why: Exercise boosts the immune system, keeping inflammation in check, and encourages problem cells to self-destruct. A 2006 study from Rutgers University found that mice that ran on a running wheel developed 30 percent fewer tumors — and smaller, slower growing tumors — when exposed to UV light than mice without a running wheel in their cage. Statistics show that the risk of all types of cancer, including skin, is higher in people who are obese.

Get started: Exercise 30 minutes every day, preferably indoors or during non-peak sun hours, and always with full sun protection (wear long sleeves, sunscreen, and a hat). Also, try to maintain a healthy body weight, which is considered to be a body mass index of up to 24.9 (go to cdc.gov/healthweight/assessing/bmi).
Get Enough Vitamin D

Be sure you're not deficient in vitamin D. Women need between 200 and 1,000 International Units (IU) of vitamin D daily, according to the National Academy of Sciences. The National Osteoporosis Foundation recommends even higher amounts: 400 to 800 IU per day for adults up to age 50; 800 to 1,000 IU per day for adults over age 50.

Why: Recent reports suggest that getting vitamin D from sun exposure may prevent the development and spread of cancers, including skin cancer. One advocate, Edward Giovannucci, M.D., a Harvard University professor of medicine and nutrition, has suggested that the health benefits of vitamin D from sunlight far outweigh the risks. He believes that for every one person who migh develop skin cancer from sun exposure, some 30 other deaths could be prevented.

Get started: The most efficient source of vitamin D is sunshine — our skin synthesizes the vitamin in response to the sun's rays hitting our skin — but sunscreen blocks that process. Should you skip the sunscreen? Not if you plan to be outside for more than 15 minutes, says Marji McCullough, R.D., a nutritional epidemiologist with the American Cancer Society. "Just walking to your car or tc the mailbox three times a week — called 'incidental exposure' — should give you plenty of vitamin D if you have light skin." (People with darker skin need ten times more exposure because their skin has more melanin, which shields the sun's rays.)

Take a test. Talk to your doctor about getting tested for vitamin D deficiency. If the test is positive, up your intake through food (salmon, tuna, fortified drinks) and consider taking vitamin D3 supplements.

LEARN MORE: For additional expert-backed skincare tips, see nattfrtilheqlthmag.com/sunscreencontest.
Use Broad-Spectrum

Sunscreen

Read labels and choose a sunscreen termed "broad spectrum" with an SPF of 30 or higher.

Why: Most sunscreens block UVB rays, which cause sunburn. Broad-spectrum sunscreens also protect your skin from UVA light, which is responsible for tanning and aging.

Get started: The FDA recently proposed new standards for sunscreens, including a four-star rating system to indicate how well they filter UVA light. Until the new labels appear on products, check the ingredient list for Avobenzone (Parsol 1789), Oxybenzone (Eusolex 4360 or Escalol 567), Mexoryl, or Helioplex, or the natural ingredients titanium dioxide or zinc oxide, which physically block both UVA and UVB.

First-rate formulas: Protect yourself further with a formula that contains antioxidants (like vitamins C or E), which reduce free-radical damage.

Apply liberally: If you aren't using a physical sunblock,you'll need to apply sunscreen at least 20 minutes before heading out, even on cloudy days. Reapply after about two hours — once sunscreen is absorbed, it's no longer effective and may make skin more vulnerable. Also, reapply after swimming or sweating; perspiration may make skin more likely to burn.

Look for: Aveeno Positively Ageless Sunblock Spray SPF 50 ($11; at drugstores), Burt's Bees SPF 30 Chemical-Free Sunscreen ($15; burtsbees.com), or John Masters SPF 30 Natural Mineral Sunscreen ($32; johnmasters.com).
Early detection is key to surviving skin cancer. Make it a habit to scan for suspicious moles every two to three months. Brightly colored fruits and vegetables — like watermelon, berries, cooked tomatoes, and peppers — contain antioxidants that can protect your skin from sun damage. Slather on generous amounts of "broad-spectrum" sunscreen before you go out — even on cloudy days.

PHOTO (COLOR)
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By Meredith Leibson and Aviva Patz

Still-life photography by Keate

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