Tanning Beds, Melanoma, and Unhelpful Doctors

[MonkeyPie]

Here's a question...I am freckly, not crazy amounts, but I have plenty. There is no way I would notice a new one unless I inspected myself and drew a map every day How the heck do you tell the difference between a melanoma and a damn freckle?

I put on double sunscreen the other day and still got my face burnt to a crisp. I was pissed. I have fairly good skin (with the occasional breakout), and I have worn sunscreen daily since I was about 22. Before that? Ouch...I blistered my back at least once a summer as a kid. I wish my mom would have put sunscreen on me more often...

 

[jstarfireb]

I've rotated on dermatology in med school and was amazed at what they could diagnose just visually, without a biopsy. Their visual diagnostic skills are really incredible. So I can't say it's outside the realm of reason to diagnose you without a biopsy. I don't have specialized training in dermatology, so I don't know what you can and can't diagnose this way...and of course I haven't seen your mole, so I can't comment on how suspicious it looks.

He's also right about tanning beds. They're like cigarettes...pretty much a cancer factory. Just say no. Spray tan is much better, and even tanning in the sun is preferable (but also puts you at risk for cancer, not to mention wrinkles and discolored spots that will be apparent as you age).

What was wrong with him was his bedside manner. Even if he's right, you shouldn't have been treated that way. I'd get a second opinion from a different dermatology group if possible. Doctors in the same group may be a bit defensive about their colleagues.

ETA: OK, get a 3rd opinion! Didn't read your reply before I posted.

 

[elrohwen]

Here's a question...I am freckly, not crazy amounts, but I have plenty. There is no way I would notice a new one unless I inspected myself and drew a map every day How the heck do you tell the difference between a melanoma and a damn freckle?

I put on double sunscreen the other day and still got my face burnt to a crisp. I was pissed. I have fairly good skin (with the occasional breakout), and I have worn sunscreen daily since I was about 22. Before that? Ouch...I blistered my back at least once a summer as a kid. I wish my mom would have put sunscreen on me more often...

As a fellow freckly person, I would say that they look pretty different from even a mole. Melanoma is generally a different color and wouldn't get darker and lighter depending on your sun exposure. It would also grow and change usually, while freckles multiply (or at least they seem to) the same freckle shouldn't get much bigger.

At least that's how I see it! I do have a couple small moles that are almost freckle colored, but I can still tell the difference (they feel raised off of the skin too, which gives it away)

 

[Pandora II]

Didn't read all posts, but I think should be aware that the body can (and will) produce new moles and freckles throughout your life.

I was recently surprised to see a new mole between my pinky toe and the next toe! Very odd, but not an illness or unusual. Just ignore them, it's no big deal.

When you choose a sunblock, choose one that has UVA AND UVB protection. Don't go for a high SPF, because the UVB protection wears off quickly and SPF is measured only in UVA. UVB is actually worse for you than UVA. Choose a 15-45 SPF, reapply every 2 hours if you are in the sun for the entire time. Reapply after sweating or swimming.

DO NOT get it in your eyes! Some old formulations caused temporary blindness (2-3 days) in the eyes.

My MIL developed a skin cancer on her finger, because she ALWAYS drove with her hand outside the car, holding on the roof. But skin cancer does not always develop at the point of exposure. It can crop up anywhere. If you are worried about it, get an all-over body check once a year by a dermatologist.

But honestly, I think you're worrying too much. Just don't increase your risk with the tanning beds. Here's the stats from the skin cancer foundation:

"Indoor ultraviolet (UV) tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.

People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma."

 

[Octavia]

Thank you for the info and link RE: being allergic to sunblock!

I use a zinc oxide based sunblock that basically looks like diaper rash ointment smoothed onto my skin. lol I use that over my little base tan and I don't burn. The problem with the zinc is that it rubs off. A normal sunblock penetrates and still gives the protection. When zinc rubs off, it seems the protection is gone. So, I end up with splotchy burns. Oh, so attractive! I avoided the sun like the plague for years. In my wedding photos, my skin was nearly as white as my dress. I just haven't found a way to be outside with the kids and not burn yet. (besides having the base tan) I'm going to look into the things listed here and maybe I won't look like a handbag either!

btw-My mom used to tan with baby oil, outside, everyday, for years, in TX. That and the smoking have made her look like old luggage.

Hmm, I've never had a problem with the Neutrogena coming off too fast, though I definitely reapply after I swim or do anything really sweaty. In fact, I think it works significantly better than the chemical kind, and this was borne out when I lent my mom some when she ran out of regular sunscreen mid-application and she burned through the regular but didn't burn through mine (same SPF). Mine is TD-based, not ZO, I wonder if that makes a difference?

Anyway, for SL -- do you know if your doctor is board-certified in dermatology? You can check certification on the ABMS website. I didn't see initially that he used to be a family practitioner, so I'd be curious what extra training in derm he has done. Either way, I'd get another opinion from a certified specialist!

 

[MonkeyPie]

Here's a question...I am freckly, not crazy amounts, but I have plenty. There is no way I would notice a new one unless I inspected myself and drew a map every day How the heck do you tell the difference between a melanoma and a damn freckle?

I put on double sunscreen the other day and still got my face burnt to a crisp. I was pissed. I have fairly good skin (with the occasional breakout), and I have worn sunscreen daily since I was about 22. Before that? Ouch...I blistered my back at least once a summer as a kid. I wish my mom would have put sunscreen on me more often...

As a fellow freckly person, I would say that they look pretty different from even a mole. Melanoma is generally a different color and wouldn't get darker and lighter depending on your sun exposure. It would also grow and change usually, while freckles multiply (or at least they seem to) the same freckle shouldn't get much bigger.

At least that's how I see it! I do have a couple small moles that are almost freckle colored, but I can still tell the difference (they feel raised off of the skin too, which gives it away)

I think you're right - I found this list about moles to be worried about:
Asymmetry. One half of the mole does not match the other half.
Border. The border or edges of the mole are ragged, blurred, or irregular.
Color. The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red.
Diameter. The diameter of a mole is larger than the eraser of a pencil.
Elevation.A portion of the mole appears elevated, or raised from the skin.

 

[icekid]

Ditto OUpear and everyone else. Tanning beds are seriously awful for your skin and will absolutely increase your risk for skin cancer. Keep going if you want to but don't fool yourself into thinking otherwise.

That doctor sounds disgusting. If you can report him to someone about the inappropriate sexual comments, I would. Your sexual history is NONE OF HIS BUSINESS. If he was a gyno I'd maaaaybe give him a pass.

Actually, a sexual history is an important part of a medical history and physical. In a derm office regarding a nevus? Maybe not, and clearly this doctor was a bit off! But regardless, your PCP and gyn SHOULD be asking a detailed sexual history.

Won't reiterate about how awful tanning beds are. Melanoma is insidious. I had a patient recently who had a melanoma removed four years ago and all looked clear since then. Then suddenly on routine surveillance it was metastatic to his lungs, spine, liver, bones. No tanning beds and no unprotected sun!!! Get your vitamin D elsewhere, please.

 

[risingsun]

Your doctor is an asshat!! I have been dealing with recurrent skin cancer for the past 10 years. A melanoma can be tiny. I have had two melanomas, one was very small and other much larger. I'm a waiting on biopsy result for two more possibilties. I have also had three basal cell and one nasty squamous cell, as well. Two of these required reconstrucive plastic surgery.

I used to live near the beach and also go to tanning salons. Big mistake. There is also a heredity factor. I'm not telling you this to frighten you, but to make sure that you find a better dermatologist. A doctor who makes light of your concerns, is not the right person to see.

More than likely, your lesion is nothing to worry about, but you need to find out for sure. Your doctor should be willing to address any concerns that you have. I hope you come back and let us know about a second opinion. It these things are caught early, they is a high cure rate. My very best to you

 

[iheartscience]

Ditto OUpear and everyone else. Tanning beds are seriously awful for your skin and will absolutely increase your risk for skin cancer. Keep going if you want to but don't fool yourself into thinking otherwise.

That doctor sounds disgusting. If you can report him to someone about the inappropriate sexual comments, I would. Your sexual history is NONE OF HIS BUSINESS. If he was a gyno I'd maaaaybe give him a pass.

Actually, a sexual history is an important part of a medical history and physical. In a derm office regarding a nevus? Maybe not, and clearly this doctor was a bit off! But regardless, your PCP and gyn SHOULD be asking a detailed sexual history.

Won't reiterate about how awful tanning beds are. Melanoma is insidious. I had a patient recently who had a melanoma removed four years ago and all looked clear since then. Then suddenly on routine surveillance it was metastatic to his lungs, spine, liver, bones. No tanning beds and no unprotected sun!!! Get your vitamin D elsewhere, please.

Of course it is, but I have never been asked about my sexual history by my dermatologist or by any other doctor aside from my gyno. I can't see how a patient's sexual history is relevant to a dermatologist, unless the patient asking about a genital wart or a herpes sore.

 

[shihtzulover]

I think that I will get another opinion, just to be sure. I can't help but continue to worry about it, because I'm the type of person to research endlessly on the Internet, and I like definite answers - not being told that I'm fine (with no true diagnosis), and to just watch for growth or changes.

I understand that it looks small and insignificant, but not all melanomas start from existing moles - so all that start on normal skin must start off as little specks, and then grow. Like I said, I first noticed mine toward the end of last summer (I was in the pool, but I think it was at the end of the season), and it definitely was large enough to notice at that point. I'm not sure if it has grown since then, and if it has, it has to be pretty minimal growth, since it is 1-2 mm now. I understand that melanomas grow, but how fast? Would there be a noticeable difference by now?

I looked, and the doctor is not board certified in dermatology (just family practice), although he has been practicing there for ten years now. Before I went to him (but after I went to the nurse practitioner), I went to an online forum and paid to have a dermatologist look at pictures of it. She said that it is probably a benign ink spot lentigo or a melanocytic nevus, but that I should have it evaluated just to be sure, along with any other new moles on my body. She suggested dermoscopy, but I'm not sure if the practitioners that I went to used that - they both looked through a goggle-like device, but I have no idea what it really was. Does anyone know?

I haven't been to the tanning bed for two weeks now, and I'm too scared to ever go back - it's just not worth the risk to me. I really think that I might try a mystic tan, and then continue to go if I really like it. If not, then I will experiment with more self-tanners, and find one that works well for me.

Oh, and I certainly don't mind disclosing my sexual history to physicians if it's relevant to the examination (like during a gynecological exam, or maybe even during a general physical), but I don't believe that any doctor has the right to tell me to reconsider premarital sex, or to make comments about guys taking advantage of me or about saving that gift for my future husband. Also, it's not like I've ever been promiscuous or anything like that. According to some statistics that I have seen, I am still well below the average numbers. Honestly, I know that this particular doctor is very religious, and I guess he feels that he should share his views with others.

 

[jstarfireb]

Dermoscopy is basically looking at the skin with a microscope and identifying features of the mole that are characteristic of either a benign or malignant growth. Remember how I said derms are very good at visual diagnosis? This is part of that. Think of it as looking at your mole through a 10x loupe!

 

[shihtzulover]

Thanks! Does it sound like the goggle device that they looked through was a dermoscope?

 

[jstarfireb]

I don't think so, but this isn't my area of expertise. The dermatoscopes I've seen usually looks like little flashlights that you hold up to the skin, like the ones here:
http://en.wikipedia.org/wiki/Dermatoscopy

I've seen dermatologists use the goggles, but I'm not sure if that counts as dermoscopy or not. I think you need a special type of polarized light.

 

[shihtzulover]

Hmmm - I think that the goggles did have a light attached, but I'm not totally sure. Even so, I'm definitely not sure that they were true dermoscopes. I think that I will still make another appointment at another dermatology practice, just to make sure.

Thank you so much for all of your help!

 

[CherryBlossom]

Please watch this: http://www.youtube.com/watch?v=_4jgUcxMezM

Also remember that you have to put sunscreen on BEFORE You put lotion on and it must be 15-20 min before you go into the sun.

 

[pixies]

I'm am normally fair/pale. I have always made the effort to protect my skin outside by wearing sunblock, hats, and big sunglasses. I had tried tanning beds a few times in my teens but I just burnt so I never made it a habit. I was supposed to be in a wedding this summer (that is no longer happening). I decided to try out high-pressure tanning, which is mainly UVA as opposed to UVB. It claims to be better and allows you to tan without burning. I doubt it's any better for you, but I tried it out and I didn't burn. It takes three to five 12 minute sessions to establish a base tan, and you only have to go two to three times a month to maintain your tan. I know it is still horrrrrrrible for your skin though. I went for about two months and then stopped when the wedding was postponed. I had a hard time quitting because I look so much better with some color. I had an event in LA to attend this past week so I bought another month of tans. I thought I had broken the habit! As soon as I got wind of the event I was like oh, better go squeeze in a few tans! Ugh! I am done after this though. I'm hoping these three months of tanning haven't done too much damage. Vanity isn't worth cancer, especially when there are alternatives.

My salon also offers Mystics. I tried it a year ago, back when I was fair skinned. It took a few hours to start seeing the results. You can shower/swim after 12 hours (once it is set). It lasted five days before it started wearing off, quite unevenly I must add. My feet looked horrendous. My results were much darker than my natural skin color. I would like to try it out again now that I'm darker. I've read that it may take more than one session to get your desired results. I'd recommend it as long as you are committed to keep going with it. If you are going out of town on vacation, I wouldn't get one unless you can find a salon to get another one so you don't start looking splotchy. I've also used canned aerosol spray tan and had nice results. The brand I used is no longer made though. Spray tans require a lot of up keep to keep them looking nice. Moisturizing, touch-ups, etc. Then again, so do real tans... I'm going to start fake tanning soon so maybe I can come back with some good alternatives.

 

[beesha77]

If you're feeling depressed without sun, take vitamin D. In huge doses. I take 3000iu per day, and it has helped my mood immensely. But yes, tanning is terrible for you. Is that a serious question?

And vitamin d actually prevents cancer. You can get in the sun because your body NEEDS sunshine, but not so much that you are looking like the lady in something about mary. Seriously, avoid the tanning bed and if you want to get in the sun just go out for 20 minutes or so, then load up on self tanner.