Tuesday 22 January 2019

Ask our GP: I used sunbeds and now I'm worried I have cancer

Sun smart
Sun smart

Nina Byrnes

Q. I was a regular user of sunbeds throughout my teens and twenties, which I now deeply regret.

Now that I'm in my forties, I find myself continually anxious about my skin and worried that I might be developing skin cancer. I did have one growth on my back checked out a few years ago and thankfully the biopsy showed that it was benign. Back then, my GP advised me to keep checking my skin regularly but my back is covered in moles and freckles, as are my legs and arms, so to be honest, I don't even know where to start in monitoring it. Are there any reliable tests I could use or what is the best way to keep track of changes to my skin? The anxiety is making me sick.

THE World Health Organisation has classified UV rays from the sun and artificial devices as carcinogenic. The UV radiation in sunbeds damages skin and is a major risk for skin cancer. Radiation from sunbeds can in fact be over 10 times stronger than that of a midday hot Mediterranean sun.

If you have ever used a sunbed, your risk of melanoma is increased by 20pc. Those who first use a sunbed under the age of 35 have a nearly 60pc increased risk of skin cancer. Regular use under the age of 30 increases it by over 75pc. The increased use of sunbeds in younger women means that melanoma has surpassed cervical cancer as the most common cancer occurring in this agegroup.

Overexposure to the UV rays is the major risk for the development of skin cancer. Children are born with few or any moles but new ones may develop up to the age of 40. Normal moles do change. They start flat then may rise over time before flattening out again and sometimes disappearing.

Skin cancer can occur on all types of skin. Those with fair skin, a personal or family history of skin cancer, excessive UV exposure, whether from sunlight or tanning beds, a history of blistering sunburn, especially in childhood, the presence of lots of atypical moles on the body, weakened immunity, and previous exposure to chemicals such as tar, petrol products, arsenic and soot are at an increased risk of developing skin cancer. The majority of native Irish people are classified as having fair skin, which immediately puts us at a higher risk of skin cancer. It takes 20 to 30 years for skin cancer to develop but damage is often done in childhood. Tanned skin is damaged skin. There are two main types of skin cancer: non-melanoma or melanoma. Non-melanoma cancer is more common, affecting just over 6,000 Irish people a year. These cancers rarely

spread but can invade skin locally. Basal cell carcinomas and squamous cell carcinomas are types of non-melanomatous skin disease. Melanoma is potentially fatal and affects approximately600 Irish people a year. It can spread to other parts of the body such as the lung, liver and brain. Being vigilant about your skin is your best protection. There is no test for skin cancer. The first sign of melanoma may be a change in an existing mole or a new, atypical mole appearing. When looking at moles, there are a few important points to consider. This is referred to as the ‘ABCDE’ classification. A stands for asymmetry. Does the mole have an irregular shape or two different halves? B is for border. Are the edges notched or scalloped? C is for colour. Are there more than two colours or uneven distribution of colour within the mole? D is for diameter. Is it growing or changing in size? Finally E is for evolving. Are there new changes such as crusting, bleeding or itching? Most moles appear before the age of30. Any new mole appearing after this carries a higher risk of abnormality and should be watched closely for the signs above. If you have a large number of moles, it is worth having an annual check-up with a skin specialist. They can use a special light called a dermatoscope to look deeper into the moles and can arrange removal of any that concern them.

Make sure you have adequate levels of vitamin D in your blood. Studies suggest normal vitamin D levels have a somewhat beneficial effect in hose diagnosed with melanoma. A supplement is probably the safest way to get this.

Do not use tanning beds, ever. Check your skin top to toe once a month, report any changes to your doctor. For more, see cancer.ie/sunsmart.

Q. I’ve noticed my six-year-old has very dark orange, sometimes brown, ear wax. It never used to be that colour and I’m wondering why. She has never had an ear infection

Dr Nina replies: The glands that line the outer part of the ear produce earwax. After wax is produced, it slowly makes its way along the ear canal to the outside, where it ultimately falls out or is washed away during bathing. Wax performs a number of important functions. It keeps the ear canal moist, thus preventing dry and itchy ears. It contains chemicals that protect the skin of the ear from infection. Lastly it traps dust, dirt and debris in the ear, preventing them from reaching the eardrum.

The build-up of earwax is a very common complaint and it occurs for no particular reason. Wax in the ear can feel uncomfortable and cause a blocked sensation or reduced hearing. When this occurs, many people scratch or poke at the ear using cotton buds, their fingers or even smaller items such as paper clips and tooth picks to try and clear the blockage. This is a bad idea.

Earwax varies from pale yellow to darker brown in colour. Wet wax tends to be lighter, whereas older, dry wax tends to be darker. The change in colour of wax isn’t of any health significance. The only caveat would be if it were red, which could suggest a small amount of blood mixed in it.

Old wax hardens and can be difficult to remove. It is important to soften the wax before removing it. Olive oil at room temperature can soften hard wax. Put a few drops into your ear at night. Then place some Vaseline on the inside of a small plug of cotton wool before placing this in the ear. The Vaseline is a very important step as this stops the oil soaking into the cotton wool and forces it into the wax.

Do this for at least a week. The wax will soften and even liquefy and may fall out itself. If it is hasn’t, make an appointment with your GP or practice nurse who can irrigate the ear for you.

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