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Johns Hopkins Bayview News - The Sun Never Sets on Skin Cancer Prevention

Fall 2013

The Sun Never Sets on Skin Cancer Prevention

By: Karen Tong
Date: October 7, 2013

Older couple walking in the setting sun
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The dog days of summer are over for this year, but sun exposure can harm your skin year round. These cooler months are a wise time to look over all of your skin, paying special attention to any moles, freckles or other growths. Johns Hopkins dermatologist Mitchell Klapper, M.D., offers some tips on what to look for and how to know when you need to see a specialist.

Skin Checks

When examining your own skin, Dr. Klapper suggests looking for non-healing sores or growing moles. “If it’s an ‘ugly duckling,’ meaning that it looks much different than others near it, then it is suspicious and needs attention,” he says.

People who had skin cancer or have a family history of it, and anyone over age 40, should have an annual skin cancer screening exam by a health care provider, such as a primary care physician or dermatologist. During this skin check, a health care provider looks for anything suspicious or unusual while examining the entire skin, not just the areas exposed to sun—even the bottom of the feet and between toes are checked.

If something abnormal is found, a biopsy often is recommended. During a biopsy, a piece of the unusual growth is removed and examined under a microscope to determine if it is normal or cancerous. “Growth doesn’t always mean cancer,” notes Dr. Klapper.

Skin Cancer Basics

There are three types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. The risk factors are the same for each one—family history of skin cancer, cumulative sun exposure over time, fair skin and having had blistering sun burns.

Basal cell carcinoma is the most common form of skin cancer, affecting more than one million people each year. It often is found on the face, has a high cure rate and rarely spreads to other parts of the body.

Squamous cell carcinoma is the second most common form of skin cancer and also has a high cure rate. It often grows faster than basal cell carcinoma and is more likely to occur in areas exposed to the sun, such as the head and neck.

The least common but most serious of the three types of skin cancers is melanoma.

“Early detection and treatment are critical,” adds Dr. Klapper. “In general, once you have had skin cancer there is an increased likelihood of developing it again, so regular follow-up is necessary.”


Dr. Klapper suggests three ways to best protect skin from the sun:

  • Limit mid-day exposure to the sun, especially from 10 a.m. to 2 p.m.
  • Wear clothing that blocks the sun.
  • Use sunscreen with broad spectrum UVA and UVB protection. Be sure to frequently reapply.

He notes, “Don’t rely on sunscreen without changing other behaviors. You also need to wear a hat and find some shade whenever possible.”

To make an appointment for a skin cancer screening exam, call 410-550-0503. For more on dermatology at Johns Hopkins Bayview, visit


A mole, sore, lump or growth on the skin can be a sign of melanoma or other skin cancer. A sore or growth that bleeds, or changes in skin coloring, also may be a sign of skin cancer. Believe it or not, melanomas can arise in unusual locations, such as the feet, hands and under the nails, especially in people with dark skin.

The ABCDE system can help you remember possible symptoms of melanoma:

  • Asymmetry: One half of the abnormal area is different from the other half.
  • Borders: The edges of the growth are irregular.
  • Color: Color changes from one area to another, with shades of tan, brown or black, and sometimes white, red or blue. A mixture of colors may appear within one sore.
  • Diameter: The spot is usually (but not always) larger than 6 mm in diameter—about the size of a pencil eraser.
  • Evolution: The mole keeps changing appearance.

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