Transcript Healthy Skin

Healthy Skin
Valerie Dzubur EdD APRN-FNP-BC
Samuel Merritt University
Originally developed by Dr. Cecily Cosby for FNP
Objectives
• Skin Cancer Prevention
• Skin Cancer Screening
• Skin care
Epidemiology
• 2 million people with a new diagnosis annually
• More than breast, prostate, lung, and colon combined
• 1 in 5 Americans will get skin cancer
• 2004 direct cost 1 billion dollars basal and squamous
• 90 % aging skin & cancer due to sun exposure
• 10k deaths per year (8.5 melanoma)
• Most common and most preventable form of cancer
Sun Exposure
• Lifetime UV Exposure in the United States
• Age of Average Accumulated Exposure*
• 1-18
22.73 percent
• 19-40
46.53 percent
• 41-59
73.7 percent
• 60-78
100 percent
Skin Cancer Prevention
• Primary
• Counsel on sun avoidance
• Secondary
• Screen for lesions with malignant features
• Refer
• Tertiary
• Remove precancerous lesions such as actinic keratoses
and suspicious moles
Skin Cancer Prevention
• The Sun
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Damages the DNA
< 6 mos old no direct sun exposure
Children avoid sunburn
Children get melanoma too
24 hours for sun burn to appear
Even children with darker skin need sunscreen
Clouds don’t block sun exposure
Skin Cancer Prevention
• Avoid mid-day sun 10 am – 4 pm
• Use SFP 15 or > (blocks 95% of the suns rays)
• Block some UVA, most UVB
• Protective clothing
• Quit smoking
• Avoid industrial carcinogen exposure
• Avoid tanning lights
Healthy Skin
• Sun Screen
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Absorbs scatters or reflects light
Apply 30 minutes before exposure
Use adequate amounts
Re-apply every 2 hrs
Expiration - 3 yrs
Skin Cancer Screening
• Asymmetry
• Borders
• Color variegation
• Diameter => 6mm (pencil eraser or larger)
• Elevation / Evolving
• Low degree of suspicion for biopsy
Skin Cancer
• Melanoma
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Vast majority caused by ultraviolet radiation
Incidence in increasing & in under reported
68,720 new dx
3 % of skin cancer & 75 % of the deaths
Early detection is key
Punch biopsy is simple send for pathology
One blistering sunburn in childhood 2 x the risk
5 or more sunburns at any time doubles the risk
Melanoma
• On the rise both in terms of rates and death
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1930
1980
2004
2015
1 in 1,500
1 in 250
1 in 65
1 in 50
Pictures
Skin Cancer
• Basal Cell
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2.8 million BCC diagnosis annually
If allowed to grow can be disfiguring
Tx – removal
40 – 50 % of Americans who live to 65 yrs-old
Skin Cancer
• Squamous Cell
• 700,000 dx annually
• 2,500 deaths
• Actinic Keratoses all becomes cancer
Skin Cancer
• Ethnicity
• Asian, African America, Latino
present with more advanced disease
• Death rate from melanoma is higher
• Skin lesions presents on non-sun
exposed areas
• Palms, soles of feet, nails, mucous
membranes
Skin Cancer Screening
• Identify high risk patients
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Light hair, blue eyes
Inability to tan
Smoking
Immunosuppression
Intense, intermittent sun exposure
Industrial carcinogen exposure
Working outdoors
History of sunburn
• Family History of melanoma
Acne
• Prevention
• Early Treatment
• Quality of life
• Self Esteem
• Prevent Scarring
• Refer to dermatology for Rx acutane
Skin Care
• Big Business
• Acne preparations
• Care Products
• Cleansers
• Moisturizers
• Make-up
• Anti-aging
• Alpha hyrox
• Glycolic acids
• Retinoic acids