Dermatologist rains on sun addicts

Dr. Sylvia Owen, Kalispell's newest dermatologist, has bad news for her patients addicted to the sun.

"You can't get a new set of skin," she said.

At best, sun worshippers end up with leathery, wrinkled skin that even laser surgery can't make perfect. At worst, they could die from melanoma, a type of skin cancer.

"That's why I spend hours on my soap box, trying to get people to take care of their skin," Owen said.

The dermatologist moved her soap box in July from Bend, Ore., to join Drs. David Murdock, Kathryn Hansen and Thomas George at Dermatology Associates in Kalispell.

Bend's exponential growth, plus the draw of Montana's great outdoors, convinced Owen to accept Murdock's invitation to join the practice. She had no shortage of possibilities.

"There's a nationwide shortage of dermatologists," Owen said. "Dermatology is one of the hardest specialties to get into."

As an example, she said Duke University Medical Center, where she trained, accepts only three residents a year in dermatology.

Along with fewer specialists and doctors retiring earlier, an increased patient load has added to the long waits nationwide for appointments with dermatologists.

An increased awareness of skin cancer and aging Baby Boomers explain the flood of patients, Owen said.

"I'm happy that people are coming in earlier," Owen said.

But she isn't happy diagnosing skin cancers among increasingly younger patients.

"I'm seeing women in their 20s and 30s getting skin cancers," she said. "There's a huge increase in the number of people under 40."

Along with sunbathing, Owen said tanning beds play a role in the increase in youthful cancers.

She said she finds skin cancers in unusual places, such as on breasts.

Most often, she said cancers appear on the face, neck and arms. The reason, Owen said, is long-term, chronic exposure to the sun.

"The sun is the number one way we abuse our skin," she said.

That's why the dermatologist spends a lot of time giving sun-protection tips to her patients and exploding myths that endanger people's health.

The No. 1 myth many patients believe is that sunscreen completely protects their skin.

"They think they can put on sunscreen and go out in a bikini all day long, and they'll be fine," Owen said.

She recalled a number of patients with terrible sunburns after the recent air show. Many were shocked because they thought sunscreen was all they needed.

"Sunscreen is only one part of sun protection," Owen said. "It's a tool, but it's not perfect. It cuts down on how much sun you get."

For days spent mostly outside, Owen recommends seeking shade whenever possible and wearing pants, hats and long-sleeved shirts.

Several companies, such as Columbia, REI and Solumbra, sell clothes designed to deflect the damaging rays.

Owen often runs into resistance to the concept of wearing more, rather than less, clothing on sunny days.

"People use the excuse that they're too hot," Owen said. "But if you have at least a short-sleeve shirt, you'll be cooler because you have some shade for your skin."

For areas not protected by clothes, the dermatologist recommends a sunscreen with a sun-protection factor of 30.

The Academy of Dermatology recommends a sun screen of at least SPF 15, Owen said. But for this altitude of 3,000 feet, she said SPF 30 represents a happy medium.

"The higher the altitude, the more UV rays you get," she said.

Although SPF numbers higher than 30 offer more protection, Owen has noticed those thicker creams and lotions don't spread as well, and people don't get the coverage they need.

Owen recommends that people apply sunscreen as part of their daily routines, like brushing their teeth and shaving.

"I put it on in the morning," she said.

New products, such as daily facial moisturizers that contain sunblock, make the process easier than ever. Owen recommends applying sunscreen to face, neck and arms even on days spent mostly inside.

"Another myth I'd like to dispel is that 80 percent of skin damage is done by the time you're 18," she said.

That notion, Owen said, was a conclusion from an early study that has been supplanted by new research on sun damage.

"It really is the total dose (over a lifetime) that matters," she said.

Owen still hears from patients about another controversy started when an endocrinologist said sunscreen caused skin cancer by blocking rays needed by the body to create vitamin D.

She said that incidental exposure to sunlight for five minutes, three times a week, is all the sun needed for vitamin D production. Also, many foods, such as milk, have vitamin D added.

No study ever proved sunscreen is harmful, she said.

"We know sun causes skin cancer," Owen said. "That's like falling off a log."

Fortunately, she said most skin cancers are the nonmelanoma varieties of basal or squamous cell carcinomas. Even melanoma, the most deadly skin cancer, responds to treatment if found early.

"Most melanomas we pick up are fairly thin," Owen said.

If melanoma is left to grow and deepen unchecked, it may spread through the body.

"We don't have good treatments for advanced melanoma," she said. "Chemotherapy and radiation aren't very effective."

Owen urges people to get a mole checked out if it grows or changes in a significant way.

"Look for the ugly duckling, a mole that doesn't look any other mole on your body," she said.

Brochures from the American Academy of Dermatology say to look for moles or lesions of the skin:

-With asymmetry where one side doesn't look like the other.

-With an irregular, scalloped or poorly defined border.

-With color varied from one area to another with shades of tan and brown, black or sometimes white, red or blue.

-With diameters larger than 6 mm as a rule (the diameter of a pencil eraser).

Because of the dermatologist shortage, Owen said that people concerned about a mole may wait several months for an appointment in the Flathead Valley.

"Because of where we live, ask your regular doctor to do an initial check," Owen said.

She said most family doctors can perform biopsies on moles.

By having a yearly skin check and dressing to deflect UV rays, Owen said people receive a double dividend of avoiding cancer as well as wrinkled, sun-damaged skin.

"I'm an outdoor person - I don't tell people to stay inside," Owen said. "I just think you have to be sensible."

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.