Summer Sun Exposure Puts You
At Higher Risk For Skin Lesions

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

I relocated to Austin from California to get married. It was a pleasant drive-until I arrived in Texas to 106-degree temperatures. The mercury shot up to 112 degrees, and, thinking I had moved to hell I contemplated canceling my wedding. Topping it off—I’d gotten sunburned on my thighs while driving.

I’m a brown skinned African American. I had never sunburned! I had been under the mistaken impression that my dark complexion provided me substantial protection from the sun’s harmful rays. I was wrong.

The sun’s rays have devastating effects on our skin. Dermatologists continually warn against excessive sun exposure and artificial tanning. Everyday I still see folks with their skin exposed to the sun and these hazards:

Freckles- Small flat brown marks are seen on the face and other sun-exposed areas of the body, primarily in children and in fair skinned people, especially those with red hair who have an inherited predisposition for them. Their color is due to pigment accumulating in skin cells. They’re more prominent in summer and fade or disappear in winter when new cells emerge. To reduce their appearance, avoid prolonged sun exposure.

Solar Lentigines-Commonly referred to as age or liver spots, they are the result of pigment accumulated in skin cells. Larger than freckles, they appear on the face and hands during middle age. They may fade in winter but won’t disappear. They’re more common in the fair skinned, but are seen in all skin types. The best treatment is prevention. Avoid excessive sun exposure, wear light colored, reflective clothing and sun block of SPF thirty or higher containing avobenzone, dioxybenzone, oxybenzone, titanium dioxide or zinc oxide.
If you’re faced with solar lentigines, (no pun intended) anti-aging creams containing hydroquinone or antioxidants like alpha hydroxy acids, vitamin C, retinoids and azelaic acid can help fade the lesions. They’re more effectively removed by chemical peels, cryotherapy (freezing) and laser treatments.
Seborrheic Keratoses (SK’s)- SK’s are the large brown, barnacle looking lesions appearing stuck onto the face, arms and trunks of older individuals, usually males. Although unsightly, they are not precursors to cancer. They are the result of lifetime sun exposure. There’s no medical reason to remove SK’s. They often become a nuisance (catching on clothing or jewelry) but most people have them removed for cosmetic reasons with cryotherapy or laser therapy.

Actinic Keratoses (AK) – These precursors to skin cancer occur in fair skinned individuals with lifetime sun exposure (outdoor workers, recreation enthusiasts). They manifest in the fourth and fifth decades, but in warm sunny climates, they’ve been seen in teens and twenty some things. AK’s are almost never seen in blacks or East Indians.

AK’s result from disruption of skin cells in the outer layer, the epidermis. Ultraviolet rays cause the cells to distort damaging the deeper layer, the dermis. AK’s can progress to Squamous Cell Carcinoma. They’re easily removed with cryotherapy, laser treatments or topical medications.

Squamous Cell Carcinoma (SCC)- This second most common skin cancer affects 250,000 people annually. Along with sun exposure, SCC can be the result of Human Papilloma Virus (the virus responsible for genital warts), immunosuppressive drugs, chronic skin ulcers, prior x-ray treatment for acne, arsenic ingestion and toxic exposure to tars and oils.

SCC looks like crusted, scaly patches on inflamed red bases that just won’t heal. Found on sun-exposed areas of the face, neck and extremities they’re also found on the genitalia. They’re treated with laser or cryotherapy, surgical excision, “Mohs” surgery or electrodessication and curettage (burning and scraping). Untreated SCC can spread and is responsible for 2500 deaths each year.

Basal Cell Carcinoma (BCC)-This most common skin cancer affects 800,000 people annually. BCC’s arise from basal cells, the bottom cells of the epidermis. In addition to sun exposure, toxic chemicals and radiation, prior scars, vaccines and tattoos can cause BCC. Fair skinned people and older men are at greatest risk but in recent years BCC among women and younger people has risen steadily.

BCC’s presents as open sores, red patches, pearly papules, pink growths or scar-like patches. BCC’s can have extensive borders within skin layers and are best treated with surgical excision.

Melanoma - A serious form of skin cancer accounting for eighty percent of all skin cancer deaths. It arises from the melanocytes, the pigment producing cells in skin. Melanomas can occur from pre-existing moles that suddenly change or from new moles, appear brown, black, red, white or blue with irregular margins. Having moles and a family history of melanoma are risk factors not related to sun exposure.

Melanoma is highly invasive and readily metastasizes to other organs. Determining how deep the melanoma extends indicates how readily it will spread. Treatment consists of surgical excision and radiation or chemotherapy as indicated. Early detection is critical and melanomas caught early can be cured. People at risk for melanoma should check their skin regularly looking for new moles or sores and should be regularly examined by a dermatologist.

Darline Turner-Lee now protects her skin from sun exposure. Share your sun protection secrets with her at