For example, 63% of Brazilians do not use sunscreen on a daily basis and that more or less 6 million Brazilians (about 3% of the population) do not protect themselves in any way when they are more exposed to the sun, such as on the beach, in pool, waterfall, or bathing in river or lake.
The World Health Organization (WHO) also shows worrying data. She estimates that in the year 2030, there will be 27 million new cases of skin cancer in the world, with 17 million deaths from the disease and 75 million people living with cancer, and developing countries will be the most affected.
In Brazil, cancer is already the second leading cause of death from disease, behind only the circulatory system. For the years 2018 and 2019, an estimated 165,580 thousand new cases of non- melanoma skin cancer are estimated .
According to the campaign data, the forecast for 2018 and 2019 presented a more optimistic scenario compared to the previous biennium, 2016 and 2017: there was a reduction of an estimated 10,000 cases, indicating results of the campaign.
Therefore, you also participate in and help to continue reducing these numbers. Skin cancer can be serious and lead to serious problems. So “expose yourself but don’t get burned”.
How did it come about?
In 2014, the Brazilian Society of Dermatology, inspired by the high-impact and adherent October Pink and Blue November campaigns , started the Orange December to warn about the risks of skin cancer.
Since then, in the last month of the year, the entity has carried out actions to remember how to avoid the disease and invites the population to participate in these actions through social networks, with a photo wearing an orange garment and publishing it with the hashtags #dezembrolaranja and # verãolaranja.
But, of course, the goal is not just to engage in actions, but to bring information to the population and help participants create habits to protect the skin.
SBD carries out actions that include monument lighting, to raise awareness, distribute information on beaches and parks, and distribute sunscreen. Every year, the actions aim to reach and attract as many people as possible, reflecting and decreasing the rates of skin cancer.
December was chosen because it is the summer month in the southern hemisphere. It is when people leave home and go to the beach and parks, where they are more exposed to the sun and, consequently, to the risk factors for skin cancer.
In the 2016 campaign, SBD created the mascot Super Protector to increase its children’s appeal. The character is a super hero who helps people to protect themselves from the damage of solar radiation.
In these 5 years of campaign, the initiative has the support of the Federal Council of Medicine (CFM) and the Brazilian Medical Association (AMB), it also has public agencies, health institutions and private sector companies, which give more strength to the action.
The action schedule, in December, mobilizes more than 4,000 dermatologists and volunteers to attend, consult and provide free information on the disease and prevention methods, in 132 health posts and units in several states.
December Orange Objectives
December Orange aims to raise awareness about skin cancer and the risks of uncontrolled sun exposure, without the use of sunscreens and other forms of protection against ultraviolet radiation.
Knowing about the symptoms of skin cancer is one of the main factors to protect yourself, because if it is diagnosed in advance, it is easily treatable and has lower mortality rates than other variations of the disease.
Therefore, the main objective is to reduce the cases of the disease, considered an absolutely achievable goal for the Brazilian Society of Dermatology – enough information and care.
Skin cancer
Skin cancer is by far the most common in Brazil, accounting for 30% of diagnoses of malignant tumors. It most commonly affects adults over 50, but that does not mean that younger people and even children are not at risk of developing it.
It appears more frequently in women than in men – of the 165,580 thousand new cases estimated for the biennium 2018 and 2019, 85,170 thousand will be in men, while 80,410 thousand will be in women.
It is mainly caused by continuous exposure to solar radiation, but it can also arise due to the mutation in the DNA of epithelial cells.
Therefore, there is a greater risk in the white population (60.78%), who are more likely to develop the disease due to the lack of melanin in the skin.
Despite being one of the most common types of cancer, due to advances in medicine, which allow for more effective treatment and early diagnosis, its mortality rates have decreased significantly.
Most cases are of the non- melanoma variety , so they are easier to be controlled, as they do not cause changes in the cell base.
Even so, it is essential to recognize the symptoms as soon as possible, since time is the key factor to prevent the tumor from becoming aggressive.
Signals and symptons
The signs of skin cancer are usually evident and easy to identify. Check out:
Appearance of spots and signs
The appearance of signs and spots on the skin, especially in irregular shapes, is one of the main symptoms of skin cancer.
They attract attention easily, as they appear suddenly and with remarkable characteristics of size, color and texture.
While some signs and spots appear only brownish, others appear with a higher texture and dark coloring.
Signal changes
Many signs appear and do not change over time. However, if any of them start to show changes, stay tuned. It is essential to pay close attention to changes in the spots and marks of the skin over time.
ABCDE rule
The ABCDE rule is a simple way invented and indicated to facilitate the recognition of the manifestations of skin cancer. In it, you need to pay attention to 5 physical aspects of the spots:
- Asymmetry;
- Edges;
- Coloring;
- Diameter;
- Evolution.
Thus, spots that present asymmetry, irregular edges, more than one color shade, diameter greater than 6mm and / or some type of irregular growth, have a greater chance of being a skin cancer.
If you notice any of these signs, consult a doctor.
Wounds that don’t heal
Normal cells regenerate in a short time in the presence of injuries or wounds. When they do not heal or hardly close completely, it is because they have some alteration that can be malignant.
Therefore, when noticing wounds that remain open for a long time, it should be considered as a sign of skin cancer.
Inflammation and redness
The presence of cells with malignant changes causes inflammatory reactions that can become noticeable both in signs and spots and in other parts of the skin.
In general, the inflammation occurs at the edges of the signs and is accompanied by redness, resembling a common irritation. However, unlike irritations, in skin cancer, the symptoms are uncomfortable and persistent and, instead of improving, they worsen over the days.
Risk factors
There are some factors that can increase your propensity to get skin cancer. Are they:
- Family history of skin cancer;
- Light skin, which tans little and is always reddish;
- Clear eyes;
- Light hair;
- Presence of many spots on the body;
- Recurrent incidence of sunburn;
- Freckles;
- Prolonged exposure to the sun without protection.
How to prevent
The harmful effects of radiation from the sun are cumulative and irreversible. This means that damage caused by ultraviolet rays persists throughout life, from childhood. So it is very important to pay attention to the following prevention tips:
- Avoid exposing yourself to the sun between 10 am and 4 pm;
- Use sunscreen every day, especially on the face;
- Apply sunscreen half an hour before sun exposure;
- Reapply the protector every 3 hours;
- Wear caps, hats and sunglasses with UVA / UVB lenses;
- Stay under shadows or umbrellas when you are on the beach;
- Consult the dermatologist once a year;
- Regularly observe the skin, paying attention to suspicious spots or spots;
- Keep babies and children protected from the sun – sunscreens can be used from 6 months of age.
Choose the right sunscreen
The minimum recommended for all skin types are sunscreens with SPF (Sun Protection Factor) 30 or higher, and lighter skins that are redder more easily should be treated with higher SPF.
In addition to the factor, the filters are differentiated by their presentation. Check out:
Spray
They are ideal for people with oily skin, as they do not leave that greasy aspect on the skin. They have a good protective film, but they do not last for long, so it has to be reapplied several times.
Cream
The sunscreen in the cream version is indicated for people with aged or dry skin, as they have an important hydration factor, in addition to many having their formulas enriched with vitamins . People with and oily skin or acne should avoid using this type of filter, especially on the face, or prefer versions with a dry touch.
Gel
The gel is more suitable for people with dark skin and who have a higher natural protection. It does not have a wide protection range and has a relatively shorter fixing time. Because its formula is less greasy, it is also indicated for people with oily or combination skin.
Care in pregnancy
Pregnancy requires special care with all things. With the skin, it couldn’t be different. Especially during this period, it is important to use sunscreens with UVA protection and SPF 30 or higher and which are certified by Anvisa.
Attention should also be paid to the risks of UV radiation, such as hyperpigmentation and melasma.
In addition, pregnant women should avoid certain substances, as they end up being stored in body fat and can affect pregnancy. Are they:
- 4-methylbenzylidene camphor (4-MBC);
- 3-benzylidene camphor (3-BC);
- Octocylene (OC).
Childcare
Protection measures for children are different from those for adults and change according to age. Children under 6 months of age, for example, should not use sunscreens – in these cases, avoiding direct exposure to the sun is the most recommended.
Above that age, specific products for children should start to be part of the routine of care.
Check now some tips for applying sunscreen to your little one:
- Pass the sunscreen 15 minutes before exposure to the sun and at least 30 minutes before entering the water;
- Perform the first application at home, before putting on the clothes;
- Apply the protector to all parts of the skin exposed to the sun, without forgetting any area of the child’s body;
- Reapply the protector every 2 hours or after long immersions in water;
- Wear waterproof protectors.
It is worth remembering that the amount of product must be generous and guarantee coverage for the entire skin. A good suggestion is to apply two consecutive layers, reducing the chances of a portion of the skin being left unprotected.
Protective capsules
Another way to prevent damage from solar radiation is through “capsule sunscreens”. The use of them does not serve to discard the sunscreen, but only helps in the prevention of skin cancer.
The capsules consist of a mix of substances that, when ingested, combine with the body in preventing cancer. Some examples are the extract of Polypodium leucotomos , a botanical species, and some polyphenols such as pycnogenol. Both work by combating oxidative stress caused by radiation in cells.
In this way, the protective capsules reduce the risk of diseases related to exposure to the sun, in addition to helping to delay premature aging.
The product can be handled under medical advice or can be purchased ready-made. Its consumption should be daily, as indicated by the specialist and most of the substances have no contraindication. Even so, it is necessary to consult a health professional before starting any treatment.
Other actives with a photoprotective factor are vitamins C and E, resveratrol, green tea, beta-carotene, lycopene, lutein and probiotics.
Treatment
The treatment chosen for skin cancer will vary according to the type and extent of the problem. The earlier the diagnosis, the higher the success rate.
Most treatments are done through surgery, but radiotherapy, chemotherapy, immunotherapy and topical immunotherapeutic medications are also options, the latter of which are only indicated in cases of superficial tumors.
In cases of melanoma , surgical interventions are the most recommended, but treatment also varies according to the extent, aggressiveness and location of the tumor, as well as the age and general health of the patient.
If the melanoma is already in the stage of metastasis (when the cancer spreads beyond the place where it started), there is usually no cure, so it is important to detect the disease as soon as possible.
As not all cases are melanoma , there are different treatment options:
Curettage and electrocautery
Used only for superficial tumors, curettage and electrocauterization consist of scraping the lesion with a curette, while an electronic scalpel destroys cancer cells.
The procedure is simple, generally causing the patient to return to daily activities on the same day and complete recovery takes about 15 days.
Excisional surgery
It consists of removing the tumor and an additional healthy skin layer with a scalpel. Healthy skin is removed as a safety measure. This technique has high success rates and can be used in the case of recurrent tumors.
Cryosurgery
This technique promotes the destruction of the tumor by freezing it with liquid nitrogen, which is at -50ºC. The procedure has a lower success rate than excisional surgery, but it is a good option in cases of small or recurrent tumors, with the advantage that there are no cuts or bleeding.
Mohs Micrographic Surgery
In this type, the cancer is removed in stages, being analyzed immediately under the microscope. The procedure is repeated countless times until no traces of tumor cells remain.
The technique preserves a good part of healthy tissues and is indicated for cases of poorly defined tumors or in critical (sensitive) areas, such as the face.
Photodynamic therapy (PDT)
A photosensitizing agent is used in the abnormal cells, which can be applied on the skin (topical use) or ingested (oral use).
The substance has a strong interaction with cancer cells, binding to them. Hours later, the treated areas are exposed to intense light, which activates the photosensitizer and destroys tumor cells with minimal damage to healthy tissues.
Does sunscreen hinder vitamin D synthesis?
No. A wide variety of studies prove that the use of sunscreens has little or no effect on vitamin D synthesis.
In reality, 10 minutes of exposure to the sun, twice a week, in an area that is not normally exposed, is already sufficient for vitamin D synthesis.
It is recommended that, for vitamin synthesis without risks, the person applies protector on the face, leaving the arms and legs exposed to the sun, for a few periods of time.
