Health This past winter, as I sat onmy balcony in Florida looking down on the pool area, I was surprised to see a number of regular senior “sun worshippers” lying in their bathing suits on their chaise lounges. Judging by the darker skin I could see, they probably used limited or no sun block. In spite of all the warnings of damage to the skin, as well as the risk of skin cancer, they seemed to be oblivious to the risk of this behaviour. As we age, we are already at increased risk for many skin conditions and there are many that can be either prevented or successfully treated if diagnosed as early as possible. For snowbirds, who are often away from their regular health-care providers for many months, assessment of any suspicious skin condition should take place before departure since most insurance policies would not cover deteriorating conditions during their trip. If rashes or abnormal skin lesions develop while away, before seeking medical attention, phone contact should be made to one’s insurer for direction. If a suspicious lesion is determined by a doctor to require a biopsy before the trip is ending, the insurer must be notified to co-ordinate that surgery while still away, or upon repatriation. There are many changes to the skin which occur as we age that, to various degrees, affect us all. Skin wrinkles and age spots are the most common. Both are more significant in persons who have had lots of unprotected sun exposure during their lives, as well as in smokers. As skin loses its elasticity and becomes thin, it is likely to be more easily injured. Skin bruising can occur more often, especially with persons on low-dose aspirin or oral anticoagulants. Skin can become itchy and dry but, for most persons, can be managed with moisturizing creams and limiting bathing. The more significant conditions requiring specific diagnosis and treatment should be seen early, in order to improve outcomes. While there are hundreds of skin diseases that are possible, the most common ones in our age group are discussed below. Basal cell cancer is the most common type of skin cancer, with an estimated 10,000 new cases per year in Canada. It is also the most benign, growing locally only and not spreading to other parts of the body. As with all skin cancers, thinning of the ozone layer and excessive unprotected sun exposure are the most common causative factors, the tumours appearing on parts of the body that are exposed to the sun…especially the face. The first appearance may look like a small bump that is usually flesh coloured andmuch like a skin-coloured mole, which can grow slowly and turn darker or develop shiny pink patches. Diagnosis should be made early and treatment is usually surgical excision. Squamous cell cancerof the skin, although less common, is more serious as this cancer can spread to other parts of the body. On sun-exposed areas, it usually appears initially as a bump or a scaly red patch of skin. It can become crusty, rough, ulcerated and may easily bleed when disturbed. This tumour should be treated early before size and spread adversely affect the outcome. Treatment is usually biopsy, followed by complete excision. Melanoma is the most serious type of skin cancer and demands early diagnosis and treatment before spread occurs. Melanoma can occur on any area of the body including armpits, backs and soles of feet. It initially appears as a new mole or one already there that shows changes. These initial changes include a change in the colour, size or shape of the mole. SKIN CONDITIONS Prevention and Cures by Robert MacMillan, MD 32 | www.snowbirds.org
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