Tuesday, July 31, 2007

pale is the new tan

I came back from my trip to California with something completely unexpected, despite the fact that I’ve lived there my whole life and I shouldn’t be surprised. I came back with a tan. I didn’t think it was that obvious, but on my first day back in the office, everyone was telling me that I was ‘glowing.’ The most common compliment I received was, “You look so good with some color.” Really? Do I look that different?

I didn’t purposely go looking for a tan. The tan found me. Normally, I’m pretty good about wearing sunscreen and carrying it around with me when I know that I will be out in the sun for most of the day. I make sure to buy lotions and make up with SPF in them. But I forgot to wear sunscreen on days that were overcast. Silly me! It may be cloudy out there but you can still get a tan (or a burn if you’re so inclined). Even Jesse got some color, which he really doesn’t like.

Do you know what a tan is? There are cells in your skin called melanocytes which produce melanin, a chemical that produces your skin color. Whenever you skin is exposed to sunlight, the melanocytes work over time to produce melanin. The melanin absorbs the UV radiation from the sunlight to protect your cells from damage. Each time your skin becomes tanned or burned, damage is done to individual skin cells and DNA. Some cells die and some repair themselves by getting rid of the damaged DNA. Cells that cannot repair themselves, eventually become defective cancerous cells.

Now that the science lesson is over, I should tell you that I wasn’t always anti-sun-exposure. In fact, I didn’t begin to question how much sun I got until 2004, when I noticed that a mole on my leg (that I had had my entire life) no longer looked so normal. You see, my brother, sister, and I all have tiny moles all over our bodies. They’re not the giant, hairy kinds. They’re little brown spots that my mom calls pequitas or ‘little freckles.’ It wasn’t uncommon for me to see a new brown spot on my skin and think nothing of it.

I had done a paper in grad school on sun exposure and skin cancer risk in children in Orange County. Following that paper, I began to pay closer attention to the suspicious mole on my leg. I noticed that it began to have texture. Pretty soon, it took on an asymmetrical shape. Also, the color was uneven. Eventually, by the end of 2004, the mole appeared to be sticking out of my skin. By 2005, I was shaving it off in the shower on a regular basis (by accident, of course). I would then bleed profusely, stick a band-aid on it and then be on my way. Shortly after the wound healed, the mole would return, with its puffy texture and uneven color.

I realized that what I had was not necessarily a mole any more. But I was scared to find out what it was. I eventually sucked it up and tried to get an appointment with a dermatologist. Every dermatologist I called in DC had a three month wait for new patients. What the hell? I could be dying but I have to wait 3 months to see if I have cancer?? I found a dermatologist in VA not too far from where Jesse lived at the time. Hers was a two month wait.

Two months later, I stepped into her office and suddenly realized why there was such a long wait to see her. All of the women in the waiting room were old. And the ladies working the reception desk were all wearing black baby tees with the word “Botox” in silver rhinestones. It was unlike any doctors office I had ever stepped foot in. I wondered if the people working behind a reception desk in an urologist’s office have t-shirts with the word “Viagra” in big, bold letters.

When I got called in to the see the doctor, she inspected my naked body while asking me my sunburn history. She paid close attention to the mole in question. She scheduled me for a punch biopsy two weeks later.

A punch biopsy, for those of you unfamiliar, is procedure done to determine whether something is cancerous. It looks kinda like an apple corer and it feels as if someone is whole punching your skin. I was under local anesthetic, so it wasn’t as painful as it sounds. The doctor took my punched out layers of skin and placed it in a tube that contained a preservative fluid. She sewed me right up (I could definitely feel that despite the anesthetic). After the procedure, I looked at the tube and the 1 inch long, thick piece of my skin floating in the fluid. I remember cringing. Jesse, who had sat with me during the whole thing (and every dermatologist appointment I had), told me that everything was going to be ok.

Two weeks later, I was to return for my results. I could not sleep the night before. I was incredibly scared. Jesse held my hand while we waited for the results. A nurse came in to my exam room with a sheet of paper. She told me what I needed to know. Unfortunately, my suspicions were true. Fortunately, the punch biopsy revealed ‘clean margins,’ meaning it had removed everything that was bad. Woo hoo! I was cancer-free! The nurse said, “Had you waited much longer, I wouldn’t have had good news for you.” Those words have really stuck with me. And as someone who works in public health, it really proves just how important preventative care is.

Eventually, my suture healed but left a nasty scar, despite my daily applications of Neosporin. Life returned to normal. I’m much more aware of protecting my skin and I make sure that Jesse protects his. Recently, he bought a facial cream with SPF in it. I couldn’t have been prouder.

I was pretty embarrassed to come back with a tan. But soon, the color will fade and I’ll be just as pale as before.

Pale and happy.


Madame M. said...

*chilled to the bone*

Man, I really think I need to have a mole checked badly.

Punch biopsy.... *cringe*

I'm glad you are cancer-free though :o)

media concepts said...

It's hard to avoid getting color out here, even if one wears sunblock every day. When people tell me I have a nice tan, I usually retort jokingly, "you mean I have good skin damage? Thanks!"

Anonymous said...

It's scary how fast skin cancer can become deadly. good for you and thank you for spreading awarness of the dangers. you never know who you might help. ~erika

sunchaser said...

"Every dermatologist I called in DC had a three month wait for new patients." And for people getting Botox no less. So lame.

But it's very smart of you to not have waited. I worked on a skin cancer study a few years ago, and there were some extremely scary and sad stories. Impt: ABCD - Asymmetrical, irregular Borders, uneven Color, and >6mm Diameter.

lizzie said...

madame--thanks! i'm happy to be cancer-free too. unfortunately, now that i've had one cancerous mole, i am more likely to have a recurrence of cancer so i have to be extra vigilant about my skin. i've got my eye on a couple of potentially suspicious moles now. if you have a mole to be checked, definitely do so as soon as you can!

media concepts--it is hard to avoid tanning in cali. that's why i make sure to wear nothing less than SPF 30 and reapply as the day wears on. the key thing is reapplying. even i forget sometimes.

erika--yeah, skin cancer at 26 was quite the eye-opener. i hope that people who read this at least become more aware of their skin. prevention is important!

sunchaser--i saw some really gruesome things when i did my research paper in grad school. if i hadn't done that research, i might've waited longer to get my mole evaluated.

and thank you for putting the ABCD's out there!

honeykbee said...

An important (and guilt riddled since I singed myself last weekend) post.

lizzie said...

honeykbee--thank you. be sure to put some aloe on that burn and don't forget to reapply sunscreen next time! :)