FORT MYERS BEACH, Fla. — Mid-July to Mid-August is the peak of summer in Southwest Florida, and the UV index is high. July is UV Safety Awareness Month, and UV rays are the leading cause of skin cancer.
Fox 4 Photographer Kevin Smith is 61 years old and has already had 9 skin cancer procedures. He said it all goes back to his time at the beach as a kid.
“I grew up at the beach in Jersey when I was a kid. Went there every day. There was no sunscreen. Mom said get a good burn, get a good peel, you've got a good base. No hats, shirtless. And now I'm paying for it," he said. “I've had eight Mohs surgeries and one Melanoma surgery.”
“Ultraviolet light, over time, will potentially cause sun damage, pre-cancerous changes in the skin, and possibly skin cancer, which is very common," Dr. Gregory Houck of Houck Dermatology said.
He said there are three types of skin cancer.
“The most common one is called basal cell carcinoma. The next most common is squamous cell carcinoma. I see these every day," he said.
Melanoma is the most deadly. And Smith has had all three. He was first diagnosed with skin cancer 25 years ago. It was squamous cell carcinoma. And ever since, he said more cancer spots have been popping up. And they can be sneaky.
“This one here. It was like a little dry spot itchy. Went to my regular doctor. He says it's just a sty, and here's some salve. After two months, it didn't go away. So I went to get my eyes checked, which was already scheduled, and I go, "Doc, what is this?' He goes, ;Oh, that's not good,'” Smith said.
That was another case of squamous cell carcinoma. But it was his most recent bout with skin cancer that was the most dangerous.
"This spot doesn't look right. It came up fast. It was a little black and brown and weird shape," he said.
It was on his calf. He told his dermatologist at his next appointment.
"They cut it out, biopsy it. About a week and a half later, I got a call and it was the M-word, which was my first melanoma. You don't screw around with melanoma,” Smith said.
Now he goes to the dermatologist every 3 months to get a skin check, and said when he's working as a Photographer at Fox 4, he wears sunscreen.
"I try to wear a hat or I say in the shade," he said.
He wants everyone to take his story as an example of why you should protect yourself from the powerful UV rays of the sun.
"If I knew back then what I know now, I definitely would've used the hats, the shirts, the sunscreens if they had it back then, but I didn’t. Now I’m paying the price," Smith said.
“We tell patients every day, have fun. We live in the Sunshine State, but protect yourself out there," Dr. Houck said.
He recommends wearing mineral-based sunscreen. It's also called physical sunscreen.
"Those have ingredients called either zinc oxide, or titanium dioxide. And those physical blockers, they're safe, and they're effective," Dr. Houck said.
He said sometimes they can leave a white film behind, but they're safer and more effective than chemical sunscreens.
“The chemical type sunscreens will filter the ultraviolet light. Like avobenzone is a common one you'll see over the counter. Some people might like them maybe because they go on lighter," he said.
But he said mineral is the way to go. As for SPF, or Sun Protection Factor, Dr. Houck recommends at least a 30.
"Anywhere from 30 minimum to 50 I think is adequate,” he said.
He said anything over 50 isn't necessarily going to give you more protection. He said the key is to reapply, and reapply often.
"Especially if you're active. If you're in the water, if you're sweating, maybe every two hours," he said.
And don't forget to apply it everywhere that sees the sun.
“Don't forget about your ears. Don't forget about your nose. Another common area, the lips. Especially the lower lip. It can accumulate a lot of sun damage over time," he said.
He also said not to forget the part of your hair, or wear a sun hat. He said UV protective clothing or long sleeves and pants will also prevent skin cancer.
Dr. Houck said with most skin cancers, early detection is key.
"Your cure rate is going to be 95 percent or more," he said.
He said it's important to know what to look out for; the ABCDEs of skin cancer.
A: Asymmetry.
"If one half doesn't look like the other," he said.
B: Borders.
"If a pigmented lesion has irregular borders, or jagged edges," Dr. Houck said.
C: Color.
"If something, instead of being light brown in one color, has multiple colors like tan, or brown and black, that's a sign to look for," he said.
D: Diameter.
"If something is larger, or growing larger than six millimeters, which is the size of a typical pencil eraser," he said.
E: Evolving.
“If you have if you have a spot that's either getting larger, getting darker, itching, bleeding, not healing, I think that's a good reason and to have that lesion evaluated by a dermatologist," Dr. Houck said.
He said a good rule of thumb is if something doesn't heal within a month, it's time to see a dermatologist.
If you go in for a skin check and the doctor notices something suspicious, Dr. Houck said they'll take a biopsy.
"Which is a sample of that particular lesion. And we'll send it to a dermatopathologist, which is a pathologist trained in skin disease, and they will evaluate that lesion under the microscope and give us a diagnosis," he said.
If they determine the lesion to be pre-cancerous, it's usually treated without surgery. Smith said he's had chemotherapy creams or blue lights used on him.
If it's skin cancer, usually you'll need surgery.
"A skin excision. And a lot of times we'll do what's called a Mohs slide, check the margins of that skin cancer at the same time, make sure we clear that tumor and then repair that defect," Dr. Houck said.
He said he treats basal cell carcinoma and squamous cell carcinoma every day at his office. Smith said the surgeries themselves aren't too bad, but it's the afterward that's difficult. Especially when he had squamous cell carcinoma on his lower eyelid.
"With my eye, I was out of work for two months because I couldn't put my eye in a viewfinder, I couldn't be outside," Smith said.
Melanoma is the most deadly form of skin cancer, so it's more serious. When Smith had melanoma on his calf, he said doctors had to remove a large chunk of his skin to completely clear the cancer.
“Eventually when it gets to the clean skin, they're done. This one right here took eight rounds. I call them innings. They had to do eight rounds to cut all that out,” Smith.
Many times, they'll also check your lymph nodes near any lesions to make sure the cancer hasn't spread. If it has, doctors will come up with a treatment plan that may include chemo or radiation.