Health & Wellness



By Nicole Gregory     10/17/2016

The very thing that makes Southern California such an attractive place to live—year-round sunshine—poses a health threat to people who enjoy outdoor living.

Many forms of skin cancer are associated with long-term sun exposure, according to the American Cancer Society, which is why Orange County residents need to protect themselves from the sun’s rays and recognize the signs of skin cancer.


Basal cell carcinoma

“The most common form of skin cancer is called basal cell carcinoma,” says Dr. Hong T. Nguyen, MD, a dermatologist with Mission Heritage Medical Group in Mission Viejo. “We see this on the head, neck, ears, face, upper chest, arms — and for women, the legs.”

“Look for light pink growths that bleed and scab, and gradually expand,” says Dr. Nguyen. Basal cell carcinoma arises from the deepest layer of the skin, and is treatable. “For the most part, these are generally not the type to metastasize to lungs or lymph nodes,” she says.

Lesions are often treated with Mohs surgery, in which very thin layers of skin with cancer are removed and examined on the spot—an outpatient procedure with local anesthetic. “They take a look at the very thin margins of skin around the cancer, to make sure if edges are clear — if not, they go back and take more slivers,” says Dr. Nguyen. “The goal is to remove the tumor with as small a margin as possible.”


Squamous cell carcinoma

“The second most common skin cancer is called squamous cell carcinoma,” says Dr. Nguyen, and it, too, is linked to chronic sun exposure. These lesions arise from the top layer of the skin and often evolve from actinic keratosis—a sun-related precancer that appears on the face, scalp, ears, back of hands, forearms and chest, explains Dr. Nguyen. “Pink scaly lesions start out thin but then get thicker and thicker and eventually become a squamous cell carcinoma.”

These patches also can be removed by freezing them or with Mohs surgery, says Dr. Nguyen.



About 90 percent of Dr. Nguyen’s patients have basal cell or squamous cell carcinomas, and only about five percent of her patients have developed melanoma, the most dangerous form of skin cancer. People who have had melanoma are at higher risk for developing another melanoma or another type of skin cancer, according to the American Cancer Society.

“Melanoma presents as ill-defined, dark brown, multiple-colored patches and bumps,” says Dr. Nguyen. Early stages of it are treated with surgery.

To see photos of all skin cancers, visit The Skin Care Foundation at


Who gets skin cancer?

Skin cancer is a major concern in the U.S. Each year more than 5.4 million cases of non-melanoma skin cancer are treated, according to a study reported in the JAMA Dermatology.

Risk factors include being fair-skinned, fair-haired, having blue eyes and having had severe sunburns in the past. Anyone who spends a lot of time in the sun is at high risk of skin cancer, too. “This means PE teachers, construction workers, gardeners — it doesn’t matter what their skin type,” adds Dr. Nguyen.

Yearly visits to a dermatologist are a must—and people who’ve had any forms of skin cancer should go twice or three times a year, or more, she says.


Protect yourself

When outside, always wear a hat and long-sleeved UV-rated clothing, advises Dr. Nguyen. Don’t use tanning beds and do use sunscreen—every day. “SPF 15-30 is fine,” she says. “If you’re outside for an extended period time or out playing sports, then go for SPF 50 or higher.” Look for broad-spectrum sunscreen that protects against UVA and UVB rays. As for ingredients? “Look for zinc oxide and titanium dioxide,” she says.