Taking blood pressure medications might do more than just lower your blood pressure — at least in some cases, they also seem to lower the risk of getting skin cancer.

Lowering your blood pressure is very important to your overall health. Blood pressure medications when taken regularly to keep your pressure down can decrease your risk of stroke, heart attack, and kidney damage. Now a study done at Brown University found that some blood pressure medications might also help protect against skin cancer.

The study examined over 1,000 medical records from veterans who received care at the local Veterans’ Administration (VA) hospital. The subjects were mostly older white men who took blood pressure medications called ACE inhibitors or ARBs. ACE inhibitors and ARBs are special blood pressure medications that help keep arteries around the kidneys dilated, leading to lower blood pressure. Previous studies have suggested that this type of medication might also have protective activity against cancers. This was the first study to examine this protection with skin cancers.

In the study, 532 veterans used ACE inhibitors or ARBs while 519 did not. Researchers examined their medical records for an average of 3.4 years. They found 472 cases of basal cell carcinoma and 309 cases of squamous cell carcinoma; these are two common types of skin cancer caused by excess sun exposure. Patients who were taking ACE inhibitors or ARBs had a nearly 40% reduction in risk of developing basal cell carcinoma and a 33% reduction in developing squamous cell carcinoma.

The types of basal cell or squamous cell skin cancers were similar and the depth of the skin cancers and risk of death was the same among the groups. This would suggest that the blood pressure medications did not stop or slow the growth of skin cancers, but seemed to help prevent them from developing in the first place.

Because this study was a review of medical records instead of a clinical trial, it cannot be concluded that blood pressure meds prevent skin cancer.  Additional studies must be done where patients are examined before starting ACE inhibitors or ARBs and are followed over time to see if the medications are truly the reason for the reduced risk of skin cancer.

Other studies have shown that anti-inflammatories called NSAIDs (which include aspirin, motrin, alleve, naprosen, and others) can also protect against skin cancer. These meds, at least at higher doses, seem to suggest that chronic inflammation has a role in developing cancer and that minimizing inflammation might be a good long term strategy to minimizing the risks of developing many types of cancer.

Particularly concerning is new data from the National Cancer Institute which shows that from 1980 to 2004 melanoma rates rose 50% for young women.

A study of this data, published in the July 10th issue of the Journal of Investigative Dermatology, analyzed 20,000 cases of melanoma in young adults ages 15 to 39. The cases were recorded in a large database maintained by the National Cancer Institute.

The authors found the melanoma rate in young women rose from 9.4 per 100,000 in 1980 to 13.9 per 100,000 in 2004. In young men, melanoma rates remained stable at about 7.7 per 100,000 during the same time period.

Why the significant increase in melanoma in women? It is not likely due to improved detection of melanoma because we would expect that melanoma rates would have increased in both men and in women equally. It is more likely due to increased exposure to ultraviolet radiation, a risk factor for developing melanoma. Other studies of the same time period have shown that:

• More and more people in the U.S. are getting sunburned
• Teenagers had a higher incidence of sunburn and reported that they spent more days at the beach in 2004 then they did in 1998.
• More young people in the U.S., especially women, are using tanning beds.

Melanoma is curable when caught early. It is life-threatening when it has spread. Here’s how to find a melanoma:

Do a self skin exam every 3-6 months, at a minimum.  Have a partner help you with hard to see areas such as the scalp and back. If you have a family history of melanoma, have many moles, or have a history of any type of skin cancer, then see your dermatologist regularly for a complete skin exam. It could save your life.

Post written by Jeffrey Benabio, MD. You might also like:

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Photo credit: Michael Cote

Want to see your dermatologist’s head explode? The next time you see her or him, ask this question: “Does sun exposure cause melanoma?” This is a hot, controversial issue in dermatology right now. And I am going to answer it for you (and keep my head together).

Melanoma is cancer of your pigment cells. These pigment cells exist everywhere in your skin from your scalp to the bottom of your toes. When melanoma cells are concentrated into little nests, nevi or moles appear on your skin.

Part of the problem in answering the question is that there are different types of melanoma. For example, lentigo maligna is a melanoma that develops on severely sun damaged skin, usually on the head and face of older people. In contrast, acral melanomas occur on bottoms of the feet or on hands, often in young people with little or no sun exposure. Sun affects these two melanomas differently.

So Why Do We Think Melanoma is Caused by Sun Exposure?

• Ultraviolet light damages DNA in your skin.
• The rate of melanoma increases significantly when you look at people’s skin color from darkest to lightest — people with lighter skin, who always get sunburned, are much more likely to develop melanoma than people with dark skin who never get sunburned.
• The rate of melanoma changes when you look at where people live — the rate of melanoma is higher in places near the equator such as Hawaii as compared to Iowa, where the sun is less intense.
• An excellent study, called the Nurses Health Study, showed that the risk of getting melanoma was doubled if people had ever used a tanning booth.

What is the Evidence that Sun Does NOT Cause Melanoma?

• Ultraviolet light increases your vitamin D levels, which might protect you against some cancers.
• Many melanomas develop in areas with little or no sun exposure such as the buttocks or the bottom of the feet.
• In general, studies have not been able to show that wearing sunscreen protects you against melanoma.
• There is some evidence that a little sun exposure might actually protect you against melanoma.
• (OK, so now my head is throbbing).

Dr. Benabio’s Answer to the Question: Does Sun Exposure Cause Melanoma?

• It’s likely that sun exposure, particularly sunburns and extensive sun damage, increases your risk of developing certain melanomas.
• The chances that sun exposure increases your risk of melanoma depends a lot on you. Does your family have a history of melanoma? Do you have many “abnormal” or dysplastic nevi or moles? Do you live in a sunny climate such as Florida? Do you sunburn easily? If you answered “yes” to any of these questions, then you should be particularly cautious of excess sun exposure as your risk of melanoma might be high. Excess sun and sunburns would likely make your risk even higher.
• If you answered “no” to these questions, then some sun exposure (getting a little sun without getting sunburned) might not increase your risk of melanoma, and in some instances, could even lower your risk.

What Do I Often Advise My Patients?

• Take 1,000 IU of vitamin D each day. Then you never have to worry about getting sun to boost your vitamin D level.
• Enjoy life outdoors. Bike, run, surf, play, watch a ball game, hang out at the beach. However, especially in the summertime and if you have fair skin, wear a broad spectrum, SPF 30 sunscreen to prevent a sunburn (and to protect against other sun damage like wrinkles).
• Don’t lie out in the sun just to get dark (or to protect yourself from skin cancer).
• Don’t use tanning booths.
• In the long run, too much real or artificial sun exposure will not protect you and will increase your risk of wrinkles, basal cell carcinoma, squamous cell carcinoma, brown spots, white spots, “broken” blood vessels on your face and chest, and other sun damage.

I hope this helps.

Post written by Jeffrey Benabio, MD. You might also like:

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Photo credit: Fdecomite, Flickr.com

Jennifer Garner has teamed up with Neutrogena® and Self® magazine to encourage women to examine their skin once a month. It’s a great campaign — if you find a melanoma, a simple skin check could save your life.

Why is it important for everyone to do self skin exams, even young women?

• 1 in every 5 Americans will develop skin cancer in their lifetime.
• Melanoma is the most common cancer in 25-29 year-olds.
• Melanoma is the second most common form of cancer in adolescents and young adults, ages 15-29.
• Melanomas are increasing faster in 15-29 year-old females than in males.
• Melanoma is highly curable when detected and treated early.

Skin cancer is there for everyone to see — including you. Everyday patients come to me having already found their skin cancer. It only takes a few minutes and a mirror.

For a full body skin check, you will need:

• A full length mirror
• A hand mirror
• A hair dryer
• A body map such as this one from Self magazine to mark any moles you have. When you repeat your skin exam, compare it to your previous notes. (And guys, if you look like this body, then please see your endocrinologist before your dermatologist — try this body map instead).

Here are eight steps for a complete skin check:

1. Start with your scalp. Use the hair dryer to blow the hair apart to see your scalp section by section.
2. Examine your face, especially your nose and lips; basal cell carcinomas and squamous cell carcinomas favor these areas.
3. Examine your hands and arms. Start with your fingertips and work up your arms to your trunk. Look at your fingernails as well; brown or black spots or streaks can be melanoma.
4. Use the full mirror to check your back including the back of your arms and legs.
5. Examine the front of your neck, chest and abdomen. Women should lift each breast to check underneath.
6. Use the hand mirror to check the back of your shoulders, arms, underarms, buttocks, and legs.
7. Sit down to exam the front of your legs.
8. Check your feet including the bottoms, between the toes, and toenails (like you do your fingernails).

Remember you are looking for a mole that has:

• Asymmetry
• Border irregularity
• Color variation
• Diameter larger than six millimeters (larger than a pencil eraser)
• Evolution, or has changed over time

In addition, any spot that bleeds or doesn’t heal over two weeks should be examined by a physician. Post by Jeffrey Benabio, MD

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Unfortunately, his melanoma was misdiagnosed by military physicians in Iraq. Eight years later it cost him his life. This video from CBS is about 8 minutes long. It is graphic and poignant. You won’t soon forget it.

This is the kind of thing that keeps me up at night. If you have a new or changing mole, a mole that is asymmetric, has irregular borders, has more than one color, or is larger than a pencil eraser in diameter, then make an appointment to see your physician to have it examined.

Melanoma is uncommon but can be deadly. It can be cured if it is caught early and removed completely.

See also: Skin Care Myths: It’s Normal for Moles to Change During Pregnancy

See also:

Think that mole is too small to be a melanoma? Think again.

How far away is your dermatologist? Farther distances lead to thicker melanomas.

Is it normal for moles to change during pregnancy? No.

However, new research has shown that at least in one study 55% of the melanomas were actually smaller than 6 mm in diameter. Although the commonly cited ABCDE (asymmetry, border, color, diameter, and evolving) guide to determining if a mole is suspicious is helpful, it is imperfect.

Unfortunately, melanoma is actually becoming more common; in fact, according to the National Cancer Institute:

In the United States … the percentage of people who develop melanoma has more than doubled in the past 30 years.

The good news is that melanoma is the only deadly cancer that can be diagnosed just by examining the skin. If you have a new, changing, or suspicious mole, even if it is smaller than a pencil eraser, then have it checked as soon as possible by your dermatologist.

Even a small melanoma is a melanoma.

A recent study from the University of North Carolina Chapel Hill published in the Archives of Dermatology showed that the farther a patient had to drive to get to a dermatologist, the thicker the melanoma at the time of diagnosis. They reviewed 615 cases of melanoma from patients in 42 counties in North Carolina and found that the thickness of the tumor (measured as the Breslow thickness) increased by 6% for every 10 miles traveled.

This is important because in melanoma, thicker cancers are more dangerous and more likely to have spread. Thin melanomas are usually cured by surgery alone; thick melanomas or metastatic melanomas are difficult to treat and can be life threatening.

Don’t let distance deter you. If you or a loved one has a new, suspicious, or changing mole, then hop in the car and have it checked. Even if you have to stop for gas on the way there.