One American dies of melanoma every hour. The single greatest risk factor for developing skin cancer is excessive ultraviolet radiation exposure.

“We can’t do anything about our genetically induced risk factors like having fair skin, light eyes and lots of moles, or even having a family history of melanoma,” says Diana Antonovich, M.D., Medical University of South Carolina’s department of Dermatology and Dermatologic Surgery. But if people are responsible about their sun exposure, she says melanoma is preventable.

First, people should do self-examinations once a month.

“Most of us don’t have a dermatologist living with us, so we have to take some responsibility ourselves to monitor things so you want to check yourself over once a month if you have risk factors.”

Not all melanomas are sun induced, so be sure to check the scalp, between toes, fingernails and genital areas. “Those areas are fair game,” she says.

If you find something you are worried about or is new, get evaluated by a dermatologist.

“The good news is that if melanoma is caught early it is very curable and that can easily be done in most cases with surgery alone. However the most advanced melanomas can be very difficult to treat and cure,” she says.

Antonovich tells her patients there are three lines of defense against melanoma.

1) Avoidance – This doesn’t mean you can’t enjoy the great outdoors. You just have to be smart about it. Seek shade when you can. Look at your shadow. If it is shorter than you are, you need to protect yourself because that means the sun is still high. Avoid sun exposure between 10 a.m. and 4 p.m. because that’s when the sun’s rays are most intense.

2) Protective clothing – There are a lot of great sun shirts and swim shirts available. This clothing is particularly useful to help protect children. “It’s easier than chasing after them trying to glob sunscreen on them …” Wearing a baseball hat isn’t adequate, instead wear a broad-rimmed hat. “I see lots of patients where the center of their faces are protected, but there’s lots of sun damage on the sides.” And always wear sunglasses, you can get melanomas in the eye.

3) Sunscreen – In general way too much stock is placed in the usefulness of sunscreen, and it can give people a false sense of security. “Every day I come across a patient with a deep tan or a sunburn who tells me he or she wears sunscreen. If you’re getting tan your sunscreen really isn’t enough. It isn’t working for you. A tan means you still have damage to your skin.” Apply 30 minutes prior to sun exposure because some sunscreens require a chemical reaction in the skin to become active – reapply every two hours. “This is probably the hardest part for sunscreen users. Most people can get that first application on, but you’re not good-to-go the whole day.” The key is to apply liberally; it takes a full ounce of sunscreen (equivalent to a shot glass) to cover the entire body. “If you have three-ounce bottle of sunscreen that lasts you all summer, you’re probably not using it effectively.” And don’t forget to protect your lips. “Sun damage on the lips is tough to treat, and it’s no fun for the patient. Skin cancers on the lips can be particularly problematic.” Apply a good lip balm with sunscreen in it.

ABCDEs of Melanoma

Look for these symptoms when doing a self-exam

Asymmetry – The left of the mole doesn’t match the right.

Border – Border should be crisp and defined, not jiggedy jaggedy.

Color – Uniform single color, not multiple colors

Diameter – Diameter should be smaller than 6 mm or the size of a pencil eraser.

Evolving – A spot that is new, changing or symptomatic.

For information on how to do a skin cancer self-exam, visit www.aad.org.

Not all sunscreens are created equal

What to look for in a sunscreen

• A broad-spectrum ultraviolet radiation protection (both ultraviolet A and ultraviolet B, both cause skin cancer). The SPF only refers to the amount of protection that the sunscreen gives you against ultraviolet B and 95 percent of the radiation reaching the Earth’s surface ultraviolet A-type

• Physical blockers such as zinc oxide, titanium dioxide

• or chemical blockers – Anthelios, Mexoryl (in the sunscreen brand Anthelios), helioplex (in Neutrogena), avobenzone

• A minimum SPF of 15

(Antonovich recommends SPF 30 – anything above 30 isn’t much more effective.)

• Water resistance

(if you’re going to go to the beach or swimming)