Less than half of older adults protect their skin from the sun, despite having the highest incidence of skin cancer, according to the Centers for Disease Control and Prevention.

In a study, CDC researchers used responses to questions in the 2015 National Health Interview Survey to find out how often older adults in the United States do each of the following when outside in the sun:

The study found that only about 15% of older adults and 8% of sun-sensitive older adults regularly used all five kinds of sun protection. Nearly 18% of older adults and 15% of sun-sensitive older adults said they didn’t use any kind of sun protection regularly.

St. Luke’s melanoma specialist Melissa A. Wilson, MD, PhD, said the median age of a skin cancer diagnosis is 65. Basal cell and squamous cell skin cancers are caused by frequent and long-term exposure to ultraviolent rays. Melanoma, which is more likely than other types of skin cancer to grow and spread, is believed to be caused by intermittent high-intensity sun exposure that results in blistering or sun poisoning. Often, these exposures occurred when the patient was a teenager or in their 20s, but does not develop into skin cancer until years, or decades, later.

“Each year, approximately 90,000 people in the United States are diagnosed with melanoma and 9,000 die from the disease,” Dr. Wilson said.

While anyone can get skin cancer, people with blond or red hair, blue or green eyes, and fair skin that freckles or burns easily, are more at risk for developing all kinds of skin cancers, including melanoma, the most-deadly type. Also, individuals who work outside are more susceptible to developing skin cancer, especially on their hands, faces, necks, and heads. Men account for about 60% of skin cancers, and more men work in outdoor occupations, like construction and farming.

Dr. Wilson encourages people, especially those with light skin or a family history of cancer, to see a dermatologist yearly. If they can’t get an appointment with a dermatologist, they should be screened by their primary care physician. If something looks suspicious, the doctor can help the patient schedule an appointment with the dermatologist and can order a biopsy of a lesion or mole. While doctors screen and ultimately diagnose skin cancer, patients are usually the first to suspect that something is wrong, Dr. Wilson told us. “I firmly believe that most people know their bodies and when something is not right,” she said. “I also ask my patients, ‘Did it itch, did it bleed, was it painful?’”

Treatment begins with surgery to remove the cancerous tumor and the area immediately around it, Dr. Wilson explained. The tumor is examined, and depending on the results, a second procedure is performed to determine whether the cancer has spread.

“At St. Luke’s, we have a multidisciplinary approach to treating melanoma cancer. We discuss the patients at Tumor Board where there’s representation from dermatology, medical oncology, surgical oncology, and radiation oncology, to formulate the best plan for each patient. We’re bringing a number of clinical trials to our region that will offer treatment for patients well beyond the typical standards of care.”

Most older adults, especially women, can remember slathering on baby oil and baking in the sun for hours in pursuit of that perfect tan. Other seniors who worked in construction, farming, and other outdoor professions, never considered applying sunscreen in their youth. At that time, it was considered harmless — even healthy — to soak in the sun’s rays.

Years later, they learned that sun exposure not only causes wrinkles, it also increases the risk of skin cancer, especially on exposed areas like the face and hands. By then, however, the damage had already been done, even though skin cancer lesions might not form until decades later.

Now, St. Luke’s dermatologists offer skin-sparring Mohs surgery, a precise and effective procedure to treat skin cancer that has a high risk of recurrence on the face and other sensitive areas.

Fellowship-trained Mohs surgeon Ryan Johnson, MD, of St. Luke’s Dermatology, explained that the procedure is the most effective technique for treating many basal cell carcinomas and squamous cell carcinomas, the two most common types of skin cancers. The Mohs surgery cure rate is 99% for an untreated skin cancer growth and 94% for a recurring tumor. The procedure is particularly effective for treating cosmetically- and functionally-sensitive areas. These includes the nose, lips, ears, scalp, genitals, fingers, toes, and around the eyes.

“Mohs surgery is a win-win,” Dr. Johnson said. “We have high cure rates, and we remove less healthy skin, which means smaller scars for patients. Over time, the removal site continues to heal for an even more cosmetically-appealing appearance.”

Another advantage of Mohs surgery is that the procedure is performed in one visit, according to Stephen Senft, MD, also of St. Luke’s Dermatology. Traditionally, a tumor is removed and sent to a lab for testing. If tests find cancerous cells in surrounding tissue, the patient must return for a second surgery.

“At the end of the Mohs surgery procedure, we are usually able to say to our patient that the tumor margins are clear, and the chance of recurrence is very low,” Dr. Senft said. “It’s gratifying when a patient comes back and says, ‘This looks great. I was so worried and now it’s very presentable.’ A lot of anxiety is alleviated.”

Dr. Senft has developed close relationships with many of his patients, he said, because each procedure can last several hours. “There are people who have 10, 20 skin cancers removed in their lives so you get to know them very well.”

Dr. Senft joined St. Luke’s Dermatology three years ago after many years of private practice.

“Being a Mohs surgeon at St. Luke’s is great because we have the entire health network behind us,” Dr. Senft said. “At St. Luke’s Anderson, we have the backup of ears, nose, and throat physicians and plastic surgeons, and have access to the hospital’s emergency team. If it’s a particularly difficult lesion, we can consult with, and refer to, oncologists, surgical oncologists, or radiation therapists. They’re all right here at Anderson.”

Both Dr. Johnson and Dr. Senft encourage people who have had skin cancer, or have a family history of the disease, to be checked regularly by a dermatologist or their primary care doctor.