Dr. Kevin Modeste talks about best practices for sun protection, even in Eugene.

By Vanessa Salvia
For Lane County Medical Society

Everyone should take care of their skin… yes, even in Eugene, where sunny days are a rarity for most months of the year. Most people don’t think of their skin as the largest organ in the body, but it is, and taking care of our skin can protect us from melanomas and other serious issues.

“Our skin has multiple, intricate functions that protect us on a daily basis,” says Dr. Kevin Modeste MBBS/FACS, a general, oncological, and robotic surgeon at Northwest Surgical Specialists and the LCMS Board Secretary-Treasurer. “It is the only organ that is easily visible and easy to examine,” he says. “It is also the one that we see and is usually the one that represents us in an initial encounter with another individual.”

Modeste, a general surgeon at Northwest Surgical Specialists since 2012, is currently finishing up a Master of Medicine in skin cancer, a two-year program from the University of Queensland Australia. He developed an interest in skin cancer because one of his residency mentors was a surgical oncologist who dealt a lot with melanomas. Sun exposure is the highest risk factor for the majority of melanoma patients.

Oregon ranks sixth among states for the highest number of UV-linked melanomas. This has multiple factors, Modeste says. People underestimate how much UV exposure they get, even on cloudy or rainy days. Many of our residents enjoy outdoor activities such as hiking and running, and usage of sunscreen is low. People who hike or ski to high elevations have a higher risk of UV exposure.

“Skin protection comes in multiple forms,” Modeste says. “Most important would be avoidance of outdoor activities when sun exposure is the highest. This varies according to latitude, but generally speaking is between 10am and 4pm.”

If activity during this time can’t be avoided, wear skin-covering clothing (clothing that contains UV blockers are available) and a hat that fully covers the head and neck. Apply sunscreen prior to going outdoors, and replace sunscreen at least every two hours when outside – more often in certain instances such as when swimming. Sunglasses protect the eyes from too much sun, which can cause uveal melanoma (the uvea is the pigmented layer of the eye). Take a close look at any hats you wear – most straw hats have breaks in them and baseball caps do not cover the neck.

Healthy skin, in general, requires both internal and external good habits. For one, staying hydrated and using moisturizer keeps the skin surface from drying out, which will decrease keratinocyte turnover (replacement of the outer epidermis) and cause skin breakage. Smoking can damage skin in multiple ways and can even affect wound healing. Frequent hot showers or baths can also lead to similar issues.

“Skin should be thought of as an organ, and we should try to prevent damage to that organ,” Modeste says. “Skin damage can take years to show, so start taking care of it in the teenage years.”

Modeste recommends checking the daily UV index and using some form of protection if it is greater than 3, especially for people with a history of easily sunburning (check the UV index on the Weather Network: https://www.theweathernetwork.com/us/forecasts/uv/oregon/eugene).

The best sunscreen, Modeste says, is the one that you are going to use. “Find one that is at least SPF 15, per CDC guidelines,” he says. “One that is easy to apply, that you enjoy or feel comfortable putting on. It should be almost second nature.”

The FDA is currently standardizing what is considered sunscreen and is considering some of the toxicities and side effects. Modeste says he expects to see some changes in regulations in 2021.

“Australia has very strict guidelines for what is called sunscreen,” he says. “I would recommend any product that is approved for use in Australia, where it must be an SPF of 30 to be called sunscreen, as this can stop almost 97% of UV rays.”

Modeste recommends getting a full skin check by a primary care physician or dermatologist for anyone with fair skin and hair with multiple moles, a family history of melanoma (especially if the family member was young when they developed it), or a history of multiple or severe sunburns as a child.

Finally, don’t take your skin for granted. Use soaps, detergents, and sunscreen that will not cause damage or irritation. When using chemicals or household products for cleaning, protect yourself with appropriate clothing and gloves. While Modeste enjoys getting to know his patients, he would rather people protect themselves than have to see him when they develop a problem.