Published on May 07, 2025

Sun and Skin with Dr. Evelyn Frederick

Suppose you’ve ever skipped sunscreen because it was cloudy or thought one tanning bed session before vacation wouldn’t hurt, you’re not alone – but according to Dr. Evelyn Frederick, a third-year Family Medicine resident at UNC Health Appalachian, that mindset could be putting you at risk.

Skin cancer is the most common cancer in the U.S. “About one in five Americans will develop skin cancer in their lifetime,” said Dr. Frederick in a recent virtual Health Talk. “That’s 9,500 people diagnosed every single day.”

And while fair skin increases risk, Dr. Frederick reminded everyone that anyone can be affected. “Skin cancer affects everybody, regardless of skin color, gender, or age,” she explained. “Even if you think you have some built-in protection because of your skin tone, it’s still important to get spots checked out. People with darker skin are often diagnosed later, when it’s harder to treat.

The good news? Much of that risk can be reduced through small daily habits, even as simple as wearing sunscreen and paying attention to new or changing spots on your skin.

What’s really happening when you tan

A tan might look like a “healthy glow,” but it’s actually a sign of skin damage. “There’s no such thing as a safe tan,” Dr. Frederick explained. “Even a ‘base tan’ is skin damage. It’s your body’s way of trying to protect itself after being exposed to UV radiation.”

Tanning beds aren’t a safer alternative either – using one before age 20 can raise your risk of melanoma by almost 50%. Her advice? “If you want the glow, use self-tanner. Fake it, don’t bake it.” Self-tanners like lotions, mousses, foams, sprays, and professional spray tans are a much safer option. They contain a sugar-derived ingredient called dihydroxyacetone (DHA) that reacts with the surface layer of your skin to create a temporary bronzed look. She laughed, adding, “They’ve come a long way. They’re not orange or streaky anymore, and they won’t raise your cancer risk.”

UVA, UVB, and the mountains

Just because the air is cooler or there’s sometimes snow on the ground doesn’t mean the sun takes a break. In the mountains of North Carolina, our higher elevation means less atmosphere to filter harmful UV rays – so we get more direct exposure year-round.

Even on overcast days, UV rays still reach your skin:

  • UVA = “aging” rays that cause wrinkles and leathery skin
  • UVB = “burning” rays responsible for sunburns

Both types can damage skin cells and increase the risk of skin cancer. So, whether it’s a blue-sky summer afternoon or a cloudy winter morning, sunscreen is still a must in the High Country.

Sunscreen basics

Here’s what Dr. Frederick recommends:

  • Use broad-spectrum SPF 30 or higher – every day.
  • Apply 20-30 minutes before going outside.
  • Reapply every two hours or after swimming or sweating.
  • Use about an ounce (a shot glass full) for full-body coverage.

Lotions or creams tend to give better coverage than sprays, and if you have sensitive skin, she recommends looking for mineral-based sunscreens with zinc oxide or titanium dioxide. “If you can see daylight, UVA is hitting your skin – even through windows,” she reminded listeners. “It’s the same strength every month of the year.”

Know the signs of skin cancer: The ABCDE rule

When it comes to spotting melanoma, remember these five letters:

  • Asymmetry – one half doesn’t match the other
  • Border – irregular or uneven edges
  • Color – multiple shades (brown, black, red, etc.)
  • Diameter – larger than a pencil eraser
  • Evolving – any change in size, color, or texture

If something looks new, different, or just off, it’s worth having it checked. Our Family Medicine providers – including Dr. Frederick and her colleagues at AppFamily Medicine – can perform skin checks and simple in-office biopsies when needed. “Most skin cancers are easy to treat if we catch them early,” she said. “Don’t wait and wonder.”

Skin cancer is common, but it’s also one of the most preventable cancers out there. The small things you do every day can make a big difference. Dr. Frederick ended by saying, “Wear sunscreen, avoid tanning beds, and know what’s normal for your skin.”

To schedule a skin check with Dr. Frederick or another AppFamily Medicine call (828) 386-2222.