NEW YORK, N.Y.—Skin cancers of the eyelid, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma, account for five to 10 percent of all skin cancers. While only a small number are lethal, eyelid skin cancers can cause significant tissue damage, blindness and can spread into the nasal and orbital cavities (the area behind the eye).
“Eyelid skin cancer is not something most people think about,” said C. William Hanke, MD, senior vice president of The Skin Cancer Foundation. “With their thin, delicate structures, the eyes and surrounding areas are particularly prone to cancers. And, it’s an area people often forget to protect from the sun.”
Most eyelid skin cancers occur on the lower lid, which receives the most sun exposure. Approximately 90 percent of all eyelid cancers are BCCs, five percent or more are SCCs and 1-2 percent are melanomas.
Detection and Treatment
Early detection is essential, but is often difficult to achieve because eyelid tumors often grow under the skin for years before presenting on the surface.
Early warning signs include:
• a lump or bump that frequently bleeds or does not disappear
• persistent red eye or inflammation of the eyelids that does not respond to medication
• newly acquired flat or elevated pigmented lesions that have irregular borders and growth
• unexplained loss of eyelashes
Treating skin cancers of the eyelids poses special challenges. Eyelids are composed of extremely specialized mobile skin. To remove BCCs and SCCs, Mohs micrographic surgery is highly effective. The affected tissue is removed layer by layer, with each thin layer studied under the microscope until a cancer-free layer is reached.
Fortunately, preventing eyelid skin cancer can be easy and fashionable. Today there are sunscreens and moisturizers specially formulated for the eye area, which makes wearing an SPF 15 or higher sunscreen daily around the eyes much easier.
In addition, sunglasses have become the ultimate fashion accessory. They not only make a chic fashion statement, but protect your eyes from the sun’s harmful ultraviolet (UV) rays. When it comes to selecting the most flattering style, face shape is probably the most important feature to keep in mind.
Eyewear experts suggest following these simple guidelines:
• Oval face: square or cat’s eye frames
• Round face: rectangular frames
• Square face: rounder oval cat’s-eye frames
• Triangular, or heart-shaped face: frames with a straight, flat top
After the face shape has been determined, there are five important steps to finding a great protective pair of sunglasses:
1. Select sunglasses with adequate UV protection. Sunglasses should block 99 to 100 percent of UVA and UVB radiation. UV-blocking lenses will also reduce eye strain due to squinting on bright, sunny days.
2. Pick the best lens color for your purposes: Gray reduces brightness without distorting color, brown creates greater color contrast, providing better visibility on solid-color surfaces. Yellow is good for both contrast and depth perception.
3. Choose a polarized lens to reduce the glare of light reflected on the water or the light you face while driving.
4. Make sure sunglasses fit comfortably over your ears and do not slip down the bridge of your nose, which would allow more UV rays in. In terms of materials, plastic frames can come in rich, complex colors and typically are easy to adjust for a custom fit. Metal frames give a thinner profile, a lighter look and are usually very durable
5. Select a sufficient lens size to shield the eyes, eyelids and surrounding areas. The more skin you cover, the better. Wraparound styles with a comfortable, close fit and UV protective side shields are ideal.
Lenses that absorb and block UV are one of the strongest defenses against eye and eyelid damage, so it’s best to wear sunglasses year-round whenever you are out in the sun. And remember, fashion and high price do not guarantee safety. A recent review of 32 pairs of inexpensive sunglasses showed that they were all effective in filtering out UVR.
Finally, hats are also an important sun-protective strategy. Wearing a hat with at least a 3-inch brim all around can block as much as half of all UVB rays from your eyes and shield your eyelids.
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