When Applying Sunscreen, Try to Remember the Easy-to-Miss Areas

I was happy to see my son applying sunscreen to the inside of my grandson’s ear, and happier still to hear my granddaughter saying, “You missed my ears.” This generation seems to be much more aware of the need for protecting against the sun’s harmful rays than my generation: the baby boomers. I am also happy to see that many of the little kids at the beach are wearing long sleeved sun protection shirts unlike any that my kids or I had.

Applying sunscreen in the right places

The sunscreen-in-the-ear moment made me think of all the places that I either never thought of or missed when applying sunscreen in the past. Frankly, I am still often careless about these places that are easy to miss or forget. And they happen to be the places where I have either had skin cancer or have had actinic keratoses that could turn into skin cancer.

Let's talk about these spots

Ok class, let’s review. We are going to cover inside and around the ear, wrists, ankles, and tops of the feet. (Cover as in discuss, though feel free to think of the double meaning of covering with sunscreen.)

Here are some of my experiences with skin cancer in easy-to-forget places

Ear

It started with me rubbing my finger in my left ear. Blood, and a little tissue, came off onto the tip of my finger. My regular dermatologist wasn’t available, so I went to see another doctor in the same practice. She gave me a cream to apply. I have had so many creams that I am sorry to say I don’t remember the name of it. When it still did not clear up, I got an appointment with my regular dermatologist. She said it looked like a basal cell carcinoma and biopsied it. Guess what? It was a basal cell carcinoma. I got Mohs surgery on it. That was no problem, but the healing process was one of the worst I have had. I imagine it’s because it’s a sensitive area.

Wrists

These days, due to thumb holes in long-sleeved shirts, it’s easier to protect your wrists. If you put your thumb in, the material will naturally follow and cover your wrists. In the past, in all my years of running and playing tennis, there was no such thing. I never even thought of wearing long sleeves. If I applied sunscreen (which is a big if), I doubt I was careful about going around my wrists. I have long arms, and when I started wearing long sleeves, they didn’t cover my wrists. The lighter color than the rest of my skin shows the places where I have had Mohs. One is a little circle at the base of my right thumb. I assume it was squamous cell carcinoma because that’s what most of my skin cancers have been. And I seem to always be treating little patches of actinic keratoses on my wrists with the Efudex/Dovonex combination that I use.

Ankle

The inside of my right ankle is the site of my worst skin cancer experience. Same as with the ear, I noticed something that was not right. The usual sign is flaking skin, but it was a little bit odder than that; it was an irritated circle that would not calm down. Again, I happened to see a different dermatologist in the large practice where I go. I believe she gave me cortisone cream to apply. It did not calm down. By the time my regular doctor did a biopsy, it was the size of a quarter. Once more, it was not my usual squamous cell carcinoma, but rather a basal cell carcinoma. It was off to Mohs again.

I needed a skin graft

It turned out that she would need to remove so much tissue that I would need a graft. The fellow assisting the surgeon drew a small rectangle on my left side. Then he numbed it and cut the skin. This sounds horrible, but I honestly remember it not being too bad. The fellow was a cute guy, and, this is going to sound strange, I enjoyed chatting with him, perhaps a bit flirtatiously. The surgeon showed me the hole. She said it might look like it would never close up, but it would. It looked bad for a long time. Now it looks like a small sand dollar. Despite the banter with the cute doctor, I would have been happier if I had avoided the experience.

Tops of the feet

For some reason I have not had a problem in this area, though I don’t think I was ever good about putting sunscreen on the tops of my feet. I am including this because my poor ex-husband was always getting sunburned on the part of his feet not covered by the leather of his sandals. The skin was bright red and I assume painful. If this is you, you could avoid the experience by applying sunscreen to the tops of your feet.

In summary, try to remember: Ears, wrists, ankles, feet. To help, you could sing to the tune of "Head, Shoulders, Knees and Toes!"