The Black Hills get maybe four good months of real sunshine a year, and as soon as the weather turns, everyone wants to be outside in as little clothing as possible. Hiking, ballparks, lake days, that first patio coffee where you tilt your face into the light like a houseplant. Ultraviolet light, though, doesn’t take the summer off. A single bad burn now can echo for decades.
Plenty of long-running beliefs about sun and skin do more harm than good, and most of them get repeated every June at the lake. Dr. Christopher Gasbarre, a dermatologist at Monument Health in Spearfish, has practiced in the region for nearly thirteen years and has heard them all. His focus is skin cancer treatment, including Mohs micrographic surgery.
The base tan myth needs to die
Plenty of folks still believe a few sessions in a tanning bed before vacation will somehow protect their skin once they hit the beach. Dr. Gasbarre hears it constantly, and he has a clearer way of describing what a tan actually is.
“Think of a tan as your body’s natural defense mechanism to ultraviolet exposure,” he said. “Your body saying, I saw too much carcinogen, and I’m going to try to defend myself as best I can by increasing pigment production.”
By the time your skin browns, the damage has already happened. Pigment is a response to UV that already hit your skin. When someone says they want “a base,” they’ve done the harm they were hoping to prevent. Dr. Gasbarre still tells patients to live their lives. Mistakes happen. Consistent protection over weeks and years is what builds real defense.
Darker skin still needs protection
Another stubborn belief: people with darker complexions are off the hook entirely. Dr. Gasbarre says the truth is more nuanced.
“One misconception is having a darker skin type makes you immune from certain types of skin cancers. And that’s not true. It does decrease risk.” Non-melanoma cancers like basal cell and squamous cell carcinomas do appear less frequently in darker skin. Melanoma risk, though, stays fairly consistent across all skin types.
More melanin means greater tolerance before a burn sets in. Everyone still has a ceiling.
Know the ABCDEs and watch for change
Self-exams matter, and Dr. Gasbarre wants people to know what to look for. Dermatologists use a simple memory tool called the ABCDEs.
- Asymmetry: a healthy mole should look the same on both sides if you draw a line through it
- Border: smooth edges are reassuring, jagged or hazy edges are not
- Color: one color is ideal, multiple colors raise concern
- Diameter: about six millimeters or less, roughly the size of a pencil eraser
- Evolution: changes over time deserve a look
Of those, evolution is the most important. A mole that itches, burns, bleeds, or changes shape, color, or size should get checked. Painful moles are uncommon, so a sore one earns a visit. Most checks turn up nothing concerning, and an unremarkable exam gives your dermatologist baseline images to compare against next year.
Genetics, history, and high-risk patients
For melanoma specifically, family history changes the calculus. If a parent, sibling, or child has had melanoma, your own risk rises. Dr. Gasbarre recommends skin screenings for those folks, often starting in childhood if there’s a strong family history or unusual moles.
Blistering sunburns in childhood also raise lifetime melanoma risk. So does tanning bed exposure, which Dr. Gasbarre flags as an independent risk factor for both melanoma and non-melanoma cancers. Early, high-intensity UV hits the skin in ways that linger for decades.
Sunscreen, applied like you mean it
Application failure is the biggest mistake Dr. Gasbarre sees. People apply sunscreen in the morning, head out for a long day at a baseball game, and the burn arrives by the fourth inning.
Apply sunscreen about thirty minutes before going outside, then reapply every two to three hours. SPF 30 minimum, higher if you can. Lotions and creams tend to be more reliable than sprays, partly because of recent independent testing that found benzene contamination in several spray products across multiple brands. Investigation continues, and Dr. Gasbarre suggests sticking with lotions if you’re concerned.
A broad-brimmed hat covers ears, the back of the neck, and the lower face. Baseball caps miss all three. UV-protective clothing has improved dramatically in the last decade and now wears comfortably enough for daily use.
When to come in
Once a year is the general baseline for a full body skin check. The American Academy of Dermatology has long used the phrase “check your birthday suit on your birthday” as a reminder. Higher-risk patients may need visits every few months.
As Dr. Gasbarre put it: “No one’s truly immune from skin cancer. And sunlight is the leading cause of most skin cancers and at least preventable causes.” Reapply, wear the hat, schedule the appointment.
