Awaiting the return of sunny days? Headed south for spring break? Just remember, like all other pleasures that are hazardous to our health, the sun needs to be enjoyed in moderation and with good judgment.

Serious sunburns and accumulated sun exposure, primarily in fair-skinned people, are the main culprits behind a diagnosis of skin cancer, of which the American Cancer Society estimated a million new cases would be diagnosed in the United States in 2007.

Local dermatologists agree there's been an increase and it's occurring in a younger population. They say we simply are not protecting ourselves like we should.

For sun protection that works, dermatologists say it has to be a daily routine

Before Dr. Keith Lopatke gets in the car for a long commute to his dermatology office, he remembers to sunscreen his arms and even the tops of his hands. He knows car windows do not protect him from the harmful rays.

Dr. Donna Ward wears sunscreen everyday, which is not unusual of course, except she is African-American. Most darker-skinned people, she says, believe their pigment protects them from the sun. Though somewhat true, she knows there are no absolutes.

Take it from the dermatologists, the sun can cause some serious damage.

"It definitely seems like (skin cancers) are on the rise and we're starting to see it in younger patients," says Ward, who practices with Medical Specialists in Dyer and St. John. "I'm actually starting to see some of my 20- and 30-year-old patients developing skin cancers of all three types -- melanoma, basal cell and squamous cell."

Melanoma, the least common but most serious skin cancer, originates in the melanocytes, the cells that produce the skin's pigment. Because they are similar to nerve cells, Lopatke says, there is potential for the cancer to spread more easily to other parts of the body. Cases of melanoma are typically associated with a history of serious burns and one's risk may be inherited.

Melanomas tend to be black, very dark or have multiple colors.

Accumulated sun exposure over time is often blamed for basal cell and squamous cell carcinomas which are the most common types. These cancers tend to look more pink, red, crusty or bleeding.

Lopatke says literature definitely points to higher rates of the most serious form, melanoma, but whether it's a result of more sun exposure or just better awareness, he isn't sure. Nevertheless, he says awareness and education about preventing skin cancers just isn't where it should be.

Sunscreen savvy

While the use of sunscreen may seem to be the obvious answer to sun protection, the doctors say people just don't use it correctly or often enough.

Ward says too many people apply it once and assume they are protected for the entire day. Add to that the fact that most don't lay it on thick enough to get the true amount of protection advertised on the bottle.

"If you are putting on an SPF 15, you are essentially only getting about a seven or eight," Ward says.

Sunscreen needs to be a daily ritual, they say, and not just brought out for vacations. People tend to remember sunscreen for leisure activities and forget about it for everyday activities and work, Lopatke says, adding that a bottle of sunscreen should last only a week or two with about a shot glass full used per application.

Lopatke advises a higher sun protection factor of 55 or even 70 to compensate for the fact that people just aren't applying it frequently enough.

"I tell patients that during the winter months and early spring, a SPF of 15 is adequate," Ward says, "But once spring and summer come and there are less cloudy days, I recommend nothing less than a 30."

But that's assuming its being applied often enough. Both doctors say sunscreen should be reapplied every two hours, or every hourly if swimming or sweating.

Lopatke also points out that SPF doesn't give the whole picture.

"Sunscreen is always a controversial topic because the way we grade sunscreen with the SPF, it really only looks at one wavelength of light -- the UVB spectrum, which is one of the ones responsible for tanning or burning," Lopatke said. "There's another spectrum that's equally important and that's UVA. That's the one that's been shown to increase skin cancers in studies and the one that can suppress your immune system in the skin which people feel leads to skin cancer."

And don't forget that the sun's rays penetrate clothing. A typical T-shirt has an SPF of about 5, Lopatke says. He recommends clothing that is considered sun protective, especially for those continuously in the sun during peak hours.

Nobody's immune

Ward says that while fair complexions put a person at greater risk for skin cancers, the dark-skinned have a way of increasing their risk by assuming they can stay in the sun unprotected for longer periods.

"The pigment does offer some protection but you have to keep in mind it only offers some and not complete protection," Ward says. "We see basal cells develop in every ethnic group including African Americans. It's rare. It's not common, but I've seen it and it does happen."

Clued into suspicious signs Ward says new moles can develop without arousing suspicion until about age 45.

After that age, any new lesions should be removed.

Be wary of anything that isn't symmetrical, has irregular borders or color or has a diameter larger than a pencil eraser. Anything that bleeds, hurts or scabs and hasn't healed after four weeks should also be evaluated, Ward says.

But moles aren't the only things deserving of attention. The doctors recommend self-examinations of the entire body involving a spouse or significant other who can see all areas about once a month.

"Only about 20 percent of melanomas arise from a normal mole so you have 80 percent that actually pop up on the skin," Ward says, "which is why it's so important ... that they look for new lesions as well as changing lesions."

The word on tanning beds and base tans

The sun can't take all the blame for skin cancers. Ward says tanning beds are "always a bad idea."

"In my opinion, I feel they are as bad if not worse," she says. "With natural sun, you are limited. With tanning beds you have year round access."

She recalls seeing a case of melanoma directly related to tanning bed use because the cancer appeared on a patient's bottom, a place the woman had exposed in a tanning bed but never the sun.

Lopatke says a person gets up to 15 times more ultraviolet light from a tanning bed. In fact, he says tanning booths are documented as a known carcinogen by the U.S. Department of Health and Human Services.

Ward wants to dispel the myth that getting a "base" tan will help prevent a person from burning on vacation.

"That's not true," she says. "No amount of baseline tan prevents you from burning. It's not safe to tan ever. The only safe tan comes in a bottle."