All right, first set. As soon as this greasy plaques psoriasis cream dries.

Hey, you need a spoter for that bench press?

Who are you? I'm your plaques psoriasis. Looks like it's topical o'clock over here. Yeah, I put some cream on a few itchy flaky patches, but no biggie.

Maybe.

But I could still show up on your scalp, elbows, nails. Come on, man. Messy plaques psoriasis creams can make for a slippery situation. Treat even a little plaques psoriasis beneath the skin. Visit beneaththeskin. Com. Com.

Back in 2015, Jackie Smith was fresh out of college. At just 21 years old, she was so excited to start her life, but there was an issue with her skin that was concerning her. She struggled to be properly diagnosed. Until one day, she received surprising and devastating news.

I could still remember his face when he walked in the room. It was very solemn. And he said, Jackie, you have stage three melanoma. And that was something that was completely shocking. Because you don't see someone that looks like this, usually, with melanoma at all. And then for it to be stage three, how did this happen?

Hi, guys, and welcome. I'm so glad you're here. I'm Nicole Berry, and this is Skinqueries, a show all about our skin and its health. A little bit about me. I create content online and IRL, mostly around plant-based cooking, intuitive eating, and all things wellness. Basically, feeling Good is at the core of everything I do, and I'm so excited to see how that relates to our skin. As we grow and age, our skin is really a record of a life well-lived because there isn't one body part that I could think of that reflects our well-being as clearly as our skin. Our habits, lifestyle, and conditions play a major role in how it looks and feels. And because our skin is such a huge factor in how the world sees us, it can affect how we see ourselves. You may have come to this show because you've had your own skin challenges. Let's face it, most of us have. So let's go on this journey together. Cancer. To really understand what's going on with our skin, let's unravel the mysteries happening inside and out. We're going to hear from experts, doctors, and people who have extraordinary stories to share about skin, health, and the power of understanding what's happening below the surface.

One of these stories comes from Jackie, who you heard off the top of the show. We're going to talk to her about her experiences with cancer and her relationship to the sun now. We'll also hear from a dermatologist who's going to guide us through all things sun protection. I can't wait to get into it. Welcome to Skinqueries. I'm going to be honest, guys. I love the sun. For me, it's such a great source of natural endorphins, energy, and such a mood booster. The way I get my daily dose of sunshine is usually walking my kids to school in the morning. In the summer, we'll go to the beach, and I try to stay out of the sun during the midday hours. I'll go in the morning with my family or in the afternoon to make sure that we're not getting those really strong rates. As I'm getting older, the more I understand how important it is to practice safe habits and encourage my kids to do the same. I have to admit, I wasn't always this way. Growing up in New Jersey, I grew up going to the tanning salon and going with my friends a few times a week.

I actually cringe to think about it, but that is what you did in the '90s in New Jersey. I remember going to Cancun on spring break and getting super crisp, flathering on the baby oil and everything I could to get as tan as possible. And though I'd like to think times have changed and we've all moved on from getting cooked in the sun after talking to a lot of people, it seems our relationship still remains a bit complicated. I love the sun, but sometimes it doesn't love me.

After the first day of senior year, I went to my friend's house, and we laid in the sun all day.

And then for the first week of school, I had sunburned eyelids.

I didn't put sunscreen on my eyelids. I didn't know I had to.

I was in the sun for four hours. And when I came back from this trip, I noticed I had a bunch of freckles on my nose, and the nose part freaking me out.

I'm like, I've never dealt with this before.

I didn't realize the sun can impact my skin so much like that.

I think I just took it for granted that sun protection is very underrated.

I don't wear sunscreen because as a Brown girl, I feel like sunscreen is a lie. No. Sunscreen is team. And my grandma, you'd always be like...

People are still not consistently wearing their sunscreen, but you could hear in their voice, they know better. Today on our first episode, we're going to talk about the sun and the damage it to our skin and learn about best practices for our skin and our health. I'm excited to chat with our first guest, Jackie Smith. You're from New Jersey?

I am. I'm from Jersey. You're from North Jersey.

Me too. What town?

I'm from Hackensack. I'm from Anglewood.

We're neighbors.

I was bored in Anglewood Hospital. Oh, my gosh. My dad was a detective in Anglewood for 30 years.

Jackie is here because she's kindly agreed to take us through her story.

I met two times, Stage 3, Melanoma survivor over the last 20 years. Believe it or not, it's been 20 years since I was initially diagnosed with stage 3 melanoma. During that time, I've volunteered and worked in patient advocacy and health policy. I'm really trying to make strides for not only people living with melanoma, but for all people affected by cancer.

It's safe to say that none of us can ever prepare ourselves for a diagnosis like Jackie's, and even more so while she was in her early 20s about to finish her undergrad degree.

I had this lump in my bikini line. No one seemed to think it was anything serious. I'd go to the health center, they'd say it was an inflamed hair follicle or something minor. They told me to take a sit bath, something that at that point, I didn't even know what that was. So you're trying to figure out things. But inside, I knew it was something serious, but no one seemed to think that it was because I was young.

And was there something about your intuition that really led you to pursue this?

I'm one of those people who need answers, and I need things to make sense. I know some of us will bury our heads in the sand. That's not me. I kept going back because it just didn't seem right. I knew it was not an inflamed hair follicle. It was a lump that was underneath the skin layer. When I detected it, it was about the size of an almond. That's not normal. As much as I wanted to believe it was, I knew it wasn't. Because I need answers, I kept going back until I felt that I had a sufficient and correct answer to that question.

How many times did you have to go to the doctor before you were diagnosed?

Countless. Honestly, I went at least four times. Wow.

Fortunately, Jackie managed to beat the odds. It was a chance encounter that finally got her the immediate and specialized care she needed.

In the end, I ended up being diagnosed after going with my mother for her mammogram and them presenting a breast with a model of a benign lump and a malignant lump. When she described what malignant lumps typically present as, mine checked all of those boxes. That's what made me go see my primary care. He referred me to a surgical oncologist. I remember being early 20s, supposedly getting ready to start my life and having to go see an oncologist was quite frightening. When I was diagnosed, and I remember it like it was yesterday, day because initially the surgeon was very jovial. He knew one of my mother's doctors. We were like, great friends meeting. So they put me to sleep. They had to remove this lump. I found out it was a lymph node that was filled with melanoma. But when I went in to get the results from the biopsy, he did not look at me when he saw me coming down the hall. Interesting. And that was something that even to this day, I can see his face. I can see this physician sitting at his little desk, and I could still remember his face when he walked in the room.

It was very soluble. And he said, Jackie, you have stage three melanoma. And that was something that was completely shocking because you don't see someone that looks like this, usually, with melanoma at all. And then for it to be stage three, How did this happen? And when did this happen? So I was completely shocked.

You mentioned that you said, Someone like me, someone who's young, this is not supposed to happen to me, right? That story. So do you believe that there's misconceptions when it comes to melanoma, whether it be your age, whether it be your race or ethnicity, that we take on as as truths and are potentially not so true?

I have been in this space for 20 years, and I know that people who are darker typically feel that melanin serves as a protectant against UV rays. I've heard this a lot, that it's like a superpower. I said, Okay, well, I I definitely have a lot of melanin, and it didn't serve as a superpower for me.

As a Black woman, Jackie has melanated skin. Melanin is a substance that produces pigmentation in the eyes, hair, and skin.

I remember, too, saying, Oh, no, I don't sunburn. Like, Oh, look at me. One of my friends said, No, you're sunburn. Look at your nose. It's red. It's going to start peeling. And it did. It's a dangerous misconception. Because one of the things I've learned over the years is that when people of color, African-Americans in particular, present with melanoma, It's typically later stage. So it's a poor prognosis. When we look at charts, the incidence rate is almost flat, but the mortality rate has a spike.

Because Jackie insisted on being her own advocate and stuck to her intuition, she survived and went on to thrive. We'll hear more about that later. But first, let's talk to a dermatologist who spends her days diagnosing and treating skin cancer. She'll tell us about the best ways to protect ourselves right after the break.

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Welcome back to Skinqueries. Let's get into the science behind our skin's relationship to the sun. I'd like you to meet Dr. Mary Stevenson, a surgeon here in New York City. Hi, Mary. Thanks for being with us today.

Hi, thanks Thanks for having me.

Mary, can you tell me a little bit about your practice in New York City?

I'm a skin cancer surgeon, specifically a Mohs surgeon, which is a specific surgery for skin cancers in a cosmetic dermatologist. But I take care of people who have melanomas, basal cells, squamia cells through a unique form of surgery invented by Dr. Frederick Mohs, generally removing cancers and then putting things back together after we take them.

We're just going to dive right in. Can you tell us, what does sun damage look like?

Sun damage comes in a lot of ways. We have sunburns, obviously, blisters, itchy skin, hot skin. In different shades of skin, you can have different things. You can have tanning or darkening. You can also have peeling. All of those things are signs that you're getting damage from the sun. Then as we continue to have sun damage, we get aging of the skin. So wrinkles, less thickness, which means more laxity. It also means if you have paper-thin skin, you'll see bruises more. Those are the things more for vanity's sake that you can see from aging in the sun.

What is your conversation when it comes to sun care?

It's definitely a range. People who've had skin cancers or very concerned they had their first skin cancer often become very compliant and want to put their sunscreen on every single day. I admit that as a skin cancer surgeon, someone who's very fair, I put my sunscreen on to prevent skin cancer but also because I want my skin to continue to look nice as I get older. Things like melasma, where you can have pigment on your cheeks. If I get sun, I start to get melasma, so I stay out of the sun, also admittedly for vanity's sake. Then there people who really stay out of the sun because they don't want their skin to age. They don't want to have wrinkles when they're older that come sooner. They don't want to have sun spots, things like liver spots. We used to call them on our hands, all of those things. People have a wide range of reasons. To me, as long as you're putting on your sun screen, I'm good with it.

And is it true that when certain people with darker skin, because they have this perception that they're not getting as much sun damage, is it that they might get diagnosed later in life or potentially have worse when it comes to their diagnosis since they haven't been so cautious?

So we definitely know in darker skin tone and skin of color, that diagnosis can be later and that outcomes can be worse because it's being caught at a later stage. I think awareness is really important. Just because you have darker skin doesn't mean you can't get burned, doesn't mean you can't get damage from the sun, and doesn't mean you can't get skin cancer. I take care of all ranges of skin. Yes, a lot of Caucasian skin, very fair skin people, are repeated need flyers in my office. But you can get cancer no matter what your skin tone. And I think a lot of people don't think that's true. A lot of people feel like, Oh, I'm tan. Even lighter patients who go get that terrible sunburn and then their skin tans say, That's my protective layer. That's not your protective layer. That is your skin making melanin and trying to fight off the rays that are damaging it.

Interesting. I actually didn't know that, that that is what it means and what your body is doing. I mean, our bodies are so amazing when it comes to trying to acclimate and protect ourselves naturally. That's incredible.

That's exactly what your body is doing. It's making melanin, which absorbs UV rays, and that's the sun's rays that are going out, and trying to make more of it from your melanocyte. So there are cells in your skin that make the melanin, and then that goes into your skin, and that's what's causing you to protect yourself.

All the years that I've been on this Earth, I had no idea that's what tanning was. And so you know me, I'm trying to be a reformed tanorexic, right? Too much. For someone who does like the sun, what are the habits that we can incorporate into our lives beyond just hiding at home?

I think there are so many things we can do. One, sunscreen. So you should put sunscreen on every day more so in the summer, and it should just be part of your routine. The little bottles of sunscreen at the drug store that are with the moisturizer are really great if they're SPF 30. A lot of them are SPF 15, and we really prefer SPF 30 or above. Okay. I usually wear higher than that, 50 or 70, but I have sunscreen on every day, on my hands, on my chest, on my neck, on my face. Ears, I find really hard, even personally, getting here, getting behind. And then besides just sunscreen, you have to use it correctly. So you have to reapply it, usually every 2 hours if you're out in the sun, if you're sweating, if you're going in the water, and you have to use enough. So we say a shot glass is what you should use to cover yourself. That's a lot of sunscreen.

For your entire body, not your face.

Yes. I mean, you can do what you want, but yes, for your entire body. But if by the end of the summer, you, for your family or yourself, still have that same bottle of sunscreen, you're not using enough. You should be going through that more quickly. And then other things like sun protective clothing we now have, which has a UPF, which tells you the factor it's blocking sun.

My kids wear rash guards during the summer. It's so easy, and there's actually really cute stuff available. But even if you can't get your hands on sunblock swim wear, regular clothes work just fine.

I was like the kid in the T-shirt in the pool, which I hated when I was little. We have a lot of options these days, and even companies making really nice options. I don't go to the beach at noon. I'll go nine o'clock, 10 o'clock for a little bit. I stay out of it, usually 11:00 to 1:00. My favorite time to go to the beach is around 3:30. It's quiet, it's nice and a little more shady. Use an umbrella. Don't be directly tanning yourself. Stay under the umbrella. Those are hard things to do because the sun feels good. But I find that they're really important behaviors to incorporate into your everyday. During the summer, if you live in a warm place, because they're going to keep you protected.

When it comes to application of sunscreen for your skincare routine, for instance, do you put a moisturizer on first and then sunscreen, or where does it fit within your skincare regimen?

It depends on the season for me. If I need less moisturizer, I'll just use my sunscreen as the daily cream. But I usually put on a mineral, which is something like titanium or zinc, similar to what might be in a baby's diaper ash cream. So very protective. We now have really nice formulations of those that aren't this pasty white. But usually my routine really is mineral sunscreen and then a tinted sunscreen over that as the idea of a foundation. So I'm double-covered and also feel like I'm looking the way I want to. Right.

And you mentioned titanium or zinc. Is one or the other better, or do you look for certain ingredients when seeking out a sunscreen?

There's physical and chemical sunscreens. I prefer physical. Most dermatologists prefer physical. Chemical sunscreens are absorbing that energy and transmitting it so that it doesn't harm you. Physical ones are reflecting those rays back, so they're not even reaching you. And these are often what we traditionally thought of as baby sunscreens. The sun also has two different kinds of rays it's admitting, UVA and UVB. So this is what we call a broad spectrum sunscreen. And there are chemical ones that say broad spectrum, but I find mineral. So be the most reliable. We're lucky now. We do have a lot of ones that prevent us from feeling like we're white and goopy. I like the white and goopier ones in the summer.

I do, too, weirdly. I don't mind it at all.

I feel like I'm more protected that way. But you should be upping the ante if you're going to be sweating or in the water or just out in the summer.

What about certain areas that get missed? You mentioned your hands. My mom actually, growing up, was always like, Don't forget your hands. Don't forget your hands. That's the first thing to show So when it comes to aging. I feel like it's such an underrated one. Admittedly, I was away recently, and I was really good about the sunscreen, but my lips were the one that got a little burnt. So what body parts are underrated?

Lips are definitely hard. You can buy a lip balm. Many of those are 15. It's hard to find a 30. I actually just use my regular sunscreen. In the summer, I'll just put a little on. Your mom is dead right. That hands are a very big giveaway of age. You get sunspots, they get wrinkles.

What about the scalp?

Scalp is hard. That's why I had, and I should have mentioned that earlier, a wide-rimmed hat. A baseball cap is a cap. Yes, it protects a little bit, but it's not a hat. You also want to have a very wide rim on your hat. Basically, sun should not be reaching your face. Okay. And sunglasses that are protective are great because it's hard to rub sunscreen here. It's very irritating as well. And no sprays, which I think you would agree with. Really? Do not spray sunscreen. One, you can't just spray it on. You have to rub it in. So you might as well be rubbing in a cream. Two, you're using an air-sol. And three, you're inhaling that air-sol. So I am really not a fan of them. I feel like they cause a false sense of security. And one of the biggest mistakes people make is they're just spraying themselves and they're not rubbing it in.

Like the perfume spray and walk in is not going to be enough.

No. It's a nice idea.

Dr. Stevenson has some basic guidelines to follow when it comes to keeping an eye on your own body.

I always tell patients, check your skin once a month, and you're looking for moles that are regular. So we talk about A, B, C, D, E's. Asimetry, which means it's not smooth around the borders. B is borders, so if you couldn't circle it with a pencil. C is color. So if it has different colors, if it's getting darker. D is diameter. So diameter, generally greater than, let's say, a pencil eraser. And then evolution, and that one's really important. If you notice something changing, growing, getting darker, has darker spots in it, that needs to get checked out. Everyone, regardless of your background should go to a dermatologist, make that relationship, get screened once, and then decide with your dermatologist how often you should get screened. In fair skin, I say once a year. If you've had a skin cancer, that's a squamous or basal cell. So these are more common than melanoma, twice a year. And then if you've had a melanoma, you should be going three or four times a year and getting checked. And you know your skin. So that really resonated with me and Jackie's story. I always tell my patients, You know your skin best.

So if something feels like it's changing, doesn't feel right, go show your dermatologist and get it checked out.

Dr. Stevenson, thank you so much for being here.

Thank you so much.

It's interesting that self-advocacy keeps coming up. It's something Dr. Stevenson tells her patients, and it's a message Jackie is spreading as well. In the decades since her diagnosis, Jackie has been sharing her story as often as possible to raise awareness and help as many people as she can. Today, Jackie is a new mom. She and her family are thriving, but that doesn't mean she doesn't bear scars. Emotionally and physically.

Yeah, 100 %. Some are good, and some make me say, why did this happen to me? I have a nine-inch scar in my groin from where they removed the lymph nodes, and then What I call my little prison tattoos, which is something I didn't realize. When you go for radiation, they tattoo you for where the beam should hit, and they do it with a needle and ink. So I have those markers.

Like a real tattoo?

Yeah. I'm like, I have a prison tattoos. So I have those markers on me. And then from radiation, I have a scar that acts as a big border around my surgical scar. I develop lymphedema in my right leg. So much like breast cancer patients have it in their arm, I have it in my right leg. Again, I have to wear a compression stocking every day. I've had three surgeries to try to help alleviate that. And that's probably one of the more difficult things because now I'm a little asymmetrical. And for years, I went and talk about this. So this is big for me to even share.

Do you feel you didn't talk about it because was it that you were ashamed of it or that you were just not ready to talk about it?

Very self-conscious because my right leg is bigger than my left. I have this compression stocking that I have to wear every day. People stare at it, and I'd become a little angry because you see people staring. I learned, wow, people are really invasive and are really comfortable asking questions of a stranger. And asking personal questions. So that's one of the things. There are moments where I wonder, will it come back? Will I have cancer again? And I'll never forget one of my neighbors said, Cancer is a shadow that always follows you. And that stayed with me because as I move forward through life, I realize how true it is. And one of the things I talk about is how they say you survived cancer, and I feel like I'm surviving because I don't know. You survived a car accident, and it's likely you'll never have that again. But it's quite possible that my cancer could come back. So I think that's the thing that it's looming in the background, and you hope that she doesn't tap you on the shoulder again. So I joked when I was going through cancer, when people would be sad for me, and I said, Well, you know what?

I might live through cancer and get in a car accident. We're all going to die from something, and we don't know what and when. But when you have cancer, it makes it more real.

Here Here's one final thought from Jackie.

You know yourself better than anyone else. So that's one of the first things I always share with people. The second thing is to be the squeaky wheel. Be annoying. If I hadn't, I wouldn't be here today.

When it comes to so many things in life, we're all just doing the best we can. But Jackie felt something was wrong, and she did something about it. She insisted on getting the medical help she needed, which is so inspiring. When it comes to our health, particularly our own skincare, trusting our intuition while understanding the best practices is so important for ourselves and our family's well-being. I am so grateful for this conversation because it shows that balance is so valuable. It's not necessarily all or nothing. It's about enjoying what we love in doses and doing it in a smart and responsible way. Today, our guests were Jackie Smith and Dr. Mary Stevenson. A massive thank you to both. Skinquarees is hosted by myself, Nicole Berry, and executive produced by Yvonne Sheehan. Our senior producer is Tori Weldon. Our junior producers are Reem El Magrabbi and Jenny Cunningham. The show is mixed and features original music by Sam Sagham. If you enjoy the show, tell your friends. You can also listen and follow on the iHeartRadio app, Apple Podcasts, or wherever you get podcasts. Don't forget to leave a review. We would love to know what you think.

Until next time.

All right, first set. As soon as this greasy plaques psoriasis cream dries.

Hey, you need a spot off for that bench press?

Who are you? I'm your plaques psoriasis. Looks like it's topical o'clock over here. Yeah, I put some cream on a few itchy flaky patches, but no biggie. Maybe, but I could still show up on your scalp, elbows, nails. Come on, man. Messy plaqueseriasis creams can make for a slippery situation. Treat even a little plaqueseriasis beneath the skin. Visit beneaththeskin. Com.