038: Why You Should Get An Annual Skin Cancer Check (Even If You Don't Go In The Sun) w/ Dr. Keira Barr

If you’re like me, you may have been a little neglectful when it comes to taking measures to prevent skin cancer. The truth is, you’re never too young to get checked for by a dermatologist. With skin cancer being the most common form of cancer in the US, it’s not something we can ignore.

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My guest today, Dr. Keira Barr, is a global speaker, best selling author, and educator. She’s a dual-board certified dermatologist with over 20 years practicing medicine. Dr. Barr has developed a process and path for fortifying your skin as the chief wellness officer at Resilient Health Institute. She’s working to redefine the delivery of skin care and ending the cycle of prescription products and fad trends.

You may feel that you know what skin cancer is but, in reality, it’s a very nuanced and varied disease. There are numerous types of skin cancers that take many forms. Dr. Barr discusses the importance of regularly checking your skin for signs of malignancy and scheduling yearly screenings.

There are many steps you can take to fortify yourself against skin cancer. Using the appropriate amount of sunscreen, wearing protective clothing, eating properly, and getting enough quality sleep will help reduce the risk of certain skin cancers. After this interview, I’m going to make an appointment with my dermatologist and I encourage you to do so, too.

Do you take steps to reduce your risk of skin cancer? Tell me about it in the comments!


In this episode:

  • 5 tips to start cleaning up your skincare routine (and buying cleaner products)
  • Characteristics of common types of skin cancer
  • Red flags to look for when examining your skin
  • How certain light therapies can increase your risk of skin cancer
  • Why you probably aren’t using sunscreen properly
  • The best ways you can protect your skin from harmful sun rays



“Bottom line is skin cancer affects everybody. We have children who are diagnosed with melanoma, so it’s never too early to get your skin checked and it's also never too late.” [2:03]

“There’s a much higher risk of developing skin cancer and melanoma from a tanning booth than from your dermatologist.” [12:29]

“Treating yourself well, living well, that is going to be your best line of defense from not only skin cancer, but any chronic disease across the board.” [17:36]



Rachael Pontillo Episode about ingredients hidden in “healthy” skincare

Why Being Too Clean Is A Problem For Your Skin

Counter Culture Clean

Find Dr. Keira Barr online

Follow Dr. Barr on Facebook | Instagram

Skin Whisperer

Interview with Kelsey Kinney on the Healthy Skin Show


“Bottom line is skin cancer affects everybody. We have children who are diagnosed with melanoma, so it’s never too early to get your skin checked and it's also never too late.”

038: Why You Should Get An Annual Skin Cancer Check (Even If You Don't Go In The Sun) w/ Dr. Keira Barr FULL TRANSCRIPT

Jennifer:              Hi everyone. Welcome back to The Healthy Skin Show. Today I have a very special guest with me, one that slightly frightens me, but more so because I realize that I have probably in hindsight not been super good about getting myself checked and so we're going to talk about what exactly this is about, but I want to welcome to the show Dr. Keira Barr She's a global speaker, internationally bestselling author and educator. She's also dual board certified dermatologist with over 20 years experience practicing medicine with all of the discovery sheets made as well as her own experience with skin cancer. That's what we're talking about today. And apparently I might, I'm feeling a little bit like I've been a little reckless and neglectful of my skin. So Dr Barr will let me know, I'll use myself as an example, but she has developed a process and path that fortifies your body, your life and your skin and throughout her programs, services and support as a chief wellness officer of Resilient health Institute, she's redefining the delivery of skincare and working to end the cycle of prescription products and fad trends that then total natural way, which I love.

Jennifer:              Thank you so much for joining us.

Dr Barr:                 Oh, it's my pleasure.

Jennifer:              So, okay, let's be honest, I'm 38. That's when we're having this conversation too. So I don't know, you know, if somebody is listening to this podcast in the beginning, you know, I've done other podcasts for a long time, so I'm just letting you guys know I'm 38 right now. So Dr. Barr, am I too young to go get my skin checked for skin cancer or am I, have I been neglectful? Be honest.

Dr Barr:                 You're never too young, you know? And, and this, so bottom line, my job is not to make anyone feel bad, right? We've got to start with where you are, right? So 38 is young, but bottom line is skin cancer affects. Everybody we have children who are diagnosed with melanoma, so it's never too early to get your skin checked and it's also never too late to get your skin checked. So I would say now is a perfect time to begin. So I think what's really important to appreciate, and I don't think most people think about this, but skin cancer is the most prevalent cancer in our country right now. It is most prevalent, more common then breast cancer, lung cancer, like then all like other cancers combined. Skin cancer is the most prevalent.

Jennifer:              And yeah, actually before we go into that, what, you know, I think we throw around the term skin cancer and melanomas and also what exactly does it mean and actually I'm asking from my own curiosity, because maybe listeners here are going, Oh, I know what skin cancer is, but I wonder if too, there's a more nuanced answer that you as a dermatologist where a, you've had this and you're helping people either determine whether they have it or whatnot. Is there a more nuanced answer of more so than just like, Oh, your skin is cancerous? Like what is skin cancer?

Dr Barr:                 Yeah, that's, that is a fantastic question because there are nuances and there are different types of skin cancer. So when I say the most prevalent cancer, I am referring to what we call non-melanoma skin cancers. And what falls into that category are the skin cancers, basal cell carcinoma as well as squamous cell carcinoma. Those are the two most common. And those are derived from your skin cells in the top layer of your skin, your epidermis. The basal cells are the very base of that top layer. And then this squamous cells are the skin cells are the keratinocytes that make up the other layer. So it, those are the skin cells that are in the very top layer of your skin. And then there are other types of skin cancers, one called Merkel cell, which is more rare, although it is becoming more common. And then melanoma, which is also derived from a skin cell called your melanocyte, which is the pigment producing cell. It gives our skin the color. It's what what we, Oh, just like if I can show you like on my hand, I have what an a mole or a [inaudible]. Those are benign collections of these pigment producing cells. And the malignant counterpart is melanoma and that is the most deadly type of skin cancer.

Jennifer:              Oh wow. So yeah. What should someone, okay, so all right, if people are listening, right? So I've been a little, I'm right there with you. Everybody, if you haven't gotten checked, I have not gotten checked. So I've been right there with ya. But if, if, if we're now going to start looking at our skin, what would be some red flags? If you're looking in the mirror tonight after listening to this, what is, I think regardless, we should make you a promise, dr Barr, that we should all make an appointment just to have, I guess a skin cancer check at the doctors, which I assume that the dermatologist would be covered by insurance, but is there any red flags that we would see on our body that you should be like, okay, this is not something you put off to next month or in three months. You need to make the appointment for this week.

Dr Barr:                 Yeah, I love this. This is so ideal. So yes. So at a minimum, what I recommend is everyone at least once a year have a total body skin exam. My favorite piece of advice for everybody is to get naked. Like I we're just getting to know each other. Like, c'mon, get naked. The best advice, you know your skin better than anyone else. So I always suggest one day a month you pick the date of your birthday and every month you check your birthday suit for any uninvited guests, right? So before you get in the shower, you're already naked. You're checking out your skin, and what are you looking for? You're looking for? With regards to the most deadly skin cancer, there is melanoma. We talk about the ABCDE's of pigmented lesions. So when you have a pigmented lesion, so something that's not flesh colored.

Dr Barr:                 Molds can be brown, black, sometimes they can be pink. But a stands for asymmetry. So when you have a spot on your skin, you want to make sure that if you draw an imaginary line down the middle, that both halves of that spot are equal, that they are the same appearance on both sides. So it's symmetric, right? B is for border. So you want to make sure that the spot has a nice sharp demarcation. It doesn't have jagged or blurry edges. You can, it's a crisp margin. C is for color. You want to make sure that something is a uniform in color throughout. So that's also important. You don't want something that is a brown, black, blue. I mean there is something called the blue naevus, but you don't want a ton of variation of color within a single lesion. D is for diameter and that is a soft call we used to as the party line was.

Dr Barr:                 If it's a larger than a pencil eraser you should get a check. But I assure you skin cancers come in all shapes and sizes including very, very tiny. So the key is really E which is for evolving a spot that is changing over time. That is the one you want to bring to your dermatologist. So you are, you know, every month you are looking for the ABCDE's. If something is not symmetric, it has a jagged or irregular border. It's changing in color or varying in color. And it is, you know, again, changing over time. The other things that you should look for for the non-melanoma skin cancers like basal cell and squamous cell is a sore that isn't healing. You think you've got a pimple on your face and it just won't go away, or you have a flaky spot on your face and you peel it off, but it keeps coming back. Those are things that are not necessarily skin cancer, but those are the type of things that you want to bring to the attention of your dermatologist. And another soft call. Sometimes you know, a spot that is just persistently itchy for, you know, it just starts itching. And it's not like a couple of days. It's like weeks and, and so that could be an indication that your, you know, your body's sending you some messages, get that spot checked out.

Jennifer:              And I know a lot of the listeners here, you know, the, because it's The Healthy Skin Show and we deal with a heck of a lot of eczema, psoriasis, dermatitis, et cetera, that probably might be freaking some people out right now. So that's another reason why I do actually encourage clients when they come to me to go get checked by the dermatologist, just to make sure that there's nothing, you know, this is a good example as to why you want to make sure that you get those itchy, flaky areas checked for what they are, what's going on there. Can I actually ask you a question, and I don't know if this is a crazy question or not, but it might have crossed some people's minds, but if you have a chronic skin condition, like one of these rashy itchy think, does that ever in a sense predispose you more to skin cancer or are they completely not connected?

Dr Barr:                 There are some connections. There are certain skin conditions that have been associated, especially with the squamous cell carcinoma type. But those, yes, there are certain chronic skin conditions that have been associated with skin cancer. You know, a caveat to that too is there are certain like an individuals who've had, who have psoriasis for instance depending on the therapy that they are being given if it's an immunosuppressive medication or they've had a lot of light therapy, those medical, those treatment modalities may put them in a higher risk stratification for skin cancer. That is always a possibility too. And that's why we follow those patients very closely and check them and make sure that again they're not, they don't have lesions that are growing, changing. One of the other signs was something that's bleeding. Did I say maybe it's not as a sore that's not healing something that's spontaneously bleeding. That's, that's another reason to get your skin checked.

Jennifer:              Okay.

Dr Barr:                 Yeah.

Jennifer:              So I actually, I want to talk a little bit more, I love what you were saying about the light therapy. So does light therapy increase the risk? Cause that's, that is used sometimes with eczema and I've seen that on message boards. I didn't use that when I had eczema, but I've seen that some people have given that a shot. And then I've seen that some people have said, Hey, I actually developed a skin problem that was going heading or was actually skin cancer as a result of doing the light therapy to resolve the rashes. Is that like a legit risk?

Dr Barr:                 M,yeah, yes. And umore so many, many years ago, back in the day we would use,uwhat we call [inaudible] therapy. It was,ufor patients with psoriasis, it's ultraviolet a,uradiation with a photo sensitizing agent called [inaudible]. And so you would, those patients would get,ulike hundreds of treatments,uand you would see that they'd have what we call [inaudible] freckles, these big brown splotches and, you knew exactly the kind of treatment they had. And there was a little bit, there was a concern and a risk for patients to develop, mkin cancer. That being said, mVB and narrowband, UVB light is what is used a lot more frequently for psoriasis patients and some eczema patients. And for other photo, mensitive conditions we actually like can be incredibly beneficial because it is an immunosuppressant. It does suppress the immune system.

Dr Barr:                 So on one hand that's what we're looking for because in psoriasis, eczema, the immune system is jazzed up and so we want to suppress that. On the other hand, we're suppressing the immune system. So some of the the, the genes that we don't want on sometimes can get turned on. So it's a very fine line. This is why when individuals get light therapy, you have to have it done by a dermatologist who was well versed in light therapy. This is why we always discourage people from going to a tanning booth where because when you go to a dermatologist, the amount of light you get, it is seconds. It is so minute. It is quick. It is fast. When you go to a tanning booth, I mean you could be in there for minutes and so the blast of light, the intensity of light, it's not regulated. There's a much, much higher risk of developing skin cancer and melanoma from a tanning booth than from your dermatologist where it's tightly regulated for therapy.

Jennifer:              Wow.

Jennifer:              That is like, that's a good differentiator there because some people might think it's either cheaper or more convenient to go to a tanning bed, but if, if you do have, and so for anybody who doesn't know this, that that is a legit option as far as treatment. And yeah, that, that was one always want to concern that I had was what about the cancer risk? But I never even if for some reason it didn't occur to me that somebody might go to a tanning bed, but now that you say that, that could be something that someone might try to do and there is a risk there. And, and the other point too that I want to underscore is that those immunosuppressant drugs, it isn't actual risk. Like it's not like nobody gets that that is a problem with those drugs and when you sign on to do them, that is a risk that you take.

Jennifer:              And I do know of people who have developed cancer as a result of taking those immunosuppressants for, for psoriasis and other immune system type diseases. So with that said is, I think this is then the question, like some people feel that they, their skin feels better when they go out in the sun. But you know, you made this interesting point before we started about sunscreen and you were saying it's actually not your first line of defense when it comes to skin cancer. And.

Dr Barr:                 Yeah.

Jennifer:              So I'm not going to share my beliefs on sunscreen because I think they're personal, but I would rather hear it from you cause you're a dermatologist. So tell us what are, what do you recommend? Like what should we do about this? Like where should we be starting as far as making sure that the rays that come from the sun, which yes, help us produce vitamin D can certainly make you feel better cause have being deprived of light and sun is depressing. But what should we be doing here?

Dr Barr:                 Yeah, so its hands down sunscreen. I think it is, it is an important part of your strategy. So there's, you know, protecting yourself from the outside in and the inside out when you go outdoors, like sunscreen. I always say it should be like brushing your teeth. It's part of your daily routine, but you can't rely on it to protect you as your one and only first and foremost. Most people don't apply enough sunscreen to begin with. The recommendation if you're going out for a day at the beach, is to use one ounce. So a shot glass worth of sunscreen for your whole body.

Jennifer:              A shot glass?

Dr Barr:                 A shot glass. Yeah.

Jennifer:              Oh my god that's a lot of sunscreen.

Dr Barr:                 Most sunscreens on the market right now, there are about a four ounce bottle. So if you, and let's just say four of your girlfriends that go to the beach, each of you should be using an ounce. If you're wearing a bathing suit and you're not wearing a rash guard or anything like that, you're just going out into your cute, teeny weeny bikini. That sunscreen bottle should be in the garbage after you've all applied. And then two hours later you need to reapply it because you know, you've either sweated it off, wiped it off on your towel, you went swimming. And most people aren't doing that, right? So sunscreen can't be your only line of defense because most of us aren't using inappropriately. We're using probably a quarter of the amount that is recommended. So that's a big reason why sunscreen can't be your only line of defense.

Dr Barr:                 So that's why we also talk about wearing clothing. I mean the skin cancer foundation, you know, they say clothing is a number one line of defense, right? It covers, you have coverage. Great. So you're wearing clothing, you're wearing a nice broad brim hat, three inches or greater. You're, you know, accessorizing with sunglasses you know, seeking shade. So those are things that you do from the outside in. So use it as a good, you know, ladies, if you want to go shop and go on a shopping spree and get the cute hat and sunglasses and you know, there's a lot of great companies now that make sun protective clothing a little bit more fashionable. There's still, there's still a lot to be desired, but it's much better than it was. The biggest, you know, to, to really, truly build your resilience. It begins nourishing yourself from the inside out.

Dr Barr:                 And that is, you know, eating whole nutrient dense foods, filling your plate with lots of colorful fruits and veggies to get your phytonutrients to make sure that you're bolstering your supply of antioxidants because those get used up very quickly when we're exposed to environmental stressors, including sun exposure, air pollution and everything else that comes our way on a daily basis. And so, so eating well getting quality sleep. You know, I'm not, I'm charging mine right now, but I do wear an aura ring to help me track like the quality of my sleep. And I know that, you know, when my deep sleep is taking a plummet, I know for sure. I'd been on my phone too long at night and I haven't shut down my screen then and there's little, little things that we can do, you know, moving your body and, and especially mindset work. So it's kind of just living, treating yourself well, living well, that is going to be your best line of defense from not only skin cancer, but any chronic disease you know, across the board.

Jennifer:              Yeah. And that's always a big thing here is like trying to clean up the diet, get rid of the junk, eat as clean. You know, I always say the 85 15 rule is pretty good. That's usually where I kind of stick. You know, I don't like people to feel guilty about how they do or don't eat. Try within the 85% of your week, eat as healthily as you can, put a lot of colors on your plate. And that's one reason, another reason why I'm not a fan of elimination diets, but you guys have heard me talk a bunch about that and you know, you certainly can check out. We can put some links for anybody who's like, but I don't like this food and I don't think I should eat this food. I'll put a link to a podcast. Kelsey Kenny and I talked to all about that. So we'll link to that so you can understand, you know, why that may not be the best way. And trying to really fill your plate out with as many colorful fruits and vegetables is really a wise way to go regardless of what your triggers are. Cause oftentimes we found with chronic cases are not food related. So but wow, Dr Barr, this has been so great and so helpful and now I realize I've got to actually make an appointment with my dermatologist. I'm going to do it.

Jennifer:              Yeah. And I teach everybody else to do it too. I, this is not just for me and I know that some of you have gone for your skin rashes, but that's different. That's not, you know, when you show up for hey, can you look at my rash on my arm or my hands? You're not, the doctor's not checking you out for that other reason. So this is going to the dermatologist for a completely separate purpose. And that's why even if you've been there last month or you were there two weeks ago, this is right. Am I right in saying that, that this is a separate intention and purpose to go to the doctors as more of a preventative measure to make sure that we hopefully don't have anything. And if we do have something, we catch it early.

Dr Barr:                 Absolutely. I couldn't agree more. And the other thing too is, you know, putting that date in your calendar every month, getting naked, checking your skin. And if you're not sure, like snap a photo, that's a beautiful thing about smartphones. Snap a photo and you can track a spot over time if you're not sure as it changing is growing. I don't know. Recruit everyone you know, get your hairdresser to check your, your scalp cause you can't see it. Get your dentist to check in your mouth. Get your ophthalmologist, your optometrist to look in your eyes. Get your OBGYN to look inside when she's doing your exam. That being said, get familiar with every nook and cranny yourself. Get that hand mirror. Get familiar with all your bits and pieces because melanoma does occur where the sun doesn't shine. So check everything between your toes. Ladies between your man, pedi's like make sure there's no pigmented lesions underneath your nails too.

Jennifer:              Wow. So this is skin and beyond.

Dr Barr:                 Yeah, yeah. And to your point about elimination diets, you know, and, all this pressure, I'm so not dogmatic about a lot of stuff, but it's all about upgrading, right? I mean, I love a good glass of wine and my chocolate and there are benefits, right? There's the resveratrol, the flavonoids in the chocolate, but it's all about like upgrading the, what you're eating, right? If we read those labels, if you can get biodynamic organic wines, like fantastic, but life is meant to be enjoyed. It's just about making the best choices you can when you can.

Jennifer:              Right.

Dr Barr:                 To serve your health. Yeah.

Jennifer:              Exactly. And I'm sure you'd cover all of that in your book. Dr. Barr has a fantastic book called The Skin Whisperer and she, I will, I will actually put a link to her website to all of her social media as well as her book. You've got some great. W this gift is actually a free copy of your book. Am I right?

Dr Barr:                 Yeah, you are right. Because I just, I want everyone to have access to the information. Like said it is not just about skin cancer, but I do put a lot of information in there about everything we talked about how to check your skin, what to look for, how to eat, to you know, stave off the, some of the damage from the environment. And so I want to make sure everyone has access to that information.

Jennifer:              Thank you so much. We appreciate it. And everybody, I'll put the links right in the show notes so it's easy for you to access if you're listening and driving, don't go online. Wait till you get home. It'll be waiting there for you. Dr. Barr, thank you so much for joining us. I really appreciate it.

Dr Barr:                 My pleasure. It was super fun.

Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.

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