Chapter SUN safety SUN SAFETY Lesson - 6 pages SUNSCREEN ACTIVITY Hands-On-Activity - 4 pages SUN-SAFE HAT ACTIVITY Hands-On-Activity - 2 pages SUN-SAFE RELAY ACTIVITY Hands-On-Activity - 2 pages SKIN SELF-EXAM ACTIVITY Hands-On-Activity - 4 pages Sun
Learning Objectives SUN SAFETY After completing this station, participants should be able to: 1. Explain the behaviors that can help prevent skin cancer. 2. Understand the importance of skin care and skin cancer prevention. 3. Explain how to complete a skin self-exam and identification of skin cancer warning signs. (Optional) Safety Requirements 1. Make certain that participants apply sunscreen with clean hands. 2. When applying sunscreen, make certain that the sunscreen is kept away from the eye area. 3. Make certain that participants wash the sunscreen off of their hands prior to eating. 4. If head lice are a concern, then consider having participants first put a protective bonnet over their hair before trying on the hats. 5. Make certain that the sunscreens that are actually applied to the children s skin does not contain the compound PABA. Some children are allergic to this compound. Age-Appropriateness This lesson is appropriate for participants of all ages. Most children are familiar with the term cancer; however younger participants may find it scary. With younger participants, focus on the importance of prevention and skin examinations. Some concepts may be difficult for younger participants. Rather than talking about skin being an organ focus on its function and talk only about the epidermis and dermis, not the types of cells in the epidermis. Emphasize the importance of preventing sunburn and the relationship between sunburn and skin cancer. Explain that ultraviolet rays are the part of sunshine that damages our skin. An 8-yearold and a 13-year old will likely have significant differences in their understanding of topics such as ultra violet radiation and the layers of the skin. Also, talk about properly applying sunscreen. With older participants add the types of skin cancers, risk factors, and warning signs. Teenagers and adults should be able to identify skin cancer warning signs during a skin self-exam, while the goal with younger children should be to simply identify skin spots that they can tell a parent or their pediatrician about. Thus, children do not need to be taught the specific warning signs of skin cancer. The depth of content and the discussion needs to be tailored to the level of understanding of the group. Refer to the Teaching Tips and Childhood Growth and Development located in the Teaching Kids section of the manual. Suggested Instructors Extension agent, dermatologist, nurse, nurse practitioner, nursing students with instructor supervision, physician, health educator, FFA students, and parent. Activities/Demonstrations Choose a Hands-On activity/demo listed below or create your own. Develop your discussion points around the Hands-On activity/demo chosen. If time allows, you may choose more than one activity/demo as part of your safety presentation. 1. Sunscreen During this activity participants will learn importance of using sunscreen, the difference between different types of SPF sunscreens and what is ultraviolet rays (UV). There are three different hands-on activities a presenter can choose from to demonstrate these key points. Activity #1: During this activity the participant will sample different kinds of sunscreens to find out which kind is preferred, most likely to be worn, and learning how to apply Chapter - Sun Sun Lesson 1 of 6
sunscreen correctly. Activity #2: During this activity the participants will work with ultraviolet beads and make a necklace or bracelets. Activity #3: During this activity the participants will paint different strengths of sun screen on sun sensitive solar paper to visualize the difference with using different strengths of sunscreen. 2. Sun-Safe Hat During this activity the participants will review proper sun protection clothing, view and try on hats that protect and do not protect their face, ears, or neck from the sun. 3. Sun-Safe Relay During this activity the participants will be placed into teams and try to dress one team member in the most sun-safe outfit and then return to the starting point. 4. Skin Self-Exam During this activity the participants will learn the importance of recognizing and inspect his or her own bodies for moles and distinguishing skin characteristics. Each participant will create his or her own personal body map to encourage follow-up monitoring. Subject Outline The following section contains information that can be shaped into your chosen Hands-On activity(ies). This is only suggested content. Choose the discussion points that best meets your objectives and correlates with Hands-On activity/demo you have chosen. I. Introduction/Capture Their Attention A. Introduce yourself and tell about your role working or playing in the sun. B. Find out about your audience. Ask questions: What happens if you stay out in the sun too long? (Make sure they identify sunburn as the answer. If someone responds with skin cancer respond with something similar to Skin cancer may come later, and we will talk about that, but what happens right away? ) How many of you have had a sunburn? How many of you have ever had a blistering sunburn? C. Discuss terminology needed to understand the lesson. Make sure they can identify a sunburn that has blistered. Ask them to describe one and provide information if necessary such as the skin swells up and looks like it has water inside. D. You may want to start with a personal story or experience. II. Discussion Points A. Skin Basics 1. Skin is the largest organ of the body. 2. The skin is made up of two main layers: the outer epidermis and the inner dermis. 3. The epidermis is made up of three kinds of cells: squamous cells, basal cells, and melanocytes. 4. Skin is the organ that holds in all the other organs and protects the organs that are inside of your body. 5. Your skin is also there to protect your body from all kinds of exposures to things such as disease, chemicals, and the sun. 6. It is your job to protect your skin. B. Skin Cancer 1. Emphasize to participants that they need to watch out for sunburn, and especially blistering sunburn because one serious sunburn can increase your risk of getting skin cancer by as much as 50%. 2. Tell participants that skin cancer is the most common form of cancer in the United States with approximately 1.3 million new cases of skin cancer diagnosed every year. 3. The major cause of skin cancer is from exposure to the sun, specifically ultraviolet Sun Lesson 2 of 6 Chapter - Sun
rays. Be sure to explain what ultraviolet means. 4. Some people are more likely to get skin cancer because their jobs involve more sun exposure. Ask participants who is likely to get skin cancer? Allow time for them to answer. Make sure their answers include outdoor workers, such as farmers. Tell participants that people who work outdoors such as farmers, ranchers, gardeners, roadway workers, lifeguards, and many others have a greater risk of getting skin cancer. 5. Farmers experience a higher rate of skin cancers than the general population. 6. There are three types of skin cancer. Each of the three types of skin cells mentioned below can develop its own type of cancer (You may choose to show a picture of each type of skin cancer from one of the brochures listed in the resource section): a. Basal cell b. Squamous cell c. Malignant Melanoma 7. Risk Factors for Skin Cancer a. Spending a lot of time in the sun b. If you have fair skin (blond or red hair, blue or green eyes, and freckles) c. If someone in your family has had skin cancer, you have a greater risk of developing skin cancer. C. Skin Cancer Warning Signs 1. The most common warning sign of skin cancer is a change on the skin, especially a new growth or a sore that doesn t heal. However, skin cancers don t all look the same. 2. The most common type of skin cancer, basal cell cancer, usually appears as a smooth, waxy or pearly bump that grows slowly. 3. Squamous cell cancer causes a firm, nodular or flat growth with a crusted, ulcerated, or scaly surface. 4. Basal and squamous cell cancers are found most often on areas of the skin that are most often exposed to the sun head, face, neck, hands, and arms. However, skin cancer can occur anywhere, even on skin that has never been exposed to the sun. 5. Discuss with participants the ABCD key warning signs of melanoma (you may wish to show pictures of these warning signs using one of the brochures listed in the resource section): D. Prevention ABCD - Asymmetry - Most melanomas are asymmetrical a line through the middle would not create matching halves. Common moles are round and symmetrical. ABCD - Border - The borders of melanomas are often uneven and have scalloped or notched edges. Common moles have smooth even borders. ABCD - Color - Common moles are usually a single shade of brown. Varied shades of brown, tan, or black are often the first sign of melanoma. As melanomas progress, additional colors such as red, white, or blue may appear. ABCD - Diameter - Melanomas tend to grow larger than common moles generally to at least the size of a pencil eraser (about 1/4 inch [6 mm] in diameter). 1. Tell participants that the key to skin cancer is prevention. 2. To help the participants understand the things they can do to prevent skin cancer, ask the following questions: Chapter - Sun Sun Lesson 3 of 6
a. What would you do if you noticed that you were starting to sunburn? Allow time for them to answer, make sure their answers include things such as you could get out of the sun, apply more sunscreen, or put on more protective clothing. b. What is SPF? Make sure they understand SPF stands for Sun Protection Factor. For example, using an SPF 15 sunscreen means that it would take 15 times longer to sunburn your skin than it would without the sunscreen. c. What SPF number do you need to look for? It is recommended that you look for broad-spectrum sunscreens and lip balms with an SPF of 15 or higher. d. How do you properly use sunscreen? 1. Put on sunscreen at least 20 minutes before going outside. 2. Sunscreen should be reapplied frequently (at least every two hours) and liberally, especially after swimming or sweating. 3. Even waterproof sunscreen needs to be reapplied frequently. 4. Be sure to apply enough sunscreen and apply to all areas that will be exposed to the sun. e. Can you name some types of protective clothing? 1. Hats with at least a 3 inch (8 cm) brim. 2. Legionnaire style hats (a baseball-style cap with a back flap that shades the neck, ears, and side of the face) 3. Long sleeve shirts and long pants (the fabric needs to be woven tightly enough to block out sunlight). 4. Sun glasses with 100% UV protection (as shown on a peel off label). 5. Special UV protective clothing is made to protect people who are highly sensitive to the sun. 3. Tell the participants that the best way to decrease the amount of sun exposure is to stay out of the sun. Since this may be impossible to do, the next best thing is to try to avoid being in the sun when the ultraviolet radiation is the highest between 10 AM and 4 PM. E. Skin Self-Exam 1. There are many people who have skin cancer but don t know it. 2. Regular skin self-examination can alert them to changes in their skin and help in early detection of skin cancer. Because some types of skin cancer can occur anyplace on the body they will need to exam the entire body, even places that are not exposed to the sun. This means that children may need a parent to help them but teenagers should be able to do a skin self-exam themselves. 3. Discuss with participants the basic steps for completing a skin self-exam: a. You will need a well-lit room, a full-length mirror, a hand-held mirror, and a chair or stool. b. Look at the front and back of your body in the mirror, then raise your arms and look at the left and right sides. c. Look carefully at your hands and arms, including the palms and undersides of the forearms and upper arms. d. Examine the front and back of the legs. Also make sure to look between the buttocks and around the genital area. e. Sit and closely examine the feet, including the soles and the spaces between the toes. f. Look at your face, neck, and scalp. You may want to use a comb or a blow dryer to move hair so that you can see better. 4. Discuss the importance of learning where their birthmarks, moles, and blemishes are Sun Lesson 4 of 6 Chapter - Sun
and what they usually look like. Then when they conduct their self-exam, they are checking for anything new, for anything that has changed, or for anything that meets the ABCD warning signs of melanoma. 5. Tell the participants that they should do a skin self-exam every three months unless a doctor tells them to do it more often. 6. Discuss with participants what to do if they find an area that seems suspicious or unusual. (Tell their parent or another adult that can help them seek proper medical attentions.) 7. Reassure participants that most skin cancers are easily treated and prevention is very important. It is important not to unnecessarily scare the participant while providing education. Chapter - Sun Sun Lesson 5 of 6
Additional Notes: Sun Lesson 6 of 6 Chapter - Sun
Learning Objectives SUNSCREEN ACTIVITY After completing this activity, participants should be able to: 1. Select appropriate sunscreen. 2. Explain the difference between lower SPF versus Higher SPF. 3. Correctly apply sunscreen. (Optional) 4. Understand the importance of sunscreen and other barriers on blocking the sun s UV rays. 5. Identify UV intensity by color of the UV beads they are wearing. (Optional) Safety Requirements 1. Make certain that participants apply sunscreen with clean hands. 2. When applying sunscreen, make certain that the sunscreen is kept away from the eye area. 3. Make certain that participants wash the sunscreen off of their hands prior to eating. 4. Make sure you use sunscreen the does not have the additive PABA. Some children may be allergic to this compound. Age-Appropriateness This activity is appropriate for participants of all ages. Emphasize the importance of preventing sunburn and the relationship between sunburn and skin cancer. Explain that ultraviolet rays are the part of sunshine that damages our skin. An 8-year-old and a 13-year old will likely have significant differences in their understanding of topics such as ultra violet radiation and the layers of the skin. Also, talk about properly applying sunscreen. The depth of content and the discussion needs to be tailored to the level of understanding of the group. Refer to the Teaching Tips and Childhood Growth and Development located in the Teaching Kids section of the manual. Suggested Instructors Extension agent, dermatologist, nurse, nurse practitioner, nursing students with instructor supervision, physician, health educator, FFA students, and parent. Equipment/Supplies Needed Supplies vary according to group size. You may want to have two or three stations. Activity #1 1. Different types of sunscreen (plan 1 oz. [30 ml] per child per type of sunscreen; vary by the SPF number, the product type, and purpose). 2. Paper towels to wipe off excess sunscreen Activity #2 1. UV-sensitive beads 2. Sunscreens with various SPF numbers. 3. Sunglasses 4. Various articles of clothing (examples should include tightly woven versus loose woven materials, and dry versus wet materials) 5. Paper towels to wipe off excess sunscreen. Activity #3 1. Two pans of sunscreen, different strengths of SPF 4 or 15 and 30 or 45 (plan 1 oz. [30 ml] per child per type of sunscreen) 2. Two large pans of shallow tap water to develop the paper in (per table or area) Chapter - Sun Sunscreen Activity 1 of 4
3. Paper towels to wipe off excess sunscreen 4. Solar/sun sensitive paper One sheet per child 5. Paper cut out shirt figures one per child 6. Paint brushes Subject Outline I. Introduction/Capture Their Attention A. Introduce yourself and tell about your role teaching sun safety or why you think it is important to talk about sun protection. B. Find out about your audience. Ask questions: What happens if you stay out in the sun too long? (Make sure they identify sunburn as the answer. If someone responds with skin cancer respond with something similar to Skin cancer may come later, and we will talk about that, but what happens right away? ) How many of you have had a sunburn? How many of you have ever had a blistering sunburn? C. Invite a person who has or has had skin cancer to share their experiences. Make sure that you communicate to your guest your lesson plan and the time allotted prior to the camp. This will allow the guest to prepare and help them to stay within his or her allotted time to talk. D. Review brochures or posters of individuals with skin cancer. II. Activity/Demonstration A. Ask participants to identify the SPF number of different sunscreens. B. Ask participants to judge the different sunscreens in terms of smell, texture, color, etc. in order to identify what they like and do not like about the sunscreens. Activity #1 Teach and assist participants how to properly applying sunscreen. Make sure they adequately apply sunscreen to all exposed skin. Take care to avoid the eye area and wipe excess off the hands with paper towels or have them wash their hands. Activity #2 A. Observe the beads changing color outside when exposed to the sun. UV-sensitive beads change from clear, light colors to darker colors corresponding to the intensity of the sun s UV rays. B. Assist the participants in examining the effectiveness of different forms of sun protection by covering the beads with: 1. Sunscreens with various SPF numbers 2. Sunglasses 3. Common articles of clothing 4. Wet clothing versus dry clothing C. Assist the participants in making bracelets and necklaces out of the UV-sensitive beads so they will always know how strong the sun s UV rays are when they are outdoors. D. Remind participants to watch the beads change color with varying degrees of UV exposure as they rotate through the rest of the day s activities. Activity #3 A. Give each participant a piece of sensitive paper and a cut out shirt figure. B. Fill two trays with different SPF sunscreens and label. C. Have the participant place the T-shirt in the middle of the paper. D. On the right side, have them paint with the lower SPF sunscreen lightly their first initial Sunscreen Activity 2 of 4 Chapter - Sun
of their name. E. On the left side, have them lightly paint their first initial of the last name with the highest SPF sunscreen. F. Take the paper in the sunlight until the paper turns almost white (Three to seven minutes). G. Remove the paper shirt figure and place the solar/sun sensitive paper in a tray of tap water for at least two minutes. The paper should still be purple where the shirt figure was and show varying degree of color where the sunscreen was as the paper dries. H. While paper is in the sunshine, discuss with the participants about the importance of wearing protective clothing and/or sunscreen to protect themselves from skin cancers. III. Discussion Points A. Skin Cancer 1. Emphasize to participants that they need to watch out for sunburn, and especially blistering sunburn because one serious sunburn can increase your risk of getting skin cancer by as much as 50%. 2. Tell participants that skin cancer is the most common form of cancer in the United States with approximately 1.3 million new cases of skin cancer diagnosed every year. 3. The major cause of skin cancer is from exposure to the sun, specifically ultraviolet rays. 4. Some people are more likely to get skin cancer because their jobs involve more sun exposure. Ask participants who is more likely to get skin cancer? Allow time for them to answer. Make sure their answers include outdoor workers, such as farmers. Tell participants that people who work outdoors such as farmers, ranchers, gardeners, roadway workers, lifeguards, and many others have a greater risk of getting skin cancer. 5. Farmers experience a higher rate of skin cancers than the general population. 6. There are three types of skin cancer. Each of the three types of skin cells mentioned below can develop its own type of cancer (You may choose to show a picture of each type of skin cancer from one of the brochures listed in the resource section): a. Basal cell b. Squamous cell c. Malignant Melanoma 7. Risk Factors for Skin Cancer B. Prevention a. Spending a lot of time in the sun b. If you have fair skin, blond or red hair, blue or green eyes, and freckles. c. If someone in your family has had skin cancer, you have a greater risk of developing skin cancer. 1. Tell participants that the key to skin cancer is prevention. 2. To help the participants understand the things they can do to prevent skin cancer, ask the following questions: a. What would you do if you noticed that you, a friend, or family member were starting to sunburn? Allow time for them to answer, make sure their answers include things such as you could get out of the sun, apply more sunscreen, or put on more protective clothing. b. What is SPF? Make sure the participants understand SPF stands for Sun Protection Factor. For example, using an SPF 15 sunscreen means that it would take Chapter - Sun Sunscreen Activity 3 of 4
15 times longer to sunburn your skin than it would without the sunscreen. c. What SPF number do you need to look for? It is recommended that you look for broad-spectrum sunscreens and lip balms with an SPF of 15 or higher. d. How do you properly use sunscreen? 1. Put on sunscreen at least 20 minutes before going outside. 2. Sunscreen should be reapplied frequently (at least every two hours) and liberally, especially after swimming or sweating. 3. Even waterproof sunscreen needs to be reapplied frequently. 4. Be sure to apply enough sunscreen and apply to all areas that will be exposed to the sun. e. Can you name some types of protective clothing? 1. Hats with at least a 3 inch (8 cm) brim. 2. Legionnaire style hats (a baseball-style cap with a back flap that shades the neck, ears, and side of the face). 3. Long sleeve shirts and long pants (the fabric needs to be woven tightly enough to block out sunlight). 4. Sun glasses with 100% UV protection (as shown on a peel off label). 5. Special UV protective clothing is made to protect people who are highly sensitive to the sun. 3. Tell the participants that the best way to decrease the amount of sun exposure is to stay out of the sun. Since this may be impossible to do, the next best thing is to try to avoid being in the sun when the ultraviolet radiation is the highest between 10 AM and 4 PM. Sunscreen Activity 4 of 4 Chapter - Sun
Learning Objectives SUN-SAFE HAT ACTIVITY After completing this activity, participants should be able to: 1. Identify pros and cons of a variety of hats with regards to sun protection. 2. Identify a style of sun-safe hat that they are willing to wear. 3. List types of sun protection clothing. Safety Requirements If head lice is a concern, then consider having participants first put a protective bonnet over their hair before trying on the hats. Age-Appropriateness This activity is appropriate for participants of all ages. With younger participants, focus on protection from the sun and add the skin cancer facts and warning signs for older participants. The depth of content and discussion needs to be tailored to the level of understanding of the group. Refer to the Teaching Tips and Childhood Growth and Development located in the Teaching Kids section of the manual. Suggested Instructors Extension agent, dermatologist, nurse, nurse practitioner, nursing students with instructor supervision, physician, health educator, FFA students, and parent Equipment/Supplies Needed A wide variety of hats including: a baseball cap, a wide brim cloth hat, a cowboy hat, a legionnaire style hat, a golf hat and others as deemed appropriate based on fashion, regional preferences, etc. Be sure to vary the width of the brim and how tightly the fabric or straw is woven so that you can discuss these differences with the participants. Subject Outline I. Introduction/Capture Their Attention A. Introduce yourself and tell about your role teaching sun safety and how it relates to being sun smart. B. Share a personal story or experience of someone who has skin cancer. C. Invite a person who has had facial/ear skin cancer to share their experiences. Make sure you communicate to your guest presenter your lesson plan and time allotment before the day of the camp. Otherwise, they may talk your entire time and/or children will be so intrigued and ask many questions. D. Find out about your audience. Ask questions: Do you know of anyone who has had skin cancer? Where was their cancer? What did it look like? What are some ways that you can protect your skin from the sun? II. Activity/Demonstrate A. Ask participants to try on the various styles of hats and rate the style, color, and likelihood of wearing each hat. B. Ask participants to rank the hats based upon sun-protection effectiveness. III. Discussion Points A. Discuss with participants factors such as coolness, comfort, style, and peer pressure that influence how likely they are to wear a particular hat around their friends. B. Explain to participants which types of hats are not considered sun-safe and why. C. Discuss with participants the type of hats their parents wear, emphasize the jobs their Chapter - Sun Sun Safe Hat Activity 1 of 2
parents do or the recreational activities they are involved in that may require them to wear a sun safe hat. This helps to promote life long habits that are safe. D. Discuss the types of protective clothing. 1. Hats with at least a 3 inch (8 cm) brim. 2. Legionnaire style hats (a baseball-style cap with a back flap that shades the neck, ears, and side of the face). 3. Long sleeve shirts and long pants (the fabric needs to be woven tightly enough to block out sunlight). 4. Sun glasses with 100% UV protection (as shown on a peel off label). 5. Special UV protective clothing is made to protect people who are highly sensitive to the sun. E. Discuss the following points from Sun Safety section of the manual: (suggestions not mandatory). 1. Skin Basics 2. Skin Cancer Facts 3. Skin Cancer Warning Signs 4. Prevention Sun Safe Hat Activity Activity 2 of 2 Chapter - Sun
Learning Objectives SUN-SAFE RELAY ACTIVITY After completing this activity, participants should be able to identify appropriate sun-safe clothing. Safety Requirements If head lice are a concern, then consider having participants first put a protective bonnet over their hair before trying on the hats. Age-Appropriateness This activity is appropriate for participants of all ages. The depth of content and the discussion needs to be tailored to the level of understanding of the group. Refer to the Teaching Tips and Childhood Growth and Development located in the Teaching Kids section of the manual. Suggested Instructors Extension agent, dermatologist, nurse, nurse practitioner, nursing students with instructor supervision, physician, health educator, FFA students, and parent. Equipment/Supplies Needed 1. A variety of hats (some sun-safe and some not) 2. A variety of sunglasses (some with UV labels on them and some without) 3. A variety of clothing (short and long sleeve shirts, shorts and long pants, clothing of different materials) Subject Outline I. Introduction/Capture Their Attention A. Introduce yourself and tell about your role with sun safety or why it is important to you. B. Start with a story or a personal experience associated with the dangers of sun exposure/ skin cancer. C. Find out about your audience. Ask questions: Do you know of anyone who has had skin cancer? Where was their cancer? What did it look like? What are some ways that you can protect your skin from the sun? D. Invite a guest who has or has had skin cancer to discuss their experiences. Make sure to communicate to your guest speaker your lesson plan and time allotment. E. Review posters and/or brochures with pictures of skin cancers. II. Activity/Demonstration A. Lay out a variety of sun-safe clothing and clothing that is not considered sun safe clothing. B. Establish a starting/finishing line away from where the clothes have been laid out. C. Form the participants into teams. D. Explain to the participants that they will need to race from the starting line to the area where the clothing has been laid out. They will need to dress one team member in the most sun-safe outfit they can identify and then race back to the starting point. They will be scored on speed and the appropriateness of the outfit their team has selected. III. Discussion Points A. Discuss with participants the appropriateness of the outfits they chose. An appropriate winning outfit would include: long pants and a long sleeve shirt made of a tightly woven fabric, an appropriate sun-safe hat, and sunglasses that provide 100% UV protection with the label still on. Chapter - Sun Sun Safe Relay Activity 1 of 4
B. Use discussion about these sun protection items as part of your activity: 1. Hats with at least a 3 inch (8 cm) brim. 2. Legionnaire style hats (a baseball-style cap with a back flap that shades the neck, ears, and side of the face). 3. Long sleeve shirts and long pants (the fabric needs to be woven tightly enough to block out sunlight). 4. Sun glasses with 100% UV protection (as shown on a peel off label). 5. Special UV protective clothing is made to protect people who are highly sensitive to the sun. C. Tell the participants that the best way to decrease the amount of sun exposure is to stay out of the sun. Since this may be impossible to do, the next best thing is to try to avoid being in the sun when the ultraviolet radiation is the highest between 10 AM and 4 PM. D. Use any of the Sun Safety discussion points listed in the Sun Lesson into your activity. Sun Safe Relay Activity Activity 2 of 4 Chapter - Sun
Learning Objectives SKIN SELF-EXAM ACTIVITY After completing this activity, participants should be able to: 1. List the steps of a skin assessment. 2. Complete a skin self-exam. 3. Identify moles and other distinctive skin characteristics on the body map. Safety Requirements It is important that the participants understand not to pinch, pluck, dig out or scrape moles, white or black heads, or any other distinguishing skin characteristic. These actions could cause further damage and the safety learning session will not be set up to control wounds. If a participant does cause an area on the skin to bleed assist them to the first aid center of your camp. If they are concerned they need to mark the location on their body map and notify their parents and/or a health care professional. Age-Appropriateness This activity is appropriate for participants of all ages. However, at the age of seven, many children become modest and very sensitive about being singled out. While some younger children will be more curious and could possibly make a game out of How many moles/spots on their skin do they have? Others will be more modest. Keep in mind that any age child or teenager could be extremely modest or sensitive and identifying any distinguishing marks on their bodies could embarrass them or make them feel as an outcast from their peers. Tell them that although it is important for them to examine their entire body, today, they can just look at their arms. Make the activity flexible to various comfort levels while explaining how thorough a private selfexamination should be. Children of all ages should be given the opportunity to refrain from this activity. Teenagers should be able to identify skin cancer warning signs during a skin-self exam, while the goal for younger children should be to simply identify skin spots that they can tell a parent or doctor about. Thus, children do not need to be taught the specific warning signs of skin cancer. The depth of content and discussion needs to be tailored to the level of understanding of the group. Refer to the Teaching Tips and Childhood Growth and Development located in the Teaching Kids section of the manual. Suggested Instructors Extension agent, dermatologist, nurse, nurse practitioner, nursing students with instructor supervision, physician, health educator, FFA students, and parent. Equipment/Supplies Needed 1. Two or more full-length mirrors. 2. A hand-held mirror for each participant. 3. Skin self-exam brochures. 4. Copies of body maps for participants to take home and complete. Subject Outline I. Introduction/Capture Their Attention A. Introduce yourself and your role teaching sun safety. B. Start with a personal story or what you have seen in your career. C. Invite a skin cancer survivor to tell their personal story. (Make sure you communicate clearly your lesson plan and the time you are allotted with your guest. Otherwise, your guest may speak or the intrigued children may ask questions for the whole amount of Chapter - Sun Skin Self-Exam Activity 1 of 4
time. D. Find out about your audience: Ask questions: Do you know of anybody that has had skin cancer? Where was the skin cancer? Do you know what a skin cancer looks like? II. Activity/Demonstration A. Set up the full-length mirrors to allow participants to closely exam their exposed skin. B. Give each participant a hand-held mirror. C. Have the participants examine his or her exposed skin for moles and other distinctive skin characteristics that they should be monitoring. For teenagers: have them explain the warning signs of basal and squamous cell cancers and the ABCD warning signs of melanoma as they are conducting their exams. III. Discussion Points A. There are many people who have skin cancer but don t know it. B. Regular skin self-examination can alert them to changes in their skin and help in early detection of skin cancer. Because some types of skin cancer can occur anyplace on the body they will need to exam the entire body, even places that are not exposed to the sun. This means that children may need a parent to help them but teenagers should be able to do a skin self-exam themselves. C. Discuss the steps for conducting a skin self-exam. 1. You will need a well-lit room, a full-length mirror, a hand-held mirror, and a chair or stool. 2. Look at the front and back of your body in the mirror, then raise your arms and look at the left and right sides. 3. Look carefully at your hands and arms, including the palms and undersides of the forearms and upper arms. 4. Examine the front and back of the legs. Also make sure to look between the buttocks and around the genital area. (Note: Remember to be sensitive to the age of the audience when discussing this area of the body may consider using other terms such as private areas). 5. Sit and closely examine the feet, including the soles and the spaces between the toes. 6. Look at your face, neck, and scalp. You may want to use a comb or a blow dryer to move hair so that you can see better. D. Discuss the importance of learning where their birthmarks, moles, and blemishes are and what they usually look like. Then when they conduct their self-exam, they are checking for anything new, for anything that has changed, or for anything that meets the ABCD warning signs of melanoma. E. Remind participants that they should conduct skin self-exams on a regular basis, every 3 months, and send a copy of the body map home with them so that they can keep track of their individual skin spots when they carry out a complete skin self-exam at home. 1. Discuss with participants what to do if they find an area that seems suspicious or unusual. (Tell their parent or another adult that can help them seek proper medical attention.) 2. Reassure participants that most skin cancers are easily treated and prevention if very important. It is important not to unnecessarily scare the participant while providing education. F. Squamous cell cancer causes a firm, nodular or flat growth with a crusted, ulcerated, or scaly surface. G. Basal and squamous cell cancers are found most often on areas of the skin that are most often exposed to the sun head, face, neck, hands, and arms. However, skin cancer can Skin Self-Exam Activity 2 of 4 Chapter - Sun
occur anywhere, even on skin that has never been exposed to the sun. H. Discuss with participants the ABCD key warning signs of melanoma (you may wish to show pictures of these warning signs using one of the brochures listed in the resource section): ABCD - Asymmetry - Most melanomas are asymmetrical a line through the middle would not create matching halves. Common moles are round and symmetrical. ABCD - Border - The borders of melanomas are often uneven and have scalloped or notched edges. Common moles have smooth even borders. ABCD - Color - Common moles are usually a single shade of brown. Varied shades of brown, tan, or black are often the first sign of melanoma. As melanomas progress, additional colors such as red, white, or blue may appear. ABCD - Diameter - Melanomas tend to grow larger than common moles generally to at least the size of a pencil eraser (about 1/4 inch or 6 mm in diameter). I. For more discussion points see Sun Safety Lesson in the manual. Chapter - Sun Skin Self-Exam Activity 3 of 4
Additional Notes: Skin Self-Exam Activity 4 of 4 Chapter - Sun