Roswell native, Dr. Brandon Cometti, is board certified in Family Medicine and focuses on skin issues/skin care/cosmetics. He attended medical school at Baylor College of Medicine in Hous­ton, Texas and stayed in Houston for his residency at Memorial Family Medicine where he had additional courses and trainings in dermatology and cosmetics. Dr. Cometti returned to Roswell in 2015, where, as one of the few doctors that specializes in dermatology in Southeastern New Mex­ico, his practice has filled a need for patients in the area. Dr. Cometti shares that there is nowhere else he would rather practice than here in Southeastern New Mexico and, “The people here are fantastic and it really has been a joy to be back and working here for the past two years.”

FOCUS: How does overall diet and exercise effect the skin?

Dr. Cometti: It’s hard to mea­sure the direct effects these will have on the skin, but we know that healthy diet and regular exercise are beneficial to essentially every part of our body, both physically and mentally, so it is certainly reasonable to expect that healthy diet and exercise will have positive effects on the skin as well.

FOCUS: What causes wrinkles in the skin as we age?

Dr. Cometti: There are several factors that contribute. Everyone loses some amount of the collagen and elastic fibers in the skin slowly over time as a natural process of aging, and this causes wrinkles. UV light exposure (from the sun, tanning beds, etc.) is another major factor… it damages the skin in such a way that those collagen and elastic fibers do not regenerate as quickly, and this accelerates signs of aging and wrinkling in the skin. Smok­ing is another factor that will increase wrinkles in the skin.

FOCUS: What causes acne and how is it best treated?

Dr. Cometti: There are several factors that contribute to acne. Genetics plays a big role – often teens and adults that have acne will have a strong family history of acne. Hormone changes are also important – for example teenagers going through puberty and young women during/after pregnan­cies often have the worst acne because of the fluctuating hormones in the body during those times. Things like diet or hygiene can play a role for a small group of people, but these are probably less important factors than genetics and hormones. The old thinking that eating too much chocolate or drinking lots of sodas can cause acne is probably not true for most people. There are numerous treatment options for acne. Often you can start with the different products that are available over the counter for acne, but if those don’t help enough then a large number of different prescription medications are available.

FOCUS: Why is it important to protect our skin from the sun?

Dr. Cometti: Sun damage will significantly increase a person’s risk for de­veloping skin cancer, including melanoma. I diagnose and treat skin cancer every single day in my office, and most of the patients I see for this have one thing in common… many years of sun exposure without using protective clothing or sunscreen. As mentioned, sun damage also accelerates signs of aging in the skin, including wrinkles, dark spots, etc. Getting that nice dark tan every summer when you’re young will probably leave you with more wrinkles and blemishes later in life.

FOCUS: Does skin color have an impact on how it is affected by the sun?

Dr. Cometti: Certainly. Darker skin doesn’t burn as easily and those with darker skin do have lower rates of skin cancer, but it’s not zero. I still see a large number of skin cancers that occur in those with darker skin. Even if your skin doesn’t burn, it can still be damaged by the sun’s UV rays and this can lead to skin cancer as well as the signs of aging mentioned above.

FOCUS: Do certain skin tones have a greater or lesser risk for certain skin cancers?

Dr. Cometti: In general, those with lighter skin have higher rates of all types of skin cancer, including melanoma. Non-melanoma skin cancers include basal cell carcinoma and squamous cell carcinoma, and these have some dif­ferences as it relates to skin tone. Basal cell is the most common skin cancer in Caucasians, Hispanics, Native American, Chinese and Japanese Asians. Squamous cell is the most common type in African Americans and Indian Asians and tends to be more aggressive when it occurs in these ethnicities. Melanoma is the third most common type for all skin types behind basal cell and squamous cell but it remains by far the deadliest.

FOCUS: What do readers need to know about tanning beds and sun bathing?

Dr. Cometti: There is very clear evidence that tanning bed use leads to higher risk of melanoma, and this risk seems to be magnified the earlier a person starts using them. It is strongly recommended that teenagers avoid tanning beds, and I would suggest adults avoid them as well. The data for sun bathing isn’t as clear mostly because there is much wider variation in how people sun bathe, but we know that long-term UV exposure and that bad sun burns increase risk of skin cancer, so my advice would be to do it in moderation and always wear sunscreen, preferably SPF 30 or higher.

FOCUS: What do people need to know or be aware of about moles?

Dr. Cometti: Most moles are harmless and will never turn into cancer.

Something interesting that most people don’t know is that it’s normal to make new moles all the way into our 40s and sometimes 50s, so a new mole isn’t necessarily a bad thing. Moles often grow and change during periods of hormone fluctuations, often in teenagers and during or after pregnan­cies, so changing moles can be normal too. If a mole is growing quickly or has an irregular shape or different colors, those are signs to watch for and probably have it checked.

FOCUS: Why is it so important to protect your skin even when the sun is not shining?

Dr. Cometti: Clouds will block the sun’s UV-B rays which are what makes us burn, so on a cloudy day you might not burn as easily. However they do not block UV-A rays, and these can still cause damage to the skin which will lead eventually to skin cancer, wrinkles, dark spots, etc. We still need to be cautious and use sunscreen on those cloudy days too.

FOCUS: How can changes in the skin signal something is going onwith your health?

Dr. Cometti: The skin is the largest organ in our body and interacts with many of our other organ systems. There are a large number of internal diseases that can have outward manifestations in the skin because the dys­function of the underlying problem will cause changes in the skin as well. This can take the form of rashes, ulcers, swelling, bruising, etc. Sometimes changes on the skin may be the first sign that another health problem exists. Any such unexplained changes in the skin should always be evaluated.

FOCUS: What do you think is the most important thing for someone to take away about skin health?

Dr. Cometti: Take care of your skin when you’re young… you only get one chance to protect it. Try especially hard to avoid tanning beds, bad sun burns and prolonged sun exposure without protective clothing or sunscreen. Damage to the skin that is done when you’re young can’t be reversed and will result in worse looking skin when you’re older, and more importantly will increase your risk of skin cancer. Our climate and high degree of sun exposure here in New Mexico is very damaging to the skin, and although it may take years to see the effects, at some point it will catch up to you and cause the problems that I see every day in my office.

 

In the Know: Melanoma

Melanoma may be one of the least common types of skin cancer (only about 2% of all skin cancers in the U.S.), but it is also one of the most dangerous and causes the vast ma­jority of skin cancer deaths. Each year in the U.S. about 75,000 people will be diagnosed with melanoma and about 10,000 will die from it.

Melanoma skin cancers are usually pigmented (brown or black), and often look like moles with irregular shapes or colors. They usually grow or change fairly quickly. Some can be painful or bleed. The “ABCs” of melanoma can help to remember what to look for (see image).

There are several known risk factors for melanoma. People with fair skin, a strong family history of melanoma, large numbers of moles on the body (especially “atypical” or funny-looking moles), or who have weakened immune systems are all at higher risk of developing melanoma. The most important modifiable risk factor that we can control is exposure to ultra-violet (UV) light. For most people, this comes from sun exposure. Tanning beds are another major source of UV exposure and have been clearly linked to an increased risk of melanoma, especially for people who start using them at a young age. The best way to help prevent melanoma is to avoid artificial UV sources like tanning beds and to always use sunscreen or wear protective clothing when outside in the sun.

Melanoma can grow quickly and has high potential for metastasis (spread to other areas within the body). Early diagnosis is important since early melanoma skin cancers are much more easily treated. If a suspicious mole or growth is detected, it is important to have it evaluated by a healthcare provider.