Back in twenty fifteen, Jackie Smith was fresh out of college at just twenty one 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 skin Querries, 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 in 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 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 Skin Querries. 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 rays. 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 nineties in New Jersey. I remember going to Cancun on spring break and getting super crisp, flathering on the baby oil and doing 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 a 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 like my friend's house and me late in the sun all day, and then for the first week of school, I had in sunburned eyelids.
I didn't put sunshurn on my eyelids.
I didn't know, so I was kind of in the sun for like four hours. And when I came back from this trip, I noticed had like a bunch of freckles on my nose, and like the nose part kind of freaked me out. I 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 want to see sunscreen because that's a brown girl.
I feel like I eat sunscreens always.
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 does 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 from Jersey. You're from North Jersey.
Me too.
I'm from Hackensack, I'm from Anglewood.
We're like name.
Oh my god, was a detective and Englewood for thirty years.
So Jackie is here because she's kindly agreed to take us through her story.
So I meant two times stage three melanoma survivor over the last twenty years. Believe it or not, it's been twenty years since I was initially diagnosed with stage three melanoma, and during that time, I've volunteered and worked in patient advocacy and health policy. I'm really trying to make strives 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 twenties about to finish her undergrad degree.
This lump in my bikini line. No one seemed to think it was anything serious. So 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 sitz bath, something that at that point I didn't even know what that was, you know, So you're like 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. So I know some of us will bury our heads in the sand. That's not me. So I kept going back because it just didn't seem right, and I knew it was not an inflamed hair follicle. It was a lump that was underneath the skin layer, and when I detected it, it was about the size.
Of an almond.
Okay, so that's not normal, right, And 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.
And 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.
And 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, and when she described what malignant lumps typically present as mine checked all of those boxes.
So that's what.
Made me go see my primary care and he referred me to a surgical oncologist. And I remember being early twenties, supposedly getting ready to start my life and having to go see an oncologist was quite frightening. So I went, I was diagnosed, and I remember it like it was yesterday because it 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
lyptnode 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, 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 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? And when did this happen? So it was you know, 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's 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 kind of take on as truths and are potentially not so true.
I have been in this space for twenty 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, and I say, okay, well, 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, And one of my friends said, no, you're sunburn like, look at your nose is red. It's going to start peeling.
And it did.
It's a dangerous misconception, right, 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.
Okay, so it's a poor prognosis.
And when we look at charts, the incident's 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, Welcome back to Skin Queries. Let's get into the science behind our skins relationship to the sun. I'd like you to meet doctor Mary Stevenson, a surgeon here in New York City. Hi.
Mary, thanks for being with us today.
Hi thanks for having me.
So, Mary, can you tell me a little bit about your practice in New York City.
So I'm a skin cancer surgeon, specifically a most surgeon, which is a specific kind of surgery her skin cancers, and a cosmetic dermatologist.
But I take care of people who have.
Melanomas basal cells squin THESS cells through a unique form of surgery invented by doctor Frederick mos generally removing cancers and then putting things back together after we take them.
And we're just going to dive right in.
So can you tell us what does sun damage look like?
So? 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. And 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. And those are the things you know more for Vanity's sake, that you can see from aging in the sun.
What is your conversation when it comes to suncare. So 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 sun screen on to prevent skin cancers, but also because I want my skin to continue to look nice as I get older, and things like malasma where you can have pigment on your cheeks. If I get sun I start to get malasma, so I stay
out of the sun, also admittedly for vanity's sake. And then there are people who really stay out of the sun because they don't want their skin to ate. They don't have wrinkles when they're older that come sooner, they don't have sun spots, you know, things like liver spots. We used to call them on our hands, all of those things. People have a wide range of reasons, and to me, as long as you're putting on your sunscreen, 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 diagnose later in life or potentially have worse outcomes when it comes to their diagnosis since they haven't been so precautious.
So we definitely know in darker skin tone, skin of color, that diagnosis can be later and that outcomes can be worse because it's being caught at a later stage. And 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 damaged 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 you know, Caucasian skin, very fair skinned people are repeat 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 tants say, you know 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 is what it means and what your body's 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's 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 melanosites. 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 or that had no idea, that's what tanning was. And so you know me, I'm trying to be a reformed tanner. Exic 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 thirty. A lot of them are SPF fifteen. We really prefer SPF thirty or above. Okay, I usually wear higher than that, fifty or seventy, 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 two 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, 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 them 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 get your hands on sunblack swimwear. 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.
Right.
I don't go to the beach at noon, you know, I'll go nine o'clock, ten o'clock for a little bit. I stay out of it usually eleven to one, Okay. My favorite time to go to the beach is around three thirty. It's quiet, it's nice and a little more shady. Use an umbrella. Don't be directly tanning yourself. Stay under the umbrella.
You know.
Those are hard things to do because the sun feels good. But I find that they're really important behaviors to incorporate into your every day during the summer if you live in a warm place, because they're going to keep you protected.
And when it comes to an 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.
So it depends on the season.
For me, if I need less moisturizer, I'll just use my sunscreen as like the daily cream, but I usually put on a mineral, which is something like titanium or zinc, similar to what might be in like a baby's typersh 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 kind of 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 perform physical chemical sunscreens are absorbing that energy and transmitting it so that it doesn't harm you. Physical ones are reflecting those raised 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 UVP, so this is what we call a broad spectrum sunscreen. Chemical ones that say broad spectrum. But I find mineral to be the most reliable, and we're lucky now, we do have a lot of ones that prevent us from feeling.
Like we're white and goofy. I'd like the white and goofier 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 uffing 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? I mean 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 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, mom, many of those are fifteen. It's hard to find a thirty. I actually just use my regular sunscreen in the summer. I'll just, you know, put a little on. Your Mom is dead right that hands are a very big giveaway of age. You get sun spots, they get wrinkles.
What about the scalp. Scalp is hard. That's why I had and I should have mentioned that earlier. A wide brimmed 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
like 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. Yeah, Two you're using an airsol, and three you're inhaling that airsol. 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 that's a nice idea.
Doctor 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 avcdes asymmetry, which means it's not smooth around the borders. Be as borders so if you couldn't circle it with a pencil, c as color, so if it has different colors, if it's getting darker, d as 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 dermatologists, make that relationship, get screened once, and then decide with your dermatologists how often you should get screened. In fairer 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.
In Jackie's story, I always tell my patient, like, you know your skin best, so if something feels like it's changing. Doesn't feel right. Go show your dermatologists and get it checked out.
Doctor Stevenson, Thank you so much for being here.
Thank you so much.
It's interesting that self advocacy keeps coming up. It's something doctor Stevenson tells her patience, 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, one hundred percent. Some are good and some make me say, why did this happen to me? I have a nine inch scar and my groin from where they remove the lymph nodes, and then what I call my little prison tattoos, which was something I didn't realize. When you go for radiation, they tattoo you for where the beams 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 kind of 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 and I have to wear 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, and people stare at it, and I'd become a little angry because you see people staring, and I learned, like 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, you will 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, like 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 kind of 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. Like 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.
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 families 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 doctor Mary Stevenson. A massive thank you to both. Skin Craze his host by myself Nicole Berry and executive produced by Yvonne Shehan. Our senior producer is Tory Weldon. Our junior producers are reem Al mcgraby and Jenny Cunningham. The show was mixed and features original
music by Sam Sagan. 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,