Nobody moves to The Villages for the winters up north. You came for the sun, and you get it nearly every day of the year.
I spend my working days looking at what that sun does to skin. Skin cancer is more common in Central Florida than almost anywhere else in the country, and one in five Americans will develop it at some point.1 Around here I treat that number as a floor.
The part worth holding onto is this: skin cancer is one of the most manageable risks in medicine. It shows up on the surface of the body, where you and I can both see it. Found early, it is almost always treatable. The whole game is finding it early.
You brought your skin history with you
Most of my patients came from the Northeast or the Midwest. Shorter summers, milder sun. All those years still count, because UV damage to skin cells adds up over a lifetime, and every bad sunburn from a Michigan childhood is still on the books. Then you retire to a state where the summer UV index regularly hits 10 or 11, and you trade an office for a golf course.
Moving to Florida in your 60s speeds that clock up considerably.
The CDC ranks Florida among the top states for melanoma incidence,2 and Sumter County skews older and more sun-exposed than the national average on both counts. Snowbirds get no exemption. Six months here can carry more UV than a full year did back home.
Three cancers worth knowing by name
Basal cell carcinoma is the most common skin cancer, and the most common cancer of any kind. It favors the skin that gets the most sun, like the face, the ears, the scalp, and the backs of the hands. It grows slowly and rarely spreads, but ignored for years it can do real local damage. Caught early, treatment is usually simple.
Squamous cell carcinoma comes second. It also favors sun-exposed skin, and unlike basal cell it can occasionally spread if ignored.
Melanoma is the serious one. It can appear anywhere, including skin that never sees the sun, and it can spread quickly. When melanoma is found while it is still localized, five-year survival is over 99%. Once it has spread to distant organs, that figure falls to around 35%.3 The distance between those two numbers is mostly a matter of timing.
You don't have to give up the golf
I never tell patients to stay inside. Nobody lives here for the indoors, and hiding from the sun is not required. UV exposure is the one risk factor you can control, and most of the control comes from adjusting the edges of your routine.
Timing does the heavy lifting. The sun does most of its damage between about 10 a.m. and 4 p.m., so an early tee time or an evening pickleball match takes a real bite out of your exposure, and it beats the heat besides.
Cover what you can. A wide-brimmed hat protects the ears and the back of the neck, which a visor does not. The tops of the ears are one of the most common places I find skin cancer in men. A lightweight UPF long-sleeve shirt on the course protects better than sunscreen that went on once at 8 a.m. Sunscreen still matters, to be clear: broad-spectrum, SPF 30 or higher, reapplied every two hours while you're out. Most people apply too little of it, once.
The small exposures count too. The cart ride to dinner, the dog walk, an hour on the pool deck. It all adds up over a decade, and it favors the driver's side. I see the evidence of left-side sun on faces and forearms all the time.
Ten minutes a month
Between visits, you are the first line of detection. Once a month, after a shower, look yourself over. In a mole, you are looking for asymmetry, where one half doesn't match the other; a border that looks ragged or blurred; color that varies within the same spot; a diameter bigger than about 6mm, roughly a pencil eraser, though melanomas can be smaller; and evolution, meaning any change in size, shape, or color, or a spot that has started to bleed or itch. Dermatologists compress all of that into the mnemonic ABCDE.
Have your spouse check your back and your scalp. You can't see them, and they can. Photos help too. A phone picture of a spot today turns "has this changed?" into an easy question three months from now. We keep a full guide to the monthly skin self-exam if you want the complete walkthrough.
One more thing. If a spot is new, changing, bleeding, or refusing to heal, call us. Don't save it for your annual.
Who should be extra careful
Some people start with a higher baseline.4 Fair skin, light eyes, or red or blond hair all mean less natural protection from UV. So does a history of sunburns, especially the blistering kind early in life, and so does a personal or family history of skin cancer. Patients with many moles, or with atypical (dysplastic) moles, need closer watching. The same goes for anyone with a suppressed immune system, whether from medication or a transplant, and for people who spent years working outdoors. Farmers, builders, veterans: this town has plenty of each.
If two or more of those describe you and your address says Florida, a yearly exam stops being optional in my book.
What a screening here actually involves
Plan on about 45 minutes at our clinic in Brownwood Square. The visit is a head-to-toe exam. Scalp, behind the ears, between the toes, the soles of the feet. We also do total body photography at the same visit: a ring of 92 cameras photographs your entire skin surface in about a second. That becomes a baseline map of every spot you have, and at future visits we compare against it. A new or changing spot stands out on the map even when memory swears nothing is different.
If something needs attention, we handle it in the same office. Biopsies and excisions happen here, and so does ongoing surveillance for patients who have had skin cancer before. You will not spend the next month collecting referrals across town.
We accept Medicare and most major insurance, and a screening generally doesn't require a referral. Here's what to expect at a skin cancer screening, start to finish.
If you're new here, or here half the year
A few practical notes I give every new patient.
Get a baseline during your first season, while everything is boring. The photography is most valuable when it starts before anything is wrong.
If you're a snowbird, book your annual for a month you are reliably in town, and keep it in the same month every year. Treat it like the car service.
If you saw a dermatologist up north, ask that office to send your records, especially any biopsy reports. Knowing the spot on your shoulder was biopsied benign in 2019 saves us both time, and it may save you a needle.
That's the whole program. One exam a year, ten minutes a month, a decent hat. The sun can stay the best part of living here.
Tyler Long, DO is a board-certified dermatologist and the lead physician at SpotDoc in The Villages. For appointments, call (352) 914-3451 or book online.
References
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American Academy of Dermatology Association. Skin Cancer Statistics. aad.org ↩
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Centers for Disease Control and Prevention. Skin Cancer Statistics. cdc.gov ↩
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American Cancer Society. Survival Rates for Melanoma Skin Cancer. cancer.org ↩
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American Academy of Dermatology Association. Skin cancer: Risk factors. aad.org ↩