Out in West Texas, where the sun-splashed scenery is as beautiful as it is dangerous, oilfield workers, ranchers, and day laborers often aren’t focused on skin cancer, a discomforting reality for local physicians.
Texas Oncology data project roughly 6,000 new cases of melanoma in 2026. Dermatologists say regular visits, a watchful eye from primary-care physician colleagues, and sun protection can benefit patients, especially those who work or spend time outdoors.
In Lubbock, doctors have taken action. For years, Lubbock dermatologists Brent Paulger, MD, and Keith Wisniewski, MD, have made the 85-mile drive southwest to Denver City specifically to treat patients for melanoma and basal cell carcinoma.
In June, their practice partner Ashley Sturgeon, MD, made her first trip to Snyder roughly 80 miles southeast of the Hub City and saw 18 patients on her first day. “We’re not just popping pimples out here,” Dr. Sturgeon said.
Their work reflects a high priority for medicine. The Texas Medical Association has advocated for increased education and awareness campaigns targeted at workers with high-risk sun exposure to promote skin cancer prevention, early detection, and treatment.
Dr. Sturgeon says the younger generation has progressive skincare routines, and most skin cancers can be treated or removed if caught early. “This is one area where social media has helped us,” she said.
Still, “there’s just as much ignoring of skin cancer as there ever has been. It’s important to stay with your dermatologist, but we’re the first appointment that gets cut when it hits the fan or other health issues get serious.”
As chair of the dermatology program at the Texas Tech University Health Sciences Center Lubbock, Michelle Tarbox, MD, wishes more primary-care physicians did complete skin exams. Many do, she says, but general practitioners are usually just focused on the high-frequency areas like the hands, neck, or face.
“One of the things that was drilled into me in my training in my residency program at the Cleveland Clinic was that you look at the patient from the top of their scalp through their hair all the way down their body in between their fingers and toes until you get to the completeness of the exam,” Dr. Tarbox said.
Scalp melanoma has a higher mortality risk than a melanoma of similar thickness elsewhere on the body. It’s also an area where patients struggle to examine themselves, which is why skin cancer education is taught at most beautician schools and hairdressing academies.
Dr. Tarbox speaks about these and other skin issues extensively on Dermasphere, a biweekly dermatology podcast she co-hosts.
For patients who must be in the sun, dermatologists encourage their physician colleagues to regularly recommend protective measures like a broad-spectrum sunscreen, long-sleeved shirts, pants, and wide-brimmed hats. That includes protecting the often-ignored ears and lips.
One overlooked protective covering might be what Dr. Tarbox jokingly calls the “Sam Elliott mustache,” based on the famous actor’s iconic look. She reviewed data back in 2019 that mustaches decrease the carcinogenesis – the formation of cancerous cells – on the lower lip, according to a study published in the Journal of American Academy of Dermatology.
“We take a lot of skin cancer off the lower lip,” Dr. Tarbox said. “[A mustache] shelters your lower lip from the radiation. It’s like a tiny umbrella.”
For more information about TMA’s resources about cancer, please see the Cancer Control and Prevention page online.