Sun Safety Questions
What is your personal approach to sun safety?
Broad brimmed hat, collared shirt, at least 30+ SPF sunscreen (including on top of my head!) and a rashie.
How should you check your skin spots?
Everyone should see an experienced General Practitioner at least once a year for a full body skin cancer check. The well-trained eye of your doctor is the most important tool in a skin cancer examination, which can be supplemented by digital skin dermatoscopy and mole-scanning technology.
What are the main indicators something could be wrong?
Always be alerted by a new skin spot, especially one that is darkly pigmented, new, changing or enlarging rapidly, irregular in shape, itchy or bleeds easily. Also be on the lookout for red/pink scaly patches or nodules that are enlarging, changing, new or tender. When in doubt, seek medical advice immediately.
How often should you get your skin checked by a doctor?
For most people, once a year is adequate with the proviso that you present at any other time if a skin lesion concerns you. For those who have a history of previous skin cancer, skin checks should be every six months or even more frequently if recommended by your doctor. I recommend starting regular skin checks from about age 13 and these should continue indefinitely throughout your lifetime.
Does this change depending on a person’s skin type?
Yes. Everyone with skin is potentially at risk of skin cancer. However those with pale skin, lots of moles and those with ginger/red hair are at particular risk of both melanoma and non-melanoma skin cancer. Those with a strong family history of melanoma in more than one close family member are also at increased risk. Those people who spend a lot of time in the sun should also be vigilant about the risk of skin cancer.
Is it true some medications can make a person’s skin more susceptible to sun damage? If so what are they?
People who take medications to suppress their immune system (for instance for autoimmune disease and organ transplants) have an increased risk of skin cancer and should have skin cancer checks at least every six months. Recent studies have suggested a link between the blood pressure medication Hydrochlorothiazide and non-melanoma skin cancer. Every medical student learns about the link between a very old asthma treatment called ‘Bell’s Asthma Mixture’ and basal cell cancer (BCC) of the skin. This may still be relevant in older patients.
Can you briefly explain the three different types of skins cancers?
Skin cancers are divided roughly into Melanoma-type cancers and Non-melanoma type cancers. Melanoma is a potentially aggressive form of skin cancer that involves the pigment-producing cells in the skin called melanocytes. Melanoma can arise out of benign moles (naevi) or can sometime arise seemingly ‘out of nowhere’. Some melanomas tend to spread along the skin surface (superficial spreading melanoma) and others tend to spread quickly into the deeper layers of the skin (nodular melanomas). The latter type is particularly dangerous and can spread to other parts of the body (metastasize) quite early in their development. Once melanoma has spread to other areas of the body, nearby or distant, it is extremely hard to cure and has a high death rate. Although medical science is making great advances in the treatment of advanced melanoma, as always early detection and treatment is still by far the best outcome and melanomas treat early with generous surgical excision have a survival rate after 5 years of 99%. This is why regular skin cancer checks and early detection are so important.
Squamous cell cancers (SCC) are a non-melanoma skin cancer involving the superficial (squamous) cell layers of the skin and are strongly correlated with excessive UV exposure. They may develop from red scaly patches called ‘sun spots’ (solar keratoses) and can spread locally in the skin, into deeper structures, into nearby lymph nodes and occasionally to distant parts of the body. SCCs on the head and neck region can be particularly problematic if they invade deeper important structures. Again, early detection and generous surgical excision gives the best outcome. Very early SCCs may be treated by experienced medical professionals with various non-surgical techniques.
Basal Cell Cancers (BCC) are a non-melanoma skin cancer involving the deep layers of the skin epidermis (basal cells) and are also strongly correlated with excessive UV exposure. They are slower growing and usually slower in their ability to invade deeper structures. BCCs should, however, not be ignored and can cause significant problems if left untreated, particularly in the head and neck region. Once again, early detection and definitive treatment is best. Early BCCs can sometimes be treated with non-surgical techniques, while other lesions need traditional surgical excision.
There are other rarer forms of skin cancer, but these three are the most common. In any case, if you find a new and unusual skin spot or bump, get it checked out by your GP.
Can a skin cancer develop? i.e. basal cell carcinoma develop into a melanoma?
Not usually. Melanomas can develop out of previously benign moles (naevi) or some types of freckles, or can arise spontaneously where there was no previous mole. SCCs can arise out of sun-related skin blemishes like sunspots or spontaneously. BCCs tend to arise spontaneously out of sun-exposed skin. But one type of skin cancer does not usually change into another unrelated type of skin cancer. Of course, some people develop several different types of skin cancer at one time, particularly if they have long history of sun exposure.
How fast can cancers develop?
This depends on the type of skin cancer. BCCs tend to develop slowly over time. SCCs and melanomas can develop much faster and melanomas particularly can spread very quickly to nearby structures and distant parts of the body, even when the primary lesion is quite small. Early detection and treatment is vital to prevent these dangerous complications.
Is there anything else in relation to this topic you’d like to add?
The risk of skin cancer is related to inherited factors such as skin type, hair colour (red heads need to be particularly vigilant), some medications and – most importantly – UV exposure from the sun and tanning machines. You can’t help inherited factors, but you can do something to reduce your risk from UV exposure – ‘Slip Slop Slap’ is still as true now as it was in the Eighties! Of course we all need some sun exposure to prevent Vitamin D deficiency, but we all should be sensible about deliberately exposing our skin to excessive amounts of UV radiation. Early detection and definitive treatment of skin cancer is incredibly important – Queensland GPs and dermatologists are world-renowned for their experience in detecting and treating skin cancer, especially in its early form. Make a regular skin check – at least once a year – part of your regular health check regime