How your patients can be more skin cancer savvy this Sun Awareness Week
Consultant Dermatologist and author of The Skincare Bible, Dr Anjali Mahto shares a short guide on everything your patients need to know about skin cancer this Sun Awareness Week (May 2-8).
Dermatologists like to talk about skin cancer. A lot. It is one area of skin health that we do not want to ignore or miss. Rates of skin cancer in the UK have been rising significantly since the 1970s. Its incidence is thought to have increased as much as 360 per cent during this time.
Why is this? Well, since the 1970s, we have seen an increase in the accessibility of foreign travel and budget holidays in the sun. The desire to be tanned has become popular, and tanning bed usage more prevalent. Combine this with the thinning ozone layer in parts of the world, and you can see how the problem has developed. Limiting ultraviolet light exposure remains the most important preventable factor in skin cancer.
There are three main types of skin cancer: melanoma, basal cell carcinoma and squamous cell carcinoma.
MELANOMA
Melanoma is the fifth most common cancer in the UK. It develops from the pigment-producing cells in the skin, known as melanocytes. Melanoma can develop as a new mole on the skin (the majority) or within a pre-existing mole.
Ultraviolet light from the sun or from artificial tanning beds is the single biggest culprit. Other risk factors include fair skin, multiple sunburns, a family history of melanoma in close relatives, conditions that cause a weakened immune system and the presence of lots of moles.
The reason we worry about melanoma is its ability to spread to other organs or ‘metastasize’. Melanoma has the potential to spread to the liver, lungs, bone and brain, where it can potentially be fatal. The good news is that most melanomas are picked up at an early stage, well before this happens.
There is no national screening programme in the UK for melanoma. The best chance of picking up a melanoma early is to know the signs and when to seek medical attention. I can’t stress enough how vital this is. For those who have private healthcare, many choose to have annual mole checks performed by a dermatologist as part of their preventative health screening.
Educating your patients is key in bringing down rates of melanoma. The skin is a visual organ, and any surface changes should, in theory, be easier to pick up than disease in some other organ, which would require an internal scan.
NON-MELANOMA SKIN CANCER
There are two main types of non-melanoma skin cancer: basal cell and squamous cell carcinoma. Ultraviolet light, usually from the sun, is yet again the most common cause of their development. These types of cancer usually look like scaly patches or pink bumps on the skin that fail to heal. They can become scabby and bleed and are occasionally tender to touch.
Non-melanoma skin cancers can develop on any part of the body but are usually seen on sun-exposed sites such as the face, neck, forearms and hands. In men, they can develop on the scalp, especially if there is little hair to provide protection. They are the result of chronic sun damage over the years and usually affect people in their fifties onwards. However, you can see them in younger individuals, particularly if there has been a lot of sun exposure. These types of cancer have a much lower likelihood of spread compared to melanoma, and treatment is usually curative, often with surgery.
Sun protection is the single most effective method for reducing the risk of skin cancer. This is particularly important if they have risk factors such as fair skin, family history or many moles.
I often get asked if it is necessary to wear sunscreen every day, including during the winter months. It is true that there is less UVB radiation in the winter in the UK, the main ray that can cause burning. However, as many skin cancers develop due to cumulative UV exposure, it is worthwhile getting into the habit of wearing sunscreen on exposed sites daily.
Special care needs to be taken with small children in the sun. Blistering sunburn in childhood can double a person’s risk of developing melanoma in later life. Young skin is particularly vulnerable to the effects of ultraviolet radiation. Babies below the age of six months have little melanin in their skin, and their skin is too sensitive for the use of sunscreens. It is therefore important that young babies are not left in direct sunlight. After six months of age, sunscreen is safe to apply.
You can read the full article in the June issue of Aesthetic Medicine, which will be out at Aesthetic Medicine Live on May 20-21.
Dr Anjali Mahto is a highly respected and renowned medical and cosmetic consultant dermatologist and the author of the best-selling book The Skincare Bible. Based at her London Clinic in Harley Street, Dr Anjali employs a bespoke and tailored approach for all of her patients and is renowned for her quality service and unrivalled patient care.