Raising awareness of skin cancer

May is skin cancer awareness month, with an aim to spread knowledge about prevention, detection, and risk factors for the disease.

Dr Derrick Phillips, consultant dermatologist, has shared his insights into skin cancer, alongside his best tip to help protect patients and practitioners alike.

Are there different types of skin cancer and who is most at risk?

The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal cell carcinomas are also known as rodent ulcers and are the commonest type of skin cancer in the UK. They are slow growing and appear as pearly red lesions that periodically scab and fail to heal.

Squamous cell carcinomas are more common in elderly patients and manifest as rapidly enlarging, painful, scaly skin growths. They can also develop within burns scars and ulcers.

Melanoma is the most worrying form of skin cancer. It can develop in new or existing moles and has the potential to spread to other parts of the body. Melanoma can affect young and old people, as has been associated with exposure to high intensity UV radiation.

Most skin cancers develop from cumulative DNA damage caused by exposure to UV radiation from the sun or tanning beds. Other important risk factors include having fair skin with red hair and freckles, multiple sunburns, rare genetic conditions, significant childhood sun exposure, multiple atypical moles, and a family history of skin cancer.

What can be done to help prevent this and support sun safety?

The risk of skin cancer can be reduced by taking appropriate precautions. These include applying high factor sunscreen (SPF50 with five star UVA protection) to exposed sites during sun exposure, and reapplying every two hours, staying in the shade between 11am and 3pm on hot days and wearing protective clothing (e.g. hats, sunglasses, shorts and long-sleeved tops).

Additionally, individuals should avoid indoor tanning beds, perform regular skin self-examinations of moles, and have a low threshold for seeking medical assistance if they notice a lesion of concern.

Tanning exposes your skin to harmful UV radiation that directly damages the skin’s DNA and increases the risk of developing skin cancer. It also accelerates the development of fine lines, wrinkles, pigmentary spots, and other signs of skin aging.

Encouraging sun-safe habits in children and promoting awareness about the dangers of excessive sun exposure also contribute to preventing skin cancer.

Why should SPF be worn every day?

Sunscreen should be applied to exposed areas of skin throughout the year, even on cloudy days. We receive two forms of harmful UV radiation from the sun, UVA and UVB. UVB is responsible for sunburn and is present during the summer months, whilst UVA which causes skin ageing and some forms of skin cancer, is present throughout the year and passes through clouds and window glass.

What are the signs of skin cancer to look out for?

Basal cell carcinomas are red, pearly skin growths with prominent, branching thread veins on their surface. They periodically scab and are often confused for a non-healing wound. Basal cell carcinomas most often occur on the face and torso.

Squamous cell carcinomas are rapidly enlarging, painful, scaly skin growths. They can bleed with minimal trauma and often occur in elderly people. They can also develop in burns or long-standing wounds.

Melanomas are a type of skin cancer that develop from new or existing moles. Early detection increases the likelihood of cure, therefore in addition to sun safety measures, it is also important to regularly monitor your moles.

The ABCDE tool can be used to determine if a mole requires further assessment by a doctor or a dermatologist:

• Asymmetry- harmless moles are typically symmetrical
• Border- unclear, ragged or irregular borders can be a sign of an abnormal mole
• Colours- the presence of two or more colours can be a sign of an abnormal mole
• Diameter – a mole more than 6mm is considered abnormal
• Evolving- changes in size, shape, colour, itching or bleeding in a new or existing mole.

The presence of two or more of these features suggests a mole requires further assessment. 

For most people it is sufficient to check your moles every two to three months, however, for those at higher risk of skin cancer, more frequent checks are required.

Risk factors for skin cancer include having fair skin with freckles, a history of multiple sunburn episodes with blistering, having more than 50 moles, the presence of atypical moles, a personal or family history of skin cancer, certain genetic conditions and medications that suppress the immune system.

What are your top tips for looking after the skin and protecting it from skin cancer?

Use SPF daily: Apply a broad-spectrum sunscreen with SPF50 and five star UVA protection to exposed skin, during sun exposure.  Reapply every two hours and more often if swimming or sweating.

Stay in the shade between 11am and 3pm when the sun is at its strongest: This will reduce the risk of sunburn and damage to the skin.

Cover up where possible: Wear protective clothing, including hats, sunglasses, and long sleeves, to shield your skin from direct sunlight. This provides an additional layer of defence against harmful UV rays.

Avoid sunbeds: Indoor tanning can significantly increase the risk of skin cancer. Opt for safer alternatives like self-tanning lotions if you want a bronzed look.

Regular skin checks: Perform regular self-examinations to monitor moles, freckles, and any changes in your skin. If you notice any unusual growth or changes, consult a dermatologist promptly.

Healthy lifestyle: Adopt a healthy lifestyle with a balanced diet rich in antioxidants, as this can support your skin's ability to repair and protect itself.