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This month (May 2021) has been Skin Cancer Awareness month. It is a subject that we, as Skin Professionals, are really passionate about as it’s one of the most common types of cancer yet is very preventable if we take the right precautions with our skin.
Melanoma is the most serious type of skin cancer.
Melanoma is usually diagnosed from a new mole or changes to an existing mole. Moles normally are uniform and smooth. If they become irregular then it is always worth having it checked as if melanoma is caught early then the prognosis can be good. However, Melanoma can grow aggressively our advice would always be to get your moles checked regularly and particularly if you notice any changes to them.
Melanoma can occur anywhere on the body but are more common on the back in men and legs in women. They are less common in areas of the body that are not exposed to UV.
The ABCDE method of checking for Melanoma can be a good indicator in the beginning but if you aren’t sure use E for Expert and get it checked out.
Asymmetry – the two halves of the area may differ in shape
Border – the edges of the area may be irregular or blurred, and sometimes show notches
Colour – this may be uneven. Different shades of black, brown and pink may be seen
Diameter – most melanomas are at least 6mm in diameter. Report any change in size, shape or diameter to your doctor
Evolving – Has it grown larger in size, or is it elevated?
Basal Cell Carcinoma (BCC) is the most common type of skin cancer and can be found anywhere on the body. It tends to grow really slowly and can sometimes be mistaken for a scar or a spot.
The prognosis can be really positive as they are curable and cause minimal damage if caught and treated early. If left untreated it can spread and cause disfigurement.
Typical signs to look for include:
1. A small pearly lump that can be mistaken for a spot but doesn’t go away.
2. A reddish or pink growth that dips in the centre. This can be mistaken for an acne scar, but you know your skin and if it wasn’t there before then get it checked.
3. A scaly patch or a sore that is close to the ear.
4. A sore that just isn’t healing and keeps weeping or bleeding.
5. A patch of skin that is slightly raised and appears as dry skin, but is pink or red and not going away.
6. A growth that is raised and skin coloured or brown. Can often be mistaken for warts.
UV rays from the sun and from tanning beds are the most common cause of Basal Cell Carcinoma and are more common in fair skin types.
Squamous Cell Carcinoma (SCC) is the second most common type of skin cancer. It is caused by overexposure to UV and other radiation sources. They can also develop from burns, scars, chronic ulcers and wounds.
People more likely to be affected:
1. Immunosuppressed individuals.
2. People who have significant, cumulative exposure to UV rays.
3. People with pale skin or albinism.
SCC can occur anywhere on the body but are more common in exposed areas of skin. As with BCC they can vary in their appearance, but typical signs to look for are:
1. Scaly or crusty area of skin that has a red, inflamed base.
2. Can be sore or tender (but this isn’t always the case).
3. Can appear as an ulcer.
4. Raised growth with central depression.
5. Wart like growth that crusts and occasionally bleeds.
The vast majority of SCC can be easily treated, though if left untreated can spread and metastasise.
What are the types of Ultra Violet Light
There are several different types of UV rays.
We all know about UVB. These are the rays that tend to burn us in hot weather. Often these are the only rays that many people consider protecting themselves against. However, that’s not the whole story.
UVB is vitally important to protect against. However, these rays don’t penetrate our skin as deeply as other types although they can cause significant damage by causing sunburn and thickening of the skin. It can also cause skin cancers and hyperpigmentation. UVB does provide the energy that is required to make vitamin D, so a maximum of 20 mins exposure per day is recommended.
So, let’s look at UVA. UVA are our ageing rays and penetrate much deeper into the skin, right into the Dermis. The rays cause free radical damage, causing oxidative stress and DNA mutations. This can lead to skin cancers. It also causes premature ageing and hyperpigmentation. UVA is around in the same strength all year round and is found in our lights and penetrates through windows. They are less intense than UVB, but there is 30 to 50 times more of them. This is one of the main reasons that it is vitally important to protect our skin all year round.
High Energy Visible Light (HEV) is emitted from the sun, but is also from our electronic devices; mobile phones, TV’s and computers. It is also known as blue light and has a particularly high energy level. These rays are not linked with cancer, but if you are concerned with ageing, then it is a priority to protect against as they also cause premature ageing and hyperpigmentation. These rays penetrate deeply in the Dermis. (Take a look at our article on Blue Light and the Skin).
The most important thing that we can do to our skin is apply an SPF (Sun Protection Factor). There are several different forms, most commonly creams, that are available.
Chemical sunscreens absorb UVA and UVB rays as they contact the skin. This diminishes the effect of UV rays on the cells. These need to be applied 20 minutes before going out into strong sunlight.
Mineral sunscreens sit on the surface of the skin and reflect and block the UV rays by providing a protective layer from the minute you apply it. They can sometimes leave a white appearance on the skin, though many formulations have improved to counteract this.
There are many debates about which is better, chemical or mineral.
Chemical sunscreens can cause more irritation and there is some evidence that some ingredients in chemical sunscreens can cause free radical damage and therefore cause cancers. The most commonly used chemical UV filters are Octylcrylene, Avobenzone, Oxybenzone and Homosalate. Triazines and Triazones are also another popular group of chemical filters that are used in European sunscreens.
Titanium Dioxide and Zinc Oxide are the most commonly found mineral ingredients and they are considered really safe with minimal irritation.
A good sunscreen should be broad spectrum, which means that it protects from both UVA and UVB. It should also contain antioxidants ideally as this will provide further protection by neutralising free radicals from UV exposure and are particularly useful in protecting against exposure to blue light (HEV) from digital devices. They also help to repair any damage that has been caused. These could be separate from your sunscreen in your skincare and/or combined into your SPF for additional protection.
SPF should be applied frequently, every 2 hours ideally. Once application in the morning is not sufficient for adequate protection even with mineral sunscreens as these can also rub off.
We know and agree that the sun makes us feel better. We aren’t saying don’t go out in the sun, we need some for our Vitamin D, but when you do, please be safe.
Follow our steps for using an SPF, wear it all year round to protect against the other UV forms and reapply regularly. Avoid sunbeds. Keep an eye out for any skin changes that you aren’t sure about and if in doubt get it checked.
It could save your life!