Prevention of Skin Cancer


UVR Protection

As discussed in the section The Role of Sun light in the causation of skin cancer  the ultraviolet radiation (UVR) is the main cause of Squamous Cell Carcinoma and Basal Cell Carcinoma of the skin and plays a role in some but not all Melanoma skin cancers. We are most commonly exposed to UVR from the sun. UVR exposure also occurs in tanning beds or solariums, and welders are occupationally exposed to a type of UVR (UVC). UVR is necessary for health, the body uses it for production of active vitamin D and as well our emotional wellbeing is influenced by sunlight. Too much UVR however causes damage and photo aging of the skin and increases the risk of skin cancer in general and for this reason sun protection is advised.

The recommendations for sun protection are as follows and they should be approached in the order listed!

  1. Avoid exposure to the sun during the highest UV exposure times 10am to 3pm.
  2. When outdoors use shade whenever possible, but remember you can burn in the shade if UVR is not completely blocked or from reflected or tangential UVR.
  3. Wear a hat, sunglasses and protective clothing to cover as much exposed skin as possible. Remember some light fabrics may not block UVR; choose a close weave fabric or one with a UV protection factor. Consider closed in foot wear and gloves in some situations hands and feet can burn and are frequently forgotten about. UV protective gloves with fingers exposed are available at most fishing stores.
  4. Where skin cannot be protected in any other way, use a broad spectrum sunscreen with a 30+ rating. Apply liberally 20 – 30 minutes before exposure for the best effect, and reapply every 2 hours with continued exposure. For swimming, water sports and activities where sweating occurs, use a water resistant product. Most importantly don’t allow yourself to get sunburn.

A lot of cumulative sun exposure however occurs simply through day to day exposure as we go about our lives. Day to day activities such as travelling to work, hanging out washing, gardening etc can cause ongoing damage particularly to the skin of our face, neck, upper chest, forearm and hands, legs and feet (sometimes referred to as the “office tan”). In the high UV environment of North Queensland we recommend daily use of sunscreen on these areas if they are exposed. This is particularly important for women who wish to prevent premature photo aging of the skin. Many cosmetic foundations and moisturisers contain a sunscreen, but remember to apply it to all exposed skin. Two products that we have found to be very good are:

1. Hamilton “Every Day Face” a skin toned non water resistant moisture cream if applied and let penetrate, make up can be applied over it in 15 minutes. Whilst marketed towards women it is also suitable for men, and is available in pharmacies only.

2. Trishave "3in 1 post shave moisturising lotion" is available in most supermarkets and is ideally suited for men to use following shaving. It can also be applied to the neck, hands and forearms if exposed.

Both of these products are not water proof but this makes them lighter and comfortable to wear on an everyday basis.

Skin Self Exam and Physician Skin Exam

Whilst UVR protection is important, we believe the most significant intervention that can reduce the burden of skin cancer for the community is regular self examination of the skin and periodic physician skin examinations. This enables detection of skin cancer especially melanoma at the earliest stage when simple removal is most likely to be curative.

Who should have regular physician skin checks? This is currently an area of controversy however we believe anyone who is concerned or anyone at increased risk of any type of skin cancer should have at least an annual physician complete body skin check.

Risk Factors for Skin Cancer

  • Family history of Melanoma skin cancer (especially in a first degree relative, that is parent, sibling or child).
  • Patients with a history of previous skin cancer be it melanoma or non melanoma.
  • Adults with fair skin and significant cumulative sun exposure or a history of sunburns. (Fair skin types are those that cannot tan or tan poorly or burn easily).
  • Adults over 40 with any skin type and high cumulative sun exposure e.g. outdoors occupation.
  • Adults with many “moles” (> 50 moles) or those with large or irregular moles, or those with “Dysplastic Nevus Syndrome”.
  • Patients with any of the many familial cancers syndromes with a skin cancer component.
  • Patients who are on immune suppressing treatment such as organ transplant recipients or treatment for other cancers (such as lymphoma).
  • Additionally anyone who detects a lesion of concern on the skin self examination, requires a full skin check.

Regular skin checks are not advised for preadolescent children except in the cases of the hereditary cancer syndromes or if they have large or multiple congenital nevi (birth marks). However we are happy to check children upon request if parents are concerned about a particular or changing lesion.