Skin Cancer Prevention

It’s no surprise that living in the sun drenched country of Australia we have the highest incidence of skin cancer in the world. More than 90 per cent of skin cancers are caused by the sun’s UVA and UVB rays, not to mention the skin damage we associate with ageing, wrinkles, sagging and pigmentation. Having said this, we do need some sun, it provides vitamin D, which helps our bodies absorb calcium necessary for strong bones, muscles and teeth. We can be smart about it. Following these guidelines is a great start.

1. Stay within the shade, especially between 10am and 4pm – the hottest part of the day when UV rays are most intense. And when you do go outdoors, limit the time you spend in direct sunlight. A clever way to tell if the sun is too intense is to take a shadow test, if your shadow is shorter than you are, then the sun’s rays are at their strongest. Try to plan your activities out of the sun during these times.

2. Try not to burn at any time. If you must be outdoors, then be sure to protect your skin with clothing and sunscreen. UV rays reach the ground every day, even when the sky is cloudy. They can also pass through water, so even when you’re in the water and feeling cool, you can still get burnt. Be especially careful when you’re on the beach as the sand reflects sunlight, increasing the amount of UV radiation you receive. If you do happen to get burnt, or even a little red, apply after-sun care lotions or aloe vera as soon as possible. Don’t use moisturisers on burns as the oils in them may make your sunburn worse.

3. Do not use tanning beds or UV sun-tanning booths – these can do just as much damage as the sun. Like the sun, tanning beds and booths give out UVA and often UVB rays, both of which can cause serious long-term skin damage, plus contribute to skin cancer.

4. Apply an SPF 30+ sunscreen about 20 minutes before you go outdoors, and reapply it every two hours. You can buy non-greasy products for the face and body, if you’re worried about residue. Sunscreens come in many forms: lotions, creams, ointments, gels, wipes, lip balms and some cosmetics, such as lipsticks and foundations, also are considered sunscreens if they are labelled with an SPF. You cannot rely on general make-up, including lipstick, which doesn’t contain a sunscreen, to protect you from the sun.

It’s important to realise that sunscreen does not provide complete protection from UV rays. The SPF number represents the level of protection against UVB rays provided by the sunscreen – a higher number means greater protection. For example, using an SPF 15 gives you about 1 minute of UV rays for every 15 minutes you spend in the sun. Therefore, if you’re out in the sun for an hour, it’s the same as spending a total of four minutes without any protection. And so wearing an SPF 30 will give you about 2 minutes unprotected skin over an hour. Also, the SPF number indicates your protection only against UVB rays. So look for products that are labelled ‘broad spectrum’ as these will protect you against UVA rays too. Products that have an SPF of 15 or higher and contain avobenzone (Parsol 1789), ecamsule, zinc oxide, or titanium dioxide are likely to be effective against UVB and most UVA rays. Be sure to check the use-by dates on the packaging, most sunscreens are no longer effective after 2-3 years.

5. Be sure to apply your sunscreen properly. And always follow the label directions. Most recommend applying sunscreen generously to dry skin 20 to 30 minutes before going outside so that your skin has time to absorb it. Don’t forget your face (including your lips), ears, neck and hands as you cover every part of your skin not covered by clothing. And if you’re going to wear insect repellent or make-up, put on your sunscreen first. Be generous with the amount you apply, too. The average adult will need to fill their palm to cover their arms, legs, neck, and face. For best results, most sunscreens must be reapplied at least every two hours – even more often if you are swimming or sweating. If the product is labelled ‘waterproof’, you may have protection for at least 80 minutes, while products labelled ‘water resistant’ may provide protection for only 40 minutes. Also remember that sunscreen usually rubs off when you towel-dry yourself, so you will need to reapply straight after doing so.

6. Wear protective clothing, including sunglasses and a hat. This is important for everyone but vital if you have fair skin, are balding and/or have a history of skin cancer.

Clothing Long-sleeved shirts, long pants and long skirts cover the most skin and are the most protective. Tightly woven fabrics protect better than loosely woven ones and dry fabric is generally more protective than wet fabric. Note that if you can see light through your clothing, the UV rays can get through, too – a typical light T-shirt usually protects you less than sunscreen with a sun protection factor SPF 15 or higher. Some sun-protective clothes and swimming costumes, such as those you can purchase from the Cancer Council, have a label listing the ultraviolet protection factor (UPF) value.

Hat Wear a hat with at least a 5cm brim all the way around it to protect your neck, ears, eyes, forehead, nose and scalp. A cap with fabric at the sides and back also works well. Skin cancers commonly develop on the back of the neck and the ears, so it is important to protect these areas. Don’t rely on woven hats, unless the weave is tight.

Sunglasses You need to protect your eye area, too, by wearing a good pair of sunglasses. Research has shown that spending long hours in sunlight without protecting your eyes increases your risk of eye disease, but wearing UV-blocking sunglasses can help. You don’t have to spend a lot of money, but it’s important that the sunglasses block 99-100 per cent of UVA and UVB rays. Just check the label to be sure – it may say ‘UV absorption up to 400mm’, which is the same as 100 per cent UV absorption. Larger framed or wraparound glasses are best, as they prevent the light from coming in around the sides. But don’t concern yourself with the colour of the lenses, the protection comes from a clear chemical applied to lenses, so it doesn’t mater if they are dark or light. Be sure to protect your children with good sunglasses as well. Toy sunglasses may look good, but they won’t do the job. You can also purchase contact lenses that block out most UV rays. However, they don’t cover the whole eye area, many skin cancers develop on the eyelids, so don’t count on them for complete eye protection.

7. Don’t rely on bronzers and mineral make-ups to protect you from getting burnt. Most are considered cosmetics, they may give your skin a golden colour, but unlike sunscreens, these products provide very little protection from UV damage.

8. Keep babies out of direct sunlight. Use hats and protective clothing whenever outdoors. Use a sunscreen on children six months and older.

9. It’s a good idea to educate children, as soon as they are old enough to understand about the dangers of the sun and when and where to wear sunscreen so that they develop good sun smart habits.

10. Self-examine your skin every month for any changes, and have a professional skin check each year. See FAQs for what you can expect from a skin check and how complete a skin check yourself.

A snapshot of skin cancer risk factors

You are more at risk of skin cancer if you.

  • have grown up or have spent much of your life in a warm to hot country, such as Australia, or live or holiday in tropical or subtropical climates
  • have many moles, irregular moles, or large moles
  • have freckly skin and tend to burn before you tan
  • have fair skin or blonde, red, or light brown hair (for example, those people from a northern white European background (Scandinavia, England, Ireland, Scotland, Russia)
  • have previously been treated for skin cancer, a melanoma or other type
  • have a family history of skin cancer, especially melanoma
  • work indoors during the week and then get intense sun exposure on weekends
  • spend a lot of time outdoors for leisure or work
  • have an autoimmune disease, such as lupus
  • have had an organ transplant
  • take medication that lowers your level of immunity
  • take oral contraceptives (birth control pills)