Dr Patrick Ormond, skin cancer specialist and Consultant Dermatologist at St James’s Hospital, Dublin, emphasises that to avoid skin cancer you must:
- Avoid sunbathing
- Avoid sunburn
- Check your skin regularly
- Never, ever use sunbeds
How sun damage is caused
Dr Ormond explained in a recent interview with the Marie Keating Foundation that the sun can damage our skin in two ways, leaving it susceptible to developing cancer in later years. It can do this by:
- Burning the skin
- Radiation penetrating the skin with or without burning.
There are two main types of skin cancer. Melanoma, which is the potentially life-threatening cancer; and non-melanoma, which is usually curable if it is caught early enough.
Non-melanoma skin cancer
Non-melanoma skin cancer is a result of a combination of:
- Your genetic skin type – how good your skin is at protecting itself against the sun’s radiation
- How much radiation you get from the sun.
Melanoma skin cancer
Melanoma is usually the result of skin damage and burning by exposure to the sun.
“I want people to enjoy the sun and the outdoors and a healthy lifestyle, but you have to be aware of and balance this with the risks associated with being outdoors. We have to be sensible with our behaviour outdoors, in the sun,” says Dr Ormond.
People are generally aware that they need to protect themselves from the sun when they are abroad. However, a lot of the sun damage is done in Ireland.
Sun-protection factor
Many people incorrectly believe that if they put on sun-protection factor (SPF) 50 then they can stay out in the sun all day without any risk.
“The problem is that we don’t use sun-protection factors correctly. We are not getting the protection that they say we are getting. Most of us don’t put it on frequently enough, thickly enough or reapply it as needed.
“We may be putting on a ‘factor 50’ and most people think it means ‘I can stay out in the sun 50-times longer’. But in fact if you put it on the way most people put it on, you will only be getting a factor 10-15. People are not putting enough on, they are not putting it on frequently enough and they are towelling it off. This means we are getting a false sense of security,” says Dr Ormond.
Never sunbathe
You should never sunbathe even with factor 50. That is misusing it. If you want to lie down outside on a sunny day, you should be:
- Underneath an umbrella or in the shade
- Wearing a light long-sleeved shirt
- Light trousers
- Sunglasses
- And have sun-protection factor 50 on your face as you cannot avoid exposing it.
Being active outdoors
“You don’t need to sunbathe. If you are out and active and doing things in the sun, that is a different thing. Being out and about is normal, but lying in the sun with the sole purpose of getting a tan, is ridiculous,” says Dr Ormond.
If you are active outdoors for work or pleasure, there are practical things you can do to minimise your risk of your skin being damaged by the sun. First you should stay out of the sun if possible, particularly when the radiation levels are high between 11am and 3pm, between April and mid-September. In addition, cover up with:
- Long sleeves and long trousers
- Broad-brimmed hat
- Sunglasses
- The shade if possible.
In those areas that you cannot cover up, use sun-protection factor.
Know your skin
It is also very important to know your skin so that if any problems do develop you can get them diagnosed and treated as early as possible. You should always get any unusual or changes in moles checked by your doctor. They are a key symptom of melanoma skin cancer. (See a guide to moles here) Look at your skin:
- Get to know what your moles look like
- Get to know where your moles are on your body
- Keep an eye on your moles
- Be familiar with your skin.
“Everyone can keep an eye on their own skin and will know their own skin better than anyone. Use two mirrors or get your partner to look at your back. We all have cameras now, so take photographs of your moles.
“You should be as familiar with your skin as you are with your kitchen. The only way you can do that is by looking at it on a regular basis. Strip down to your underwear and use a full length mirror in daylight. Do it frequently enough so that you become familiar with your skin.
Check it out with a doctor
“If you are worried about a mole, get it checked by a doctor. Don’t wait and see. Get it checked,” says Dr Ormond.
Moles change and alter as part of our normal ageing and changing. But some may change in an abnormal way.
Don’t ever use sun beds
“Sun beds are an absolute no-no. We know they are bad for you. They are as dangerously carcinogenic [cancer causing] as asbestos from smoking. Sunbeds are worse than sun exposure because they give you a much higher dose of radiation than you would get from natural sun,” said Dr Ormond.
Non-melanoma skin cancer
Non-melanoma skin cancer is a result of a combination of:
- Your genetic skin type – how good your skin is at protecting itself against the sun’s radiation
- How much radiation you get.
The longer you live and the more you are outdoors, working or with hobbies the more radiation you are going to get.
“Our skin is designed to protect us against radiation, but it can eventually break down. The fact that we are now ageing well and healthier for longer, is one of the reasons skin cancer is increasing.
“Your skin is going to be something that will be with you your whole life. You need to look after it and reduce any risk to it, not only for the next year but for the next 10, 20, 30, or 40, 50 years’ time. Non-melanoma skin cancer comes from chronic (long-term) radiation that you get throughout a period of time.
“Anyone who is outdoors a lot is more at risk, farmers, golfers, fishermen, builders. They are all at a higher risk of getting more sun damage,” says Dr Ormond.
If treated early, most non-melanoma skin cancers can be cured.
Know your skin type
The typical pale Celtic skin common in Ireland, along with red hair and blue eyes, does not protect you very well from the sun. Mediterranean and African people get much better protection from their skin.
Skin-ageing damage
Some 70% or more of the ageing effect on our skin is due to sun damage.
“The one anti-ageing cream that you can use that does work is sun-protection factor,” says Dr Ormond.
Early detection
Symptoms for non-melanoma skin cancers are different to melanoma.
Non-melanoma skin cancer, is sometimes also called:
- Basal-cell carcinoma
- Squamous-cell carcinoma.
The symptoms for non-melanoma skin cancer tend to be slow growing little lumps or bumps.
“They typically break down, or don’t heal, or bleed easily or ulcerate – they are just something wrong on your skin. They can be crusty and scaly, or round and red. It is something that is not right for your skin. It isn’t clearing or going away and is slowly changing.
“They are usually very slow growing initially, but there are some that are very rapid in growing.
“If you think you notice something on your skin that you are not sure about, go to your GP. Know your skin,” says Dr Ormond.
Keep children out of the sun
- Children under the age of 2 should not be out in the sun.
- Bring children inside during the middle of the day.
- There are tents for babies and toddlers on the beach, and sun suits and hats – use them.
“Enjoy the sun but be sensible. We don’t let children drink; we don’t let them smoke, nor should we allow them to go out in the sun. If that child gets burnt, that is damage starting early, so try to reduce the damage in their childhood,” says Dr Ormond.
