Know your moles
Moles are clusters of pigment-containing cells (melanocytes) and are usually harmless. Melanomas – the least common, but most dangerous type of skin cancer – can arise in pre-existing moles. Things to look out for include rapid growth, a change in colour, shape or border, and a previously flat mole becoming raised. Bleeding, itching, scaling or ulceration, also warrant urgent medical attention. It is useful to know what is normal, too; new, harmless moles often appear up to the age of 25, they tend to fade with age but often get darker in pregnancy. Dermatologist Howard Stevens says melanomas can look like innocent moles (“a wolf in sheep’s clothing”), so if you notice a single large mole (greater than 6mm in diameter) that is growing or changing, ask to see a dermatologist.
Spotting the changes
If you have lots of moles, it can be hard to keep an eye on them. Programmes that monitor your moles (mole mapping) use computer-assisted technology to photograph, analyse and store images of your moles over regular intervals. But you can do it yourself by looking out for the ABCDE of moles; asymmetry, border irregularity, colour change, diameter increase and enlargement or elevation.
Watch your ears and eyes
Take special care of areas of skin that are often exposed to sun, burn easily and don’t heal well – such as the tips of your ears and areas around the eyes. Basal cell cancers – the commonest and least destructive type of skin cancer – often arise near the eyes and sides of the nose. Squamous cell cancers – less common, but occasionally aggressive cancers – can arise on the tops of your ears and lips, often starting as a roughened patch that won’t heal. Melanomas can arise anywhere on the body, either in an existing mole or as a new raised nodule or spot that looks like a mole.
Know your risk
Anyone can get skin cancers, but, as with most cancers, they are much more common as you get older. People most at risk of a melanoma have fair skin and hair, blue eyes, more than 20 moles, have been exposed to severe sunburn (especially in childhood) and have a close family member who has had a melanoma. Once you have had a melanoma, you are at greatly increased risk of another.
Exposure to high levels of ultraviolet (UV) radiation from sunlight or sunbeds increases the risk of all types of skin cancer. UVA rays cause skin damage such as wrinkles and play a part in some skin cancers. UVB causes sunburn and direct damage to skin cells and increases the risk of most skin cancers. UV levels can be high even on cloudy days. Rays are strongest from 10am to 4pm, at high altitude and the nearer you are to the equator. The Met Office publishes a UV index forecast for 417 world cities, giving a level of risk from 1-11 and advising about suitable precautions.
What are ‘suitable precautions’?
Look after babies and children; later development of skin cancer is linked to childhood sunburn. Babies should be kept out of direct sun and kids should never be allowed to burn. When the UV index is 1-2 (a typical UK winter day), no protection is needed; UV 3-7 means you should wear a shirt, sunscreen, a hat and sunglasses. For UV 8-11, the advice is to seek shade, stay indoors during midday hours and wear a shirt, hat, shades and sunscreen at all times when outside. A hot summer day in the UK may well reach 7 or even 8.
What sort of sunscreen is best?
You need a broad spectrum (UVA/UVB) sunscreen with a sun-protection factor (SPF) of 30-plus if the UV index is above 3. For an adult, you need two tablespoons (about the amount you can fit in your palm) of sunscreen for your entire body, including ears, neck, face, hands and feet. Put it on while still indoors because it takes about 15 minutes to be absorbed into the skin and start doing its job. Reapply every two hours or immediately after swimming or heavy sweating. Use a lip balm SPF 15-plus to protect lips.