Consumers can do with guidance on looking out for skin changes, write Dr Esther Lau and Professor Lisa Nissen
Do you know your ABCDEFG …?
Australia has the highest rate of skin cancer and melanoma in the world. Many people think skin cancers are only found in older people who spend a lot of time in the sun. However, it is imperative to remember that much younger people, and people who never spend time in the sun, can also develop skin cancers.
The three main types of cancer are basal cell carincoma (BCC), squamous cell carcinoma (SCC), and melanoma. Non-melanoma skin cancers (BCC and SCC) are much more common, and most are not life threatening.
On the other hand, melanomas are less common (2% of all skin cancers), but are responsible for 75% of all skin cancer deaths.
As with all cancers, early detection improves outcomes. Pharmacists are well placed to remind people to look for any changes in their skin that might suggest a skin cancer because it isn’t always about a mole, e.g. crusty non-healing sores, lumps that are different in colour.
When patients self-check their own moles, they need to be reminded that suspicious looking spots require further investigations:
Asymmetry – irregularly shaped
Border – irregular edges, uneven border i.e. edges are not smooth and even
Colour – number of different colours through it
Diameter – diameter >6 mm
Evolving – changing over time – be it colour, shape, elevation, or new symptoms e.g. bleeding, itching, crusting.
Firm – mole is harder than surrounding tissue and does not flatten when pressed
Growing – growing or changing in diameter over time
Smart phone apps can also help with detecting skin cancers, but they do not replace mole checks by doctors. Annual skin checks with doctors at skin cancer clinics which record/take a photo of the spots are also helpful with tracking and identifying any changes.
Sun exposure (both UVA and UVB) is responsible for the majority of skin cancers, so sun protection measures are vital. The slip on sun-protective clothing, slop on broad spectrum SPF30+ sunscreen, slap on a hat, seek shade, slide on some sunglasses with UV protection and that reduces sun glare; campaign has been enormously successful in promoting sun protection.
However, most people only apply half the recommended amount of sunscreen, meaning they do not get the protection stated on the product.
Sunscreen should be applied liberally – at least a teaspoon for each limb, front and back of the body and half a teaspoon for the face (don’t forget the lips!), neck and ears.
Sunscreen also must be reapplied every two hours, or after swimming, towel drying, sweating/exercising to maintain the same level of protection, regardless of what the product might say!
Dr Esther Lau and Prof Lisa Nissen are from the School of Clinical Sciences, Queensland University of Technology.