Education

Are you at Risk?

There are a various risk factors causing the high rates of skin cancers in New Zealand.

Personal factors

1. Fair skin type that does not tan easily, often in combination with freckles, green eyes, red or blonde hair.
2. Having a large number of moles
3. Having a past history of skin cancers
4. Family history of skin cancers especially melanomas
5. Medical conditions eg organ transplant patients on immunosuppressant medications

Sun or UV exposure

1. Excessive sun exposure, in particular sunburns during childhood
2. Outdoor activities / sports / work
3. Use of tanning beds /solariums
4. Arc welding

Prevention

Be Sun Smart:

1. 1. Sun Avoidance
      • Try to avoid sun exposure during the middle of the day (between 10am – 3pm)
   2. Sun Protection
      • Seek Shade where possible
      • Wear Protective Clothing
        • Broad Brimmed Hats (preferably choose hats that protect the face, ears and neck)
        • Wear long trousers and long sleeve clothing if possible
        • Wear Sunglasses
      • Apply sunscreen to exposed areas of your skin
        • Try to apply the sunscreen at least 20 minutes before sun exposure
        • Preferably Choose 50+ SPF sunscreens (at least 30+ SPF recommended)
        • Remember to reapply after 2-3 hours and immediately after coming out of the water

Skin Cancer Warning Signs

Moles or Lesions that should be checked are:

1. 1. Changing Spots
      • Brown Moles –
        • which have changed in size, shape or color
        • suddenly raised
        • growing
      • Red/Pink spots –
        • which persists or do not heal after a few weeks
        • which bleed without history of trauma
      • Crusty spots that are sore or persists

2. New moles or spots that look different from the neighboring moles
3. Spots that are starting to get symptoms – eg. soreness, bleeding, itch

Check your Skin and Moles

Skin and Mole Check – Why?

Melanomas are dreaded for being potentially fatal cancers. They can occur in healthy individuals without pre warning and rapidly metastasize  to the internal organs.

Fortunately, most melanomas are found in places that are easily visible, but only if we are aware and care to look for them.

Checking your skin and moles and finding a melanoma at the earliest stage means one can achieve a 100% cure rate. If the melanoma has been allowed to grow unnoticed to more than 4mm deep, the survival rate can fall to less than 50%.

Most melanomas grow silently without symptoms. Self-skin check will increase the rate of diagnosis and early detection.

Skin and Mole Check – How Often?

Cancer Council recommends all adults should check their skin and moles themselves every 3 months. Those at high risk should have a trained doctor examine them at least once a year. Melanomas can develop in between visits to your skin cancer doctor, therefore you should know how to check your own skin and moles.

A melanoma only shows the classic ABCD features when it has grown to a certain size. Therefore, do not wait until it has ALL the features. Any CHANGE to a mole needs to be examined by trained doctors with dermoscopy and specialised equipments. If you examine your skin regularly and observe for changes listed below, you will hopefully notice a potential melanoma at the early stage and have it examined.

Skin and Mole Check – How?

• Obviously, you will need a find a private area with good lighting, and preferably with a large full-length mirror.
• Find yourself a small handheld mirror to check the difficult to see areas.
• Undress completely (yes – everything off please). Start from the top of your head, scan from one side to the other, paying special attention to your eyebrows, around the eyes, the nose and your ears. Move down, scanning each body part by body part. Use the mirrors to see around difficult areas.
• Note any existing moles, and their rough sizes and positions. You may wish to use a digital camera to record these areas, using the “macro” function if available, or keeping the camera a good distance from the skin to keep the photo in focus. It also helps to put a ruler on the skin to record the sizes of the moles.
• Use a hairdryer to help spread your hair to check the scalp.
• Remember to check the back of your neck and legs. Also remember to check your fingers, toes and the nails.

What is Vitamin D?

Vitamin D is a nutrient that has many important functions to help maintain good health

What does Vitamin D do?

Vitamin D has been shown to:

• benefit bone health. Vitamin D is required for the body to absorb calcium from our food. Adequate level of calcium is important against developing osteoporosis.
• protect against some cancers, especially colon cancer, prostate cancer and breast cancer
• help with the function of muscles and nerves
• help with immune function

How is Vitamin D produced?

Vitamin D is produced through a process that starts when the skin is exposed to the UVB rays of the sun. This is the main source of Vitamin D.

A small amount of Vitamin D is also obtained from certain foods. This is normally not enough for your body’s requirements.

Foods that contain Vitamin D include oily fish (such as salmon, tuna and mackerel), cod liver oil, cheese and egg yolks. Certain types of milk and margarine may have vitamin D added into them.

What is the UV index?

The UV index is a number issued by the Bureau of meteorology which is used to describe the strength of the sun’s UV rays for a certain place on a certain day. It acts as a guide to help people avoid overexposure to the sun’s UV rays when it is at harmful levels.

A UV index of 3 and above may damage your skin within a short exposure time and lead to increased risk of skin cancer.

A UV alert (in the form of a color coded graph) is issued by the Bureau of Meteorology, which will show the times of the day when the UV index is above 3. At these times, it is important to protect your skin from the sun.

Remember that UV radiation cannot be seen or felt, so the heat of the sun is not an accurate measure of the strength of the UV rays.

How much Sun do I need to get enough Vitamin D?

The amount of sun you need for adequate vitamin D depends on:

• UV index – which changes with the time of the day
• How much of your skin is exposed to the sun
• Your skin type

How much of my body do I need to expose to the sun to get enough Vitamin D?

During these summer months, most people will meet their vitamin D requirements by exposing their face, arms and hands for only a few minutes during the peak UV times (between 10am to 3pm) on most days of the week.

Remember that after a certain level, further sun exposure will not increase vitamin D production, but it will increase your risk of skin cancer.

Winter months may require two to three hours of total sun exposure per week to the face, arms and hands to get your vitamin D requirements.

Does my skin type affect the amount of sun I need to get enough Vitamin D?

Yes. Dark skinned (eg. Asians and Africans) people have more melanin production that gives them some natural protection against UV rays, but also means that less vitamin D is produced. These people may require as much as three to six times the amount of sunlight to get adequate amounts of vitamin D, compared to fairer skinned individuals.

Does using sunscreen mean I will not get enough Vitamin D production?

Not necessarily. Studies have shown that in real life conditions, regular sunscreen use does not significantly impact on vitamin D levels.

This was thought to be the result of more time spent in the sun (in the individuals who used regular sunscreen), so they already had adequate levels of vitamin D production.

How do I check if I have enough Vitamin D?

Vitamin D can be checked by a simple blood test. If this is found to be low, you can discuss your options with your GP or our skin cancer clinic doctor to assess the best way to increase your vitamin D levels.