15, 906 people were diagnosed with melanoma in 2015. 2,285 died from melanoma in 2016. My Uncle was one of them. Skin cancer runs in our family; squamous, basal cell and the deadly melanoma have all touched my immediate family and therefore I grew up knowing I had to be careful. I always did, and continue to, wear Factor 50+ sunscreen and reapplied as instructed. I was the kid who had to wear one of those swimsuits that look like you’re about go diving. I was the kid who blatantly refused to go out of the shade during “peak sunshine time” because I was terrified of burning. I’m now the teenager who forgoes fashion for ‘safety’, dressing in shouldered, knee length summer dresses or trousers and a massive sun hat. I never use tanning beds or even risk tanning. Despite having acne, I sacrifice makeup to be able to reapply sunscreen and end up looking like a sweaty pepperoni pizza.
Okay so I’m joking in the above paragraph but in all seriousness, the sun terrifies me. I was, and still am, incredibly careful about the sun. Thankfully for me, in England it is rarely a concern but days to the beach or to a festival fill me with a sickening feeling in the pit of my stomach. I might sound like I’m being over-dramatic, and maybe I am a little, but getting sunburn just once every two years is enough to triple your risk of the deadliest skin cancer; melanoma. I’m not talking the memes you see on Twitter where people are poker hot red or blisters. Simply skin that feels hot, irritated, itchy or the slightest bit pink has been burnt.
The idea of burning is what I’m scared of, not the sun itself. My Uncle was religious in his application of sunscreen. He sat in the shade. He wore hats and never used sunbeds. Yet he spent fourteen years of his life fighting squamous cell skin cancer. As I grew up I watched him lose patches of skin from all over to repair the numerous surgeries he had on his back. He looked a lot like a patchwork doll. I saw the pain when he came out of surgery. I saw how tired he got. I saw how sick he was. And then, the cancer spread to his eye and, he lost it. My Uncle, who’d done everything he could to protect himself, had just lost his sight to skin cancer. Eventually, he also lost his life. And that’s where my fear comes from. What if I’m next? I know so far this article might be rather scary. It can sound like we’re all destined to suffer in the sun but that’s not the truth. The truth is we just need to learn how to enjoy it safely and to be educated on skin cancer risks and symptoms.
Let’s start with the best way to tackle the sun. There are 3 key techniques; Clothes, Sunscreen and Shade or “Slip, Slop, Slap”. SLIP on a cover-up, SLOP on the Sunscreen and SLAP on a hat.
Clothing: I know we’re teenagers and we have an image to keep up but is it really worth four hours burning in the sun and a lifetime risk of cancer just to wear your favourite new skirt? At the end of the day, the more skin that is covered by clothing, the more unlikely you are to burn. Loose fitting, deep in colour and tightly woven is even better as UV rays will have a harder time penetrating it. Look for the UV 400 label on sunglasses too.
Sunscreen: Now the obvious thing to do is apply Factor 50 but how much and how often can determine the success. Aim for sunscreen with a high UVA star rating too, don’t just focus on the factor. However, keep in mind that sunscreen is not an invitation to sunbathe for longer. No sunscreen, no matter the factor is 100% foolproof for burning. “All day” sunscreens should still be reapplied throughout the day as they can rub off in water or from sweating. If your makeup contains SPF, do not be fooled into thinking that is enough. You will not be applying anywhere near as much foundation as necessary to get the correct protection. So how much? According to Cancer Research UK: “Around 2 teaspoonfuls of sunscreen if you're just covering your head, arms and neck. Around 2 and a half tablespoonfuls if you're covering your entire body, for example while wearing a swimming costume.” How often? Reapply every two hours and more frequently if you are in and out of water or exercising. Make sure the sunscreen you’re using is still in date and don’t store them in hot places as this ruins their effectiveness.
Shade: Especially between the peak hours of 11am and 3pm, try to spend time in the shade. Taking time out to sit under a parasol or a tree or an umbrella is all it takes! I know hats aren’t exactly prime fashion but find a wide brimmed hat that covers your ears and neck as these areas are extremely sensitive.
Even so, my family are proof that this isn’t always enough and therefore we need to be educated on what to look out for. Your risk is also increased depending on a variety of factors:
Let’s start with melanoma as it is the most common and the deadliest. Recognising melanoma comes with the ABCDE Rule:
A for Asymmetry: A benign mole is more likely to be asymmetric. Draw an imaginary mole through the line and if it doesn’t look symmetrical this could be a red flag.
B for Border: A benign mole has smooth even borders. In comparison, melanoma will be scalloped, uneven and jagged.
C for Colour: The majority of benign moles are one colour, usually brown. A variety of colours in a mole including tan, black or red are another warning flag.
D for Diameter: Benign moles are usually smaller than a pencil eraser, (6mm). Keep an eye on any moles that seem to be larger.
E for Evolving: Benign moles should not change. Keep an eye for the slightest change in a mole and report it to your doctor. It may be nothing but it is better to be safe than sorry. MiiSkin is an app that reminds you to photograph your mole(s) monthly and this gives you piece of mind as you have physical evidence of any changes.
Here is a link to Cancer Research’s picture page of abnormal moles in case you are concerned. https://www.cancerresearchuk.org/about-cancer/melanoma/pictures-abnormal-moles and I’ve included their info page on any concerning moles if you have further questions: https://www.cancerresearchuk.org/about-cancer/melanoma/symptoms
Basal cell carcinoma and squamous cell can be harder to identify as they can appear as what look like bug bites or scratch marks. Basal cell can often be a shiny nodule on your skin whereas squamous may be a cut that refuses to heal. As a general rule though, here are a few things to look for:
Again, these can be symptoms of other conditions but it is always better to be safe than sorry.
Finally I assume it goes without saying but stay away from tanning beds. It is not worth being a little bronzed for the pain that cancer puts you and your loved ones through.
In the end, sun should be for fun but I hope this article encourages you to also make it a time of safety. Skin cancer is terrifying and it is life-threatening but it is also, almost, always preventable. Don’t take the chance.