The Canadian Dermatology Association (CDA) wants Canadians to know the simple steps that can help protect them from the sun’s harmful ultraviolet radiation, which could lead to skin cancer.
“With skin cancer being the most common form of cancer but easily preventable and detectable, it is a priority to learn self-skin examinations and practice sun-safe behaviours,” Sunil Kalia, the CDA Sun Awareness Working Group's national chair and associate professor at the University of British Columbia, says in a press release.
Monica Li, a Vancouver-based dermatologist, says the most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma.
Both carcinomas are found on the head and neck region, according to Li. Basal cell carcinoma is the least worrisome of the three, but if left untreated it can spread to the bones and tissue. Moreover, squamous cell carcinoma has the potential to spread to the lymph nodes and the rest of the body.
“The worst type of skin cancer is melanoma,” Li says, adding that it can spread throughout the body into your lungs, bones and liver. “It can be deadly very quickly.”
Using a full length mirror in a well-lit room, the CDA recommends checking your body from head to toe (yes, even in between the toe cracks) for any irregular spots or moles. When checking your back, use an additional mirror to reflect any areas out of sight.
Li also recommends using a popular guideline referred to as the “ABCDEs of melanoma.”
The A represents asymmetry, which Li says is a good indication that you should have your mole examined by an expert.
“The B is border irregularity,” Li adds, which means a spot is jagged or lopsided rather than round or well-defined.
The C stands for “colour variation,” referring to different colours within a spot. For instance, it's not all dark or light brown, but it has bits of blue, black or red.
The D is for “diameter” and the general rule is to watch out for anything that's more than six millimetres.
“Of course there are things bigger than six millimetres that can be benign and things less than six millimetres that are sinister, but that’s usually the number we go by,” Li says.
Finally, the E, meaning “evolution” or change, is best determined by the individual themselves, since physicians only see their patients at a snapshot in time, adds Li.
“They live in their skin,” she says. “If an individual sees that there’s a change in shape or symptoms, like a beauty mark that previously wasn’t itchy or bumpy or didn’t bleed, and all of a sudden they’re noticing changes or it’s painful, then that’s when they need to bring it to the attention of a family physician or dermatologist.”
Typically, you should check your skin every several months, or go to the doctor more regularly if your family has a history of skin cancer.
Li says that people with fairer skin tones, or “less richly pigmented skin,” are also at increased risk compared to people with naturally darker features.
“Having said that, there’s a false perception out there, even among physicians, that if someone has darker skin they naturally have sun protection,” she says. “Unfortunately, in more richly pigmented individuals, there can be a delay in skin cancer diagnosis and it’s usually at a worse state.”
As summer approaches, it’s common for many people to want to tan, but Li cautions that “there’s no such thing as a safe and healthy tan.” Once there is increased colour on the skin, that is a sign of sun damage.
“You can think of the skin as having a memory for sun damage,” she says, meaning that one tan doesn’t equivalate to getting skin cancer, but the risk increases with each tan.
Li recommends getting an artificial spray tan or using a tanning lotion as an alternative but strongly advises against tanning beds due to the direct and concentrated exposure to UV light.
When it comes to using sunscreen, the CDA recommends having a sun protection factor (SPF) of 30 or higher. You also have the option of either chemical sunscreens or physical (also known as mineral) sunscreens.
Li says chemical sunscreens use chemical filters to convert UV radiation to infrared radiation, meaning it is converted to heat and protects the skin underneath. Physical sunscreens use mineral filters, such as zinc oxide, titanium dioxide or iron oxide.
“If someone has more sensitive skin or if they are concerned about environmental damage, ... I would recommend individuals use a mineral [sunscreen],” Li says.
Other sun protection practices include clothing protection — including wearing a hat and sunglasses — and seeking shade whenever possible.
“Also, avoid direct sun exposure during peak hours where UV or ultraviolet rays are most intense,” she says, adding that that’s typically between the hours of 11 a.m. to 3 p.m.