Skin cancer is the most common cancer in the United States,1 and is a major public health problem. Although advances are being made in the treatment of skin cancer, many healthcare providers advocate the importance of prevention efforts, such as avoiding ultraviolet (UV) radiation, using sunscreen, and performing regular skin self-examinations.
Avoid Ultraviolet Radiation
Sunlight is a portion of the electromagnetic radiation given off by the sun and is divided into 3 major wavelength spectrums: UV, visible, and infrared. The UV range is of great concern, because it can cause skin damage, such as photoaging (premature aging of the skin from exposure to the sun) that could lead to skin cancer.
Basal-cell and squamous-cell skin cancers, which are the most common types of skin cancer, are usually found on sun-exposed parts of the body. The risk of melanoma, a more serious but less common type of skin cancer (not all melanoma is skin cancer), is also related to sun exposure, although this link is not as strong.2
The danger of UV radiation is that it can cause skin-cell damage and genetic mutations. The human body has cellular mechanisms that repair DNA damage or remove severely damaged cells; however, the additive effects of gene mutations involved in these mechanisms can lead to abnormal cell proliferation and tumor development.3
Understanding the risks and effects of UV radiation, we can adopt a few simple changes in our behavior and lifestyle to prevent repeated sun damage and reduce our risk of getting skin cancer4:
- Minimize sun exposure, especially from 10:00 AM to 4:00 PM (peak sun hours)
- Wear sun-protective clothing, such as wraparound sunglasses, clothing that uses tightly-woven fabric, and a hat with an all-around brim
- Use sunscreen as needed on all exposed skin, even on the lips
- Avoid exposure to artificial tanning, such as tanning beds and lamps.
Use Sunscreen
When used properly, there is little dispute that sunscreen is effective in preventing sunburn. However, contrary to what many people believe, the direct effects of sunscreen in preventing skin cancer have not been well-established, which led the International Agency for Research on Cancer to suggest that sunscreen should not be the first choice for skin cancer prevention and should not be the sole means of sun protection.5
One reason for this inconclusiveness is that to determine the preventive effects of sunscreen against skin cancer, researchers would need to conduct a controlled clinical trial in which participants are exposed to long-term UV radiation, where some participants use sunscreen and others do not. In the research community, such a study is considered unethical and not feasible.
That said, the benefits of sunscreen should not be completely dismissed. Australians and Hawaiian Caucasians, who have some of the highest per capita use of sunscreen, have had a reduced incidence of melanoma with the use of sunscreen.5 Scientific evidence, although limited, supports the beneficial effects of sunscreen on the occurrence of skin cancer and skin photoaging.6
When shopping for commercial sunscreen products, the sun protection factor (SPF) number on the product label is important. The FDA mandates the following classification scale for sunscreens7:
- SPF between 2 and 12: minimal sunburn protection
- SPF between 12 and 30: moderate sunburn protection
- SPF higher than 30: high sunburn protection.
It is not always necessary to shop for sunscreen with the highest SPF number. Moderate sunburn protection would suffice for occasional exposure to sunlight, such as walking your dog or driving to work. Regardless of the sunscreen’s SPF, it is important to re-apply sunscreen every few hours during extended outdoor activities.
Perform a Skin Self-Examination
Most skin cancers are curable when caught early. It is recommended that we examine our skin at regular intervals and have a physician evaluate any suspicious moles or pigmented spots. By doing regular skin self-examinations, people can save their own lives.
However, many people have never performed a skin self-examination. According to a survey of nursing students, people often do not know what to look for when performing a skin self-examination, never think of one, or do not know one should be done.8
So, how do you perform a skin self-examination, and what should you look for?
For a skin self-examination, you need to examine your entire body. Although most non-melanoma skin cancers are found on sun-exposed parts of the body, melanoma can often appear on parts of the body that are normally covered by clothing.2
To perform a full-body skin check, you should examine the front upper body, especially the face and neck, as well as the arms, shoulders, chest, and stomach; the front lower body (the groin and genital region, legs, and feet); and the back of the body, including the back of the neck, upper back, lower back, and legs.
During the skin self-examination, look for9:
- New or changing moles
- A translucent, red, brown, or black skin growth that increases in size
- Any skin growth that bleeds or itches
- Open sores or scabs that do not heal
- A lesion that lasts longer than you think it should (for example, a pimple that does not go away for months)
- Discoloration under your fingernails or toenails (especially important if you have skin of color).
References
- Guy GP, Machlin S, Ekwueme DU, Yabroff KR. Prevalence and costs of skin cancer treatment in the US, 2002-2006 and 2007-2011. American Journal of Preventive Medicine. 2015;48:183-187.
- American Cancer Society. Ultraviolet (UV) radiation. www.cancer.org/cancer/cancer-causes/radiation-exposure/uv-radiation.html. Accessed May 9, 2022.
- Soehnge H, Ouhtit A, Ananthaswamy HN. Mechanisms of induction of skin cancer by UV radiation. Front Bioscience. 1997 Nov 1;2:d538-d551.
- Narayanan DL, Saladi RN, Fox JL. Review: Ultraviolet radiation and skin cancer. International Journal of Dermatology. 2010;49(9):978-986.
- Mahon SM. Skin cancer prevention: Education and public health issues. Seminars in Oncology Nursing. 2003;19(1):52-61.
- Iannacone MR, Hughes MCB, Green AC. Effects of sunscreen on skin cancer and photoaging. Photodermatol Photoimmunol Photomed. 2014;30(2-3):55-61.
- Serpone N. Sunscreens and their usefulness: have we made any progress in the last two decades? Photochemical & Photobiological Sciences. 2021;20(2):189-244.
- Arnold MR, DeJong W. Skin self-examination practices in a convenience sample of U.S. university students. Preventive Medicine. 2005;40(3):268-73.
- American Society for Dermatologic Surgery. Skin cancer exams. www.asds.net/Portals/0/PDF/secure/Skin-Experts-Skin-Exam.pdf. Accessed May 9, 2022.