Stay out of sun to keep your looks for longer and lower cancer risk

THE UK skin care industry is said to be worth around $4.14billion.

That is a lot of money and it reflects a preoccupation with our skin that has existed throughout our history.

After all, skin is integral to our outward appearance upon which we all place at least some value.

It is not unreasonable, therefore, for us to place so much importance on looking after it.

And yet, while there are countless options for helping our skin to look more youthful, the best and most important measure is also probably the simplest one. That is avoid exposure to UV light or, in other words, protect your skin from the sun. This measure is also by far the cheapest.

Of course, reducing the signs of ageing are important for many people but the greatest benefit from reducing exposure to UV radiation is the subsequent reduction in the risk of developing skin cancer. Interestingly, while many people are aware of the links between the sun and skin cancer these days, this wasn’t always the case.

I frequently speak to older patients who recall their younger years running around without any form of protection from the sun because, as they put it, they just didn’t know.

As such, often years down the line, people who have had a lot of sun exposure are more prone to developing skin cancer.

Indeed, someone who experienced even just one bad episode of sunburn that blistered as a child has twice the risk of developing a melanoma later in life.

Although the links between skin cancer and UV light have been known about since the early 20th century (sunscreen was first produced in 1928), it is only more recent public health campaigns that have made the difference to our behaviour.

One of the most famous of these was the 1981 “Slip, Slap, Slop” campaign in Australia which is thought to have significantly altered public attitudes to so-called sun-worshipping.

Of course, the high proportion of lighter skin in the Australian population relative to other regions of similar sun intensity, coupled with the outdoor lifestyle, makes its inhabitants particularly prone to high levels of skin cancer.

Why is this? Well, given the relatively short time since European populations have come to live in Australia, evolution has not yet had time to darken their skin.

In equatorial regions, for example, populations developed naturally darker skin due to higher concentrations of the pigment known as melanin (from the Greek mela, meaning black).

Melanin protects the cells in their skin from harmful UV rays which, if undeterred, can damage DNA and cause cells in the skin to potentially begin dividing uncontrollably — in other words causing cancer.

Typically, populations living further north have evolved lighter skins in order to absorb the relatively lower levels of UV light available.

After all, some UV radiation is important for the stimulation of vitamin D production — vital for absorbing calcium and keeping our bones strong — which happens in the skin.

It’s a fine balance and one which the European migration to Australia rather upset.

Our skin is roughly made up of two layers, the dermis on the outside and the epidermis just below. It is in the epidermis that skin cells, or keratinocytes, are most at risk of developing cancer.

These cells are layered on top of each other and at its base, before you get to the fatty tissue below, there is a final layer of keratinocytes.

In among these deeper layers are the second type of cells that we need to be aware of — the melanocytes. These cells produce the melanin.

When UV radiation reaches and damages the epidermis, it can cause skin cancer.

There are three main types:

• Melanoma.

• Squamous cell carcinoma, which affects the mid layers of keratinocytes.

• Basal cell carcinoma, which affects the base layer of keratinocytes.

Of these, melanomas are the most serious but fortunately not as common.

Having said that, there are currently around 15,400 melanomas diagnosed each year in the UK and, despite greater awareness of sun exposure, their incidence seems to have increased faster than any common cancer.

It is currently the fifth most common cancer in the UK and can be life-threatening if it spreads (metastasises) to other parts of the body. Detection and early treatment are therefore extremely important as this significantly raises chances of a full recovery.

A melanoma can sometimes be obvious but other times can be deceptively subtle. For that reason, it is always important to get any skin lesions you are not sure about checked.

The things to be particularly vigilant for are spots or lesions on your skin that are growing, especially if they are more than 7mm in diameter, and have an irregular border, a lack of symmetry or a tendency to feel sore, bleed or itch.

If skin cancer is suspected, it is likely a doctor will look at it through a device called a dermatoscope — a sort of handheld microscope which can show the lesion in detail.

If the suspicion remains, a dermatologist may then be called upon to remove the lesion and send it to the lab to be looked at under a microscope where a formal diagnosis can take place.

The other two main types are not as serious but can still cause problems.

Basal cell carcinoma tends to have a pearly appearance and can have smooth raised edges.

Squamous cell carcinoma often develops a rough scabbing exterior.

There is a huge amount of variation and, if suspected, these will also need to come off.

Fortunately, basal cell carcinoma almost never spreads but will potentially keep growing if not dealt with.

Squamous cell carcinoma is more prone to spread but not as much as melanoma.

As such, neither of these two cancers is included on the cancer register and they are often referred to as non-melanoma skin cancers.

If they were included, it would add in excess of 156,000 cases to the register each year.

It should be said that there are countless other rare types of skin cancer but those are the big three.

In people with particularly sun-damaged skin, rough patches known as solar keratosis or actinic keratosis can develop.

These are areas of precancerous lesions which hold a higher risk of changing into squamous cell carcinoma, so do need dealing with by traumatising the region affected in order to allow healthy skin to grow back in place.

The main treatments are cryotherapy (freezing with liquid nitrogen) or a rather nasty inflammatory cream called efudix.

So over this summer be mindful of your exposed skin when the sun eventually arrives. Remember, even with light cloud cover, those UV rays will get through.

Sun protection factor guidance can be found in detail on the NHS website but the general recommendation is to use cream with an SPF of at least 30 but also to cover up and stay out of the sun, particularly during the middle of the day.

After all, if you remember to slap on that sun cream or pop a hat on your head, not only will your future self be grateful for reducing the risk of skin cancer but it will keep your skin healthy and younger looking for longer!