Safe, Summer Skin: Your questions on skin cancer answered

30 May 2012

Ever worried about the sting of sun burn after a day in the sun?  Or been concerned about an unusual freckle, mole or bump on your skin? You're right to be vigilant - but there are lots of things that can be done to protect your skin and keep it healthy long term.

And to help you stay on top of skin care in the summertime, we asked health expert Professor Nick Stuart to answer your questions in our skin cancer live chat on Wednesday the 30th of May.

As a professor of Cancer Studies at Bangor University, and the author of 35 peer reviewed publications, Professor Nick was able to provide expert insight and guidance on anything skin cancer related....and this is what he said:

Healthy asked: I'm a gardener and never wear sunscreen as when I sweat the sunscreen runs into the sweat and into my eyes and is painful. Is there an alternative?
Professor Nick Stuart: My suggestion would be to use sun-block on all areas of exposed skin below the eye line and to wear a wide brimmed hat to protect your forehead. Gardening is a common way to get sunburn so it's important to cover up as well as use sun block.
Don't forget wearing a hat gives better protection for the scalp is easier to put on than sun cream and also looks better!
andrewcox: I have eczema on my hands, so I wondered if there's any extra precautions i should take out in the sun (and some sun creams irritate it too!)
Professor Nick Stuart: I'm not aware that eczema is an extra risk when it comes to sunshine. Some skin rashes are made worse by sun and if this is the case you need to seek medical advice in case it isn't simply eczema. As for sun creams I would suggest try it and see. Each is formulated differently and I'd hope you could find one that would suit.
andrewcox: thanks - just wanted to check that it wasn't more susceptible to skin cancer - I'll keep trying some different sun block :-)
Fiona: Hi there - I'm prone to freckles and moles, and they've always got me worrying. Some are quite red in colour. Should I be using a higher sunscreen for these and what changes should I be watching for?
Professor Nick Stuart: The key is to know your own skin and to look for changes. Some moles are red but if they've always been like that then that's OK. If a mole turns red or itchy or starts to scab or bleed or changes size or shape then you need to get it checked out.
MissEllisYoung: I am really moley and have had a mole removed (more precaution) before. I do tan well though, so as a standard is facto 10 ok for me or should I be using something higher? Thanks
Professor Nick Stuart: As for sun factors then it's a matter of opinion. The safe option is the higher the better or cover up. In practice factor 10 - 15 is adequate for most people. It's important to wear it every time you go out in the sun and not to miss any bits of skin that are exposed.
morgan: Hi Nick, I have a question. I have a mole or something on my scalp, it's the same colour as my skin though. The GP said it was fine but it itches sometimes. Should I be worried about it?
Professor Nick Stuart: Morgan: Itching can be sign of something nasty starting up. It depends how persistent it is. If it is persisting or getting worse you can always go back and have it looked at again.
morgan: Thank you. My scalp does burn quite easily if I'm not careful, so I will go back to the GP.
MissEllisYoung: Do you know why new moles appear? I have got a new raised one, that is perfectly round, so not abnormal in that sense.
Professor Nick Stuart: I have to say I don't know why moles appear. Some people have more than others so your genes must come into it. Most people get additional moles as they get older too but I'm not sure why. Sorry.
MrRoss asked: Hi, I'm going on holiday to Cyprus in a couple of weeks and recently I've noticed I have a few moles on my back. I've heard it is dangerous to expose these to the sun, is there any truth to that? Or can I just use sun cream as normal?
Professor Nick Stuart: Sadly all exposure to sunlight has dangers with it. The best advice is always to use sun-block, to wear a hat and T-shirt and to avoid getting sun-burned. This advice is the same whether you have moles or not. You should keep an eye on your moles from time to time and if they start to change then get them checked by your doctor.
Robyn asked: Hi Prof. Stuart. I got sunburnt over the weekend - should have worn some sun cream. In your opinion what is the best way to treat sunburn - is there a way to reduce the redness associated with it? Thanks
Professor Nick Stuart: Oops! Better make sure it's the last time you forget! But seriously, no, there isn't any way to make the redness go down more quickly. Simple skin moisturisers can help to stop the skin getting cracked or sore but the redness has to take time.
Robyn: Thanks for that - I should know better - I'm originally from South Africa where the sun is very strong - I got caught out by the UK sun!
Professor Nick Stuart: Robyn: Easy to do. Just because it not very hot doesn't mean the sun isn't strong. This time of year, when the sun is at its highest, you can burn in 10 minutes at midday. Same as in the Sahara.
Funnyman asked:  What are the signs and symptoms of skin cancer? I had my moles checked a year or so ago but they occasionally hurt/burn - is this normal and at what stage should I seek medical attention?
Professor Nick Stuart: all moles sometimes get a little red or itchy - particularly if they are in areas where they can get rubbed or knocked. But if there is persistent redness, itching, bleeding, or scabbing. Or if the mole is changing shape or getting bigger, then it needs looking at. The best thing is to make sure you know you own skin so you know if anything has changed.
fionad asked: Does skin cancer ever occur without moles? Are there any other things we should be looking out for?
Professor Nick Stuart:  Absolutely! Moles can turn cancerous but so can normal skin. So it's important to look out for lumps, bumps, ulcers or other changes particularly if they are growing.
A question from an AXA PPP Twitter follower: Can I wear too much sun cream?
Professor Nick Stuart:  No - you'll just get very slippery. Seriously though, extra sun cream doesn't help. So, two dollops of factor 10 isn't the same as one lot of factor 20.
MaryRoseMK asked: How would you explain the SPF values to people? There seems to be so much mis-information!
Professor Nick Stuart:  I think even the experts disagree about SPF. Firstly it stands for Sun Protection Factor. The idea is that it gives you an idea how much protection the cream offers. A SPF 10 means you get the same effect after wearing the cream for 10 hours as you would for 1 hour without the cream. The problem is that different makers test their creams differently. So SPF 10 from one brand isn't necessarily the same as SPF 10 from another. In general though, the higher the SPF the more protection that is offered. SPF 15 - 20 should be adequate for most people.
AXAPPPhealthcare asked: Thanks, can you explain why two dollops of factor 10 isn't the same as one of 20?
Professor Nick Stuart:  The SPF is based on the concentration and type of chemicals in the cream - they are there to absorb the damaging UV-rays. So SPF20 is different to SPF10. More of the same doesn't make it more effective.
MaryRoseMK asked: Thank you and how about your opinion on UVA and UVB? (Have been told to remember that the B=burn and the A = age! Neither good in sun terms!)
Professor Nick Stuart:  Personally I agree with you and think they are both bad. Sun can do a lot of damage to skin as well as causing skin cancer so it's best to protect yourself against all forms of sun - and that includes sun beds. I'd rather look 40 when I'm 60 than have a nice tan when I'm 20.
AXAPPPhealthcare asked: Professor Nick on the topic of sun cream is there a risk of always wearing sun cream with a high factor, during the summer months? Leading to any issues because of a luck of sunlight.
Professor Nick Stuart:  Yes, there has been some talk recently that some people are being overprotective when it comes to sunlight. Sunlight is essential for the body to make vitamin-D and vitamin-D is needed for strong, healthy bones. However, you would need to be very protective - covered from head to toe or never going out in the sun at all to risk problems. So take care but enjoy the sun as well.
MaryRoseMK asked: And one more question about babies and sun exposure. What do you recommend as appropriate for babies? I am really concerned when I see tiny babes outside with what I would think is little or no protection.
Professor Nick Stuart:  Keep babies out of strong sunshine completely I'd say. They can play under cover or wait until the sun has gone down later in the afternoon. Still wise to apply some sun cream though, just in case.
A question from an AXA PPP Twitter follower: Strong sunlight always seems to give me a headache, tried drinking more water but it doesn't seem to help, can people be sensitive to sunlight?
Professor Nick Stuart:  I think some people are more sensitive than others. Do you wear sunglasses? Bright lights can affect the eyes and cause headaches. I wonder if that could be the problem.
AXAPPPhealthcare asked: For people who are undergoing treatment, should they follow a specific diet or add particular foods to their diet?
Professor Nick Stuart:  I don't think so. A healthy diet for someone having cancer treatment is the same as a healthy diet for anyone else. The same rules apply - lots of fruit and veg, as little fat as possible and not too much red meat, etc.
A question from an AXA PPP blog reader: I heard it worse to burn only a few times in your life, then have a continual sun tanning lifestyle, is that true?
Professor Nick Stuart:  For skin cancer, yes. Episodes of sun burn on a background of little exposure (the typical 'Brit' on holiday) is worse than continuous tanning exposure (the Mediterranean look). However, continuous tanning is worse for skin aging i.e. wrinkles.
Shelley asked: Hello - I'm 38 and have spent a fair amount of time on holidays getting a tan. Now i've a few more freckles, darker patches on my face - is this sun damage and can it lead to anything worse?
Professor Nick Stuart:  Yes, that sounds like sun damage. It doesn't of itself lead to anything worse but it does indicate that you have spent time in the sun and therefore are at greater risk of skin cancers. You need to keep an eye on your skin. Know where any spots or moles are, know what they are like and know if they start to change.
Shelley: Thanks for your response - I'll keep an eye on those marks / skin quality - luckily I don't have any moles yet.

Professor Nick Stuart tells us about skin cancer treatment developments
The most worrying type of skin cancer is malignant melanoma. This is the type that can spread to other parts of the body and which can be fatal. Until recently we have had very few treatments for patients with melanoma where the tumour has spread. The main treatment was a type of chemotherapy called dacarbazine. This has been used for 30 years and until recently was still the main treatment. Recently new drugs have been developed that work in new ways. One uses the body's own immune system to attack the cancer. Another targets a particular part of the cells chemistry that goes wrong in melanoma. Both can be effective for some patients and both are a step forward from chemotherapy. Both treatments are new so it will be some time before we can work out the best way to use them and know how effective they are.