Your Questions on Skin Cancer answered

15 October 2012

From examining moles and getting sun protection right, to the latest developments in treatment, we started our week of cancer Q&A sessions by inviting our expert Dr Hady Bayoumi to answer your questions on skin cancer.

As a Consultant Dermatologist working out of three hospitals, The Spire Bushey Hospital, the Rivers Hospital in Sawbridgeworth and BMI Cavell, Dr Bayoumi was well placed to discuss your queries in an interesting and busy live chat.

Here’s what he had to say:

AXA PPP healthcare:We have our first question from a blogger - 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?

Dr Hady Bayoumi:There are several types of skin cancer. If you are talking about changing moles, they can cause malignant melanomas. The signs are: A rapid growth in size, a change of colour, getting darker, a change in surface, becoming uneven, and itching or bleeding for no reason. The best thing to do is to get your doctor or a dermatologist to check the mole for you.

A question from a Twitter user:Can I wear too much sun cream? For example wearing factor 20 as part of my makeup all years around?

Dr Hady Bayoumi:Thank you. No you cannot wear too much sun cream. The idea is to protect your skin from the strong sun, especially in the middle of the day, say from 11.00 am to 3.00 pm. At other times you need a little bit of sun to build up your vitamin D levels. Factor 20 is not usually enough in very bright sun and you should consider using higher factors of protection.

A question from a Twitter user:Can you explain why two dollops of factor 10 isn't the same as one of 20?

Dr Hady Bayoumi:That is a very interesting question. Because you cannot use 5 dollops of factor 10 to make a factor 50. Sunscreens are used in [reasonable] amounts to be acceptable both from the practical and cosmetic points of view. Also the factor is (built in) rather than added on. I hope this answers your question.

AXA PPP healthcare:As a broader subject - can you tell us about skin cancer developments recently, as an update as to how things have changed or moved on?

Dr Hady Bayoumi:Although the main treatment for skin cancer remains surgical there have been some recent modifications and/or additions to the available treatments in recent years. MOHS surgery is one of them. This is a method of removing larger tumours, especially those on the face. The idea is to remove the tumour with labelling it a s it is removed. A histopathologist is on standby to check the tissues removed and tell the Dermatologist or Surgeon if the excision is incomplete and, if so where more should be removed more. This ensures: A. Complete removal of the tumour. And B. Preservation of as much normal tissue as possible. Also more advances are being made in the treatment of malignant melanoma with the use of immuno modulatory drugs. These are still largely experimental and used in Clinical Trials.

A question from a blogger:I have eczema on my hands, so I wondered if there are any extra precautions I should take out in the sun (and some sun creams irritate it too!)

Dr Hady Bayoumi:The eczema should be treated as usual. With regard to sun protection, there should be no difference in protecting your hand, except that you should find yourself a sun protection preparation that does not irritate your hands. You may be allergic to an ingredient in the preparations that you have tried. It would be a good idea, as per good medical practice, that with hand eczema you should be allergy patch tested, a process in which you would be tested to substances that are harmless to most people, but can cause irritation or eczema to some people. The tests, which are carried out on the skin, are usually done by dermatologists or allergists.

Sharron asked:I have recently been told that I have solar keratosis. I have had two biopsies to check whether the lesions are pre-cancerous, but everything seems clear. What is the best thing to do? I seem to get more lesions and nothing helps. What should I do as I am concerned they could develop into cancers? Thank you

Dr Hady Bayoumi:Thank you. Solar (actinic) keratoses are skin lesions caused by skin damage, usually old, that happened years ago. They are commoner on the sun-exposed areas of the skin, especially face and bald parts of the scalp in men. They can turn cancerous several years later. Your Dermatologist should be able to treat these with either topical creams, or by cryotherapy (freezing). Freezing is a very effective (although) a little painful.

A question from a blogger:A question is relation to child care in the sun - 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.

Dr Hady Bayoumi:You are absolutely right to be concerned about babies and children outside with little or no sun protection. In fact most of the sun damage happens when people are young. I recommend that children are protected from excessive sun exposure, especially in the middle of the day. Children need a small amount of Sun light for their vitamin D production, but this should happen at either end of the day when there is light, but the sun is not fierce.

Sharron asked:
Thank you Dr Bayoumi. I have recently bought some Vitamin D cream. What's you view on this? Can it help or should you get this from sunlight. As I try to protect my skin as much as I can now with a factor 50, can I still get enough vitamin D from the sun?

Dr Hady Bayoumi:Thank you Sharron. The best way to get your vitamin D is for it to be made in your body with the help of sunlight. The second best is from capsules. Vitamin D is fat soluble and is stored in the body fat. The small amounts in any cream will never be enough to supply the amounts that you need. I am also not sure of the absorption of vitamin D through the skin.

The dark patches on your face could be caused by several things. They should be checked by your GP or Dermatologist. The sun is usually a factor in producing the dark patches on the face. This could be the only cause, or in combination with other things, such as hormones from pregnancy oral the contraceptive pills/patch/devices, or perfume, or some drugs and occasionally some rare diseases. Check with your doctor. The treatment depends on what the cause is. Long term results also depend on what it is exactly we are dealing with.

NickB:Hi Dr Bayoumi. I have fair skin so tend to burn quite easily in sunlight; does this mean I have a higher risk of suffering from skin cancer?

Dr Hady Bayoumi:Having fair skin on its own does not mean higher risk of skin cancer. However, exposure to the sun is more damaging if you have fair skin, especially if you burn easily in the sun. You just need to make sure you take enough precautions in the sun.