Our love affair with beach holidays is driving skin cancer rates to an all-time high. Here's everything you need to know about spotting the signs and keeping healthy on the beach
Words by Lizzie Pook
Skin cancer is on the rise (diagnoses for those under 55 have risen by 66 per cent in the last 20 years – and it’s a whopping 222 per cent for those above that age) and melanoma (a type of skin cancer) is now the fifth most common type of cancer in the UK, with around 15,000 people being diagnosed each year. Both my parents have had skin cancer. One of them is still with us; the other isn’t. If those stats don’t scare you, getting sunburnt just once every two years actually triples our chance of developing skin cancer, and even just reddening of the skin is enough to raise the risk. So how can we stay safe in the sun, and spot if there’s a problem?
Key signs of skin cancer
You can get skin cancer anywhere on your body. ‘For men, the most common place is the back; for women, it’s the legs,’ says NHS skin cancer specialist Dr Ross Perry. But you can also get some skin cancers on parts of your body that aren’t even exposed to the sun, such as the palms of your hands, so be vigilant.
‘Every two to three months, give yourself a quick check in the mirror after you shower,’ advises Dr Adam Friedmann, leading consultant dermatologist at The Harley Street Dermatology Clinic. ‘You’ll build up a good impression of what your skin looks like, so you’re able to notice straight away if things start to change.’
The main thing to look out for, he advises, is a mole that’s growing fast and has a different appearance (it doesn’t matter if it’s flat or raised – change is key). ‘When a mole darkens, alters in size, shape or colour, or becomes more irregular or blurred around the edges, that’s when you need to have it looked at,’ says Dr Friedmann.
It’s not just traditional moles you need to keep an eye on, either. ‘Non-melanoma skin cancers (also known as basal cell or squamous cell carcinoma) can be harder to spot, because they can look like wounds or scaly plaques of psoriasis or eczema,’ says Dr Friedmann. ‘But they’re stubborn. So if something doesn’t heal up within three to four weeks of its own volition, see a doctor. Early skin cancers like these aren’t as dangerous as melanoma, but they can happen to anyone who has spent extensive amounts of time in the sun. I’ve had patients as young as 25.’
Who is at risk from sun damage?
‘The rate of skin cancer is sixfold higher than it was 40 years ago,’ says Dr Friedmann. ‘Many believe the advent of the package holiday is to blame. Northern Europeans with fair skin suddenly had access to cheap flights to countries like Barbados and Tenerife, and spent two weeks burning themselves in a way they’d never have been able to in the past.’ And who can say they haven’t been guilty of this at some point? Most women I know have a ‘whack some aftersun on it and it’ll go brown’ attitude.
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‘The thing with sun damage is that you can’t really see the physical signs, like wrinkles, until you’re older,’ says Gemma, 30, a writer from west London. ‘I’m a “deal with it later” type of person, but I’m starting to see some sun spots around the top of my forehead and I’ve still got a scar on my stomach from when I burnt myself raw on a holiday to Bali. I know I should start taking better precautions, but it’s hard when soaking up the sun is one of the easiest ways for me to relax.’
Nowadays, we’re more aware of how to keep ourselves safe, but there are still certain groups who are more susceptible to skin cancer. ‘Anyone with white skin is more at risk,’ says Dr Friedmann. ‘If you’re strawberry blonde or ginger, burn very easily or have a pale complexion, your chances of getting it is far higher.’ You’re also more prone if there is a history of skin cancer in your family, and you need to be vigilant if you work outdoors. If you have more than about 100 moles on your body or sustained bad, blistering sunburn as a child, you’re also more at risk.
It can be put down to our genes, too. A 2014 study published in the American journal Cancer Epidemiology, Biomarkers & Prevention found that people with blue eyes may be more prone to skin cancer. This is because the genes tied to blue eyes could put people at higher risk for moles or freckling in childhood, which are often precursors to melanoma later in life. The same study also found that those who grew up spending their holidays by the water were more likely to get skin cancer when they’re older, too.
But bad luck has a huge part to play as well. ‘You’ve got a wagon-wheel effect in respect of risk,’ says Dr Perry. ‘Half these spokes will purely be bad luck – anybody can get a melanoma. Not all skin cancers are related to sun exposure. The most common misconception I come across is that you have to have been sunburnt in order to get skin cancer. That’s simply not the case.’
How skin cancer is treated
Premalignant moles and skin cancers (where your cells have mutated in a way that’s considered to be a precursor to cancer) can usually be treated without surgery. ‘Quite often we’ll take a small biopsy,’ says Dr Friedmann. ‘If it’s premalignancy, it can be treated with liquid nitrogen to freeze it off, or some cancer creams that encourage the immune system to attack the precancerous cells.’
Melanomas will almost always be treated with surgery, and the earlier you catch them, the better: when they’re less than 1.5mm thick, you’ve got a 96 per cent chance of being disease-free within five years. The thicker it is, the more it correlates with a chance of recurrence or death.
How to stay safe in the sun
The advice is simple: wear adequate sunscreen and a hat, never let your skin burn and cover up with loose but long layers, especially in the midday sun. ‘We often forget certain parts of the face when we apply sun lotion,’ says Dr Susan Mayou, consultant dermatologist at the Cadogan Clinic, specialising in mole monitoring and skin cancer. ‘The tops of the ears, back of the neck, under the eyes and the area at the top of the forehead by the hairline often get missed,’ she says.
‘We rarely put enough cream on, either. You need about one teaspoon for your face and one tablespoon each for your front, back and either sides of your legs.’ Suncream should be at least factor 30. ‘Even in the shade in a hot climate, you’ll get five times the amount of sun that you would pottering around your English garden,’ says Dr Friedmann. And never sunbathe on holiday in direct sunlight, either – that means lounging in the midday sun on the beach in your new bikini is a no-no.
Finally, be warned that even away from the beach we’re at risk. ‘The lamps used to set gel manicures in nail salons emit UV rays, too,’ says Dr Mayou. ‘These are mostly UVA rays, which are linked to both premature skin ageing and skin cancer. While the risk is low, I would advise people to apply 50+ sunscreen to the hands 20 minutes before the manicure for adequate protection.’
The key message is vigilance. ‘Fear, anxiety and people worrying about things mean they dwell on changes in their body,’ says Dr Friedmann. ‘We don’t want that. If in doubt, just get it checked out. Catch it early, minimise the cosmetic impact and increase your chances of it being cured. Simple.’