UV PROTECTION INFORMATION

Over-exposure to solar ultraviolet radiation can cause sunburn, skin damage and an increased risk of developing skin cancer. UVR exposure also places our eyes at risk of photokeratitis, photoconjunctivitus and cataracts. The most obvious short-term effect of over-exposure to UVR is sunburn.
The more UVR received, the worse the sunburn becomes. Continued over-exposure for many years, especially in children, can increase a person's risk of developing skin cancer in later life. Skin cancers affect people of all skin types and can also develop on people who do not have a history of severe sunburn. A person's cumulative exposure to UVR along with the number of severe sunburns they have received, especially during childhood, increases their risk of developing skin cancer.

Check out Sun Safety For Kids: The Ultimate Guide For Parenting, from 'Mom Loves Best'

Skin Cancer facts in Australia

• 1 in 3 men and 1 in 4 women will be directly affected by cancer before the age of 75.
• In Australia each year, more than 88,000 new cases of cancer are diagnosed.*
• More than half of them will be successfully treated.
• The survival rate for many common cancers has increased by more than 30 per cent in the past two decades.
• But, cancer is still the leading cause of death in Australia - over 36,000 people die from cancer each year.
• The most common cancers in Australia (excluding non-melanoma skin cancer) are colorectal (bowel), breast, prostate, melanoma and lung cancer.
• Cancer costs $2.7 billion in direct health system costs (5.7%)
• $215 million was spent on cancer research in 2000-01, just above 18% of all health research expenditure in Australia.
• About 374,000 cases of non-melanoma skin cancer (the most frequently occurring cancer in Australia, but the least life-threatening) also are diagnosed each year.

Skin cancer is present when malignant cells are found in the outer layers of the skin. The skin protects the body against heat, light, infection, and injury. It also stores water, fat, and vitamin D.

The skin has two main layers and several kinds of cells. The top outer skin layer is called the epidermis. It contains three kinds of cells: flat, scaly cells on the surface called squamous cells; round cells called basal cells; and cells called melanocytes, which give the skin its colour.

There are several types of cancer that start in the skin. The most common are basal cell cancer and squamous cell cancer. Melanoma is more uncommon but is a more serious type of cancer. Skin cancer can occur anywhere on the body, but it is most common in places that have been exposed to more sunlight, such as face, neck, hands, and arms.

Types of nonmelanoma skin cancer

Basal Cell (Basal cell carcinomas - BCC)

Basal cell carcinoma is the most common form of skin cancer. These cancers are found in the basal cells, which are at the bottom of the epidermis. It usually occurs on areas of the skin that have been in the sun, most often on the nose. Often this cancer appears as a small raised bump that has a smooth, pearly appearance. Another type looks like a scar and is flat and firm to the touch. Basal cell carcinoma may spread to tissues around the cancer, but it usually does not spread to other parts of the body.
In a few cases, contact with arsenic, exposure to radiation, and complications of burns, scars, vaccinations, or even tattoos are contributing factors.
People who have fair skin, light hair, and blue, green, or grey eyes are at highest risk. Those whose occupations require long hours outdoors or who spend extensive leisure time in the sun are also at risk.

Squamous cell carcinoma

Squamous cell carcinoma is the second most common form of skin cancer. It starts in the epidermis involving the squamous cells that make up most of the upper layers of skin. Squamous cell cancers may occur on all areas of the body, but are most common in areas exposed to the sun such as the ears, lower lip, and the back of the hands.
Squamous cell carcinoma may also appear on areas of the skin that have been burned or exposed to chemicals or radiation. Often this cancer appears as a firm red bump. Sometimes the tumor may feel scaly or bleed or develop a crust.
Although squamous cell carcinomas usually remain confined to the epidermis for some time, they eventually penetrate the underlying tissues if not treated. Squamous cell tumors may spread to nearby lymph nodes and in a small percentage of cases, they spread to distant tissues and organs. When this happens, they can be fatal.

Actinic keratosis

Actinic keratosis is a skin condition that is not cancer, but sometimes changes into squamous cell carcinoma. It usually occurs in areas that have been exposed to the sun, such as the face, the back of the hands, and the lower lip. It appears as rough, red, pink, or brown, raised, scaly patches on the skin, or cracking or peeling of the lower lip that is not helped by lip balm.

Risk factors

Sunlight

Over exposure to sunlight increases the risk of developing nonmelanoma skin cancer and actinic keratosis (which can lead to skin cancer).

Artificial sunlight and sunlamps

Being exposed to artificial sunlight can increase the risk of developing skin cancer.

Skin Colour

Having a fair complexion (blonde or red hair, fair skin, green or blue eyes, history of freckling) increases your risk.

Environment

The level of UV light today is higher than it was 50 years ago because of the reduction of ozone in the earth's atmosphere. Ozone serves as a filter to screen out and reduce the amount of UV light that we are exposed to. With less atmospheric ozone, a higher level of UV light reaches the earth's surface.
Other influencing factors include elevation, latitude, and cloud cover. The rays of the sun are also strongest near the equator. In Antarctica, Chile, and New Zealand, the UV level is much higher than normal especially in the springtime due to the ozone hole in the southern hemisphere.
One factor that actually reduces UV is cloud cover. Climates and micro-climates with regular cloud cover may have a 50% lower level of UV light. The actual amount is affected by the density of the clouds.

Actinic, or solar, keratosis.

Actinic keratoses increases the risk of developing Squamous cell cancer. The keratosis are rough, scaly, slightly raised growths that range in colour from brown to red and may be up to one inch in diameter. They appear most often in older people.

Actinic cheilitis

This is a type of actinic keratosis occurring on the lips that increases the risk of developing Squamous cell carcinoma. Lips become dry, cracked, scaly, and pale or white. It mainly affects the lower lip, which usually receives more sun exposure than the upper lip.

Leukoplakia.

These are white patches on the tongue or inside of the mouth and they have the potential to develop into Squamous cell carcinoma.

Bowen's disease.

This is now thought to be a superficial Squamous cell carcinoma that has not yet spread. It appears as a persistent red-brown, scaly patch which may resemble psoriasis or eczema. If untreated, it may invade deeper structures.

Other contributing risk factors

• Having scars or burns on the skin.
• Being exposed to arsenic.
• Having chronic skin inflammation or skin ulcers.
• Being treated with radiation.
• Taking immunosuppressive drugs (for example, after an organ transplant)

Prevention

Avoid the midday sun

The main way to minimise the risk of skin cancer is to protect the skin from the sun. The following guidelines help to reduce the suns damaging effects.

• Minimize exposure to the sun at midday and between the hours of 10:00AM and 3:00PM.
• Apply sunscreen with at least a SPF-15 or higher, to all areas of the body which are exposed to the sun.
• Reapply sunscreen every two hours, even on cloudy days. Reapply after swimming or perspiring.
• Wear clothing that covers your body and shades your face. (Hats should provide shade for both the face and back of the neck.)

Avoid artificial sunlight

Avoid exposure to UV radiation from sunlamps or tanning salons. UV rays damage skin and can increase the risk of non melanoma skin cancer.

Protect children

Children's skin is very delicate and can burn easily from the sun's rays. The damage done to young skin may not manifest itself until they are older. It is very important to protect children adequately from the sun's harmful rays.

• Children under six months of age should be kept completely out of the sun
• Keep children older than six years of age out of the sun from 10:00am and 3:00pm when sun exposure is at its strongest
• Apply sunscreen liberally and frequently to children

Screening

The following people should ensure they visit their doctor for regular mole checks.

• People with fair skin, whose skin tends to burn quickly
• People who have a large number of abnormal moles
• People with a long history of sun exposure

There is no national screening programme in any European country

Symptoms

Nonmelanoma skin cancer and actinic keratosis often appear as a change in the skin.
Possible signs of nonmelanoma skin cancer include:

• A sore that does not heal
• Areas of the skin that are:
  • Small, raised, smooth, shiny, and waxy
  • Small, raised, and red or reddish-brown
  • Flat, rough, red or brown, and scaly
  • Scaly, bleeding, or crusty
  • Similar to a scar and firm

Possible signs of actinic keratosis include:

• A rough, red, pink, or brown, raised, scaly patch on the skin.
• Cracking or peeling of the lower lip that is not helped by lip balm.

Diagnosis

The following procedures may be used to diagnose skin cancer:

• Skin examination: A doctor or nurse checks the skin for bumps or spots that look abnormal in colour, size, shape, or texture.
• Biopsy: All or part of the abnormal-looking growth is cut from the skin and viewed under a microscope to see if cancer cells are present.
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MEN

• The majority of people diagnosed with melanoma are white men over age 50.
• Skin cancer is the #1 cancer in men over age 50, ahead of prostate, lung and colon cancer.
  Middle-aged and older men have the poorest track record for performing monthly skin self exams or regularly visiting a dermatologist. They are the least likely individuals to detect melanoma in its early stages.
• Men over age 40 spend the most time outdoors and have the highest annual exposure to ultraviolet radiation.

WOMEN

• Melanoma kills more young women than any other cancer.
• In the past thirty years, skin cancer has tripled in women under age 40.
• The incidence of melanoma is increasing rapidly in women under age 40. It is now the most common cancer in young women aged 25-29, and second only to breast cancer in women aged 30-34.

TEENS/CHILDREN

• One blistering sunburn in childhood more than doubles a person's chances of developing melanoma later in life.
• Regular sun protection throughout childhood can reduce the risk of skin cancer by 80%.
• It is estimated that 2.3 million teens visit a tanning salon at least once a year.
• Teens may be especially susceptible to skin cancer because their cells are dividing and changing more rapidly than those of adults.
• In the past 20 years there has been more than a 100% increase in the cases of pediatric melanoma.
• Unlike for adults, there are currently no set guidelines for skin examinations in children.
• Less than half of all teenagers use sunscreen.
• The effects of photoaging (skin aging caused by the sun or tanning machines) can be seen as early as in one's 20's.

The Risk Factor (Source: The Cancer Council)

- Skin Cancer is caused by the build-up of Ultraviolet radiation (UVR) in the cells of the skin. This may eventually cause a tumour to develop.
- Unprotected exposure to the sun in the first 15 years of life more than doubles the chances of getting skin cancer.
- The risk of developing melanoma is one in 25 for males and one in 38 for females.

Further information about the UV-Index

• Visit The World Health Organisation (WHO) website to find more information about UV index reports in your country. CLICK HERE or follow link WHO WEBSITE