Melanoma – how to be aware + stay protected

May is Melanoma Awareness Month, a time that spreads awareness of melanoma – a type of skin cancer. Melanoma develops from skin cells called melanocytes, which produce the melanin that gives our skin its colour. Currently there are over 13,000 cases of skin cancer per year in Ireland, about 1300 of which are melanoma. If melanoma is recognised and treated early, approximately 90% are curable, but if it is not, the cancer can advance and spread to other parts of the body, where it becomes difficult to treat and can be fatal. This means it is vital to be vigilant and check your skin regularly. Today, The SKINday Times chats to Professor Caitriona Ryan of the Institute of Dermatologists, Ireland about the warning signs and how to check your skin correctly.

What do you wish people would be more aware of when it comes to skin cancer?
I wish they used sunscreen on their faces and hands every day!! Daily sunscreen use on exposed areas could greatly reduce their risk of skin cancer. Most Irish people are great at wearing SPF when abroad on holidays but rarely wear it at home, where they get most of their cumulative sun damage.

At what stage do people usually discover they have skin cancer?
The stage at which people typically discover they have skin cancer varies depending on the type of skin cancer, and the location of the cancer. Skin cancer is more likely to be detected at an early stage if people are regularly monitoring their skin and seeking medical attention if they notice any changes or abnormalities.

Early detection is crucial. The most common forms of non-melanoma skin cancer are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). If left untreated, some types of non-melanoma skin cancer can spread to other parts of the body but thankfully can almost always be completely cured and treated early.

What are the warning signs to be aware of?
The most important warning signs of a melanoma are changes in the size, shape or colour of a mole. Here is a handy 5-point check, which we call the ABCDE of melanoma:

A is for Asymmetry; Is one half of the spot unlike the other half?
B is for Border: Does the spot have an irregular, scalloped, or poorly defined border?
C is for Colour: Does the spot have varying colours from one area to the next, such as shades of tan, brown or black, or areas of white, red, or blue.
D is for Diameter: While melanomas are usually greater than 6 millimetres (about the size of a pencil eraser), they can be smaller.
E is for Evolution: Is your spot changing shape or appearance?

Consult with your GP or dermatologist immediately if you have a changing or new mole, or any skin abnormality, such as a lump, ulcer, lesion, or skin discolouration that has not healed after 4 weeks. While it may not be skin cancer, it's always best to get checked.

How often should we examine our skin?
Examine yourself from head to toe every month. Learn the moles, freckles and other skin marks that are normal for you. Stand in front of a long mirror and have a hand mirror that you can use to check parts that are hard to see. Ask a relative or friend to check your back or other hard-to-see areas like your scalp or the back of your neck. It may help to take photographs of your skin and compare any changes that occur over time. If you detect something that concerns you, visit your GP.

If we discover a mole or patch that concerns us, how long is the assessment period likely to take?
It typically takes about 10-20 minutes for a GP or dermatologist to take a history and do a full skin examination

‘Toasted Skin Syndrome’ is a skin condition that has been discussed on platforms such as TikTok, with a report suggesting a possible link between this syndrome and nonmelanoma skin cancers. Should we be worried?
Erythema ab Inge, is a pattern of reddish-brown discoloration and reticulated (net-like) skin on areas of the body that have been chronically exposed to heat or radiation. Traditionally we used to see it in patients who always used a hot water bottle in the same spot at night or in people using heat packs for pain in their back or other areas. More recently we are seeing much more of it on the front of the thighs of people who hold their laptops on their lap. The risk of developing skin cancer from erythema ab igne is extremely low, but it can occur if the skin has been repeatedly exposed to heat or radiation over a long period of time or people who have fair skin that is more susceptible to sun damage or genetic mutations which make them more predisposed to skin cancer.

Do gel manicures cause UV damage?
Gel manicures can cause UV damage to the skin and nails if UV lamps are used to cure and harden the gel polish. The UVA radiation from these lamps penetrates the skin leading to premature aging and an increased risk of skin cancer. Typically nail salons now use LED lamps, which emit less UV radiation than traditional UV lamps. Use broad-spectrum UV on your fingers and hands before your treatment.