Frequently Asked Skin Cancer Questions
What is skin cancer?
Skin cancer is the most common form of cancer in Australia. It is a disease of the body’s skin cells caused mainly by cumulative exposure to ultraviolet radiation (UVR) from the sun. Cancer is a group of diseases in which cells are aggressive (grow and divide without respect to normal limits), invasive (invade and destroy adjacent tissues), and sometimes metastatic (spread to other locations in the body). Skin cancer is normally divided into two categories: melanoma and non-melanoma skin cancers.
What is a non-melanoma skin cancer?
There are two main types of non-melanoma skin cancer (NMSC): basal cell carcinoma – BCC and squamous cell carcinoma – SCC (for more information on these see footnotes below). BCC is the most common form of skin cancer. It usually develops as a small, round, raised, red, pale or pearly-coloured spot, and it may become ulcerated like a sore that will not heal. SCC is the second most common form of skin cancer. It normally appears as a thickened red, scaly spot that may later bleed easily or ulcerate. Both types of NMSC mainly develop on areas of the body that are exposed to ultraviolet radiation and are usually able to be treated if detected early.
What is a melanoma?
Melanoma is the least common form of skin cancer, but the most deadly. If left untreated, melanoma can spread to other parts of the body. Melanoma appears as a new or existing spot, freckle or mole that changes in colour, size or shape. A melanoma usually has an irregular or smudgy outline and can be more than one colour. A melanoma can grow over weeks to months, and can appear anywhere on the body, including areas of the body that aren’t exposed to ultraviolet radiation from the sun.
What is ultraviolet radiation (UVR)?
UVR is the part of sunlight which causes sunburn and skin damage leading to premature ageing and skin cancer. Damage to the skin occurs as soon as skin is exposed to UVR. Sunburn is the extreme form of this damage. The effects of UVR on the skin are cumulative so the damage is building up even without burning.
UVR cannot be felt or seen. It is not related to, or indicated by, heat, high temperatures or light, and therefore can be present even on a cloudy day. Light-coloured and shiny surfaces, such as sand, snow, concrete and water, all reflect UVR.
UVR intensity can be measured by the Ultraviolet (UV) Index - the higher the Index value, the greater the potential for damage to your skin and risk of developing skin cancer. The UV Alert, which is issued when the UV Index forecast reaches 3 or higher, shows the time of the day when it is essential to protect yourself and can assist you in taking action to minimise your exposure to the sun’s rays. The daily UV Index forecast and UV Alert can be found in the weather pages of local papers, and on the Australian Bureau of Meterology website and the Australian Radiation Protection and Nuclear Safety Agency website.
What are the main risk factors for skin cancer?
Anyone in Australia can develop skin cancer but risk is increased for people who:
- are exposed to ultraviolet radiation (UVR) during childhood and adolescence
- have repeated exposure to UVR over their lifetime
- have episodes of severe sunburn
- have a light complexion (red or fair hair; blue or green eyes; skin that burns easily, freckles and doesn’t tan)
- are older
- have a had a previous non-melanoma skin cancer (NMSC)
- have a personal or family history of melanoma
- have a large number of moles
- have unusual types of moles (eg dysplastic naevus)
- are immunosuppressed (including organ transplant recipients)
Is it possible to develop skin cancer if your skin does not burn?
Yes. Anyone can develop skin cancer regardless of whether or not their skin burns. Although people with fair skin are at a greater risk of developing skin cancer, people with tanned skin are also at risk of developing skin cancer if they do not protect their skin when going outdoors.
Does a tan provide protection against developing skin cancer?
No. Any form of a tan which has been obtained from exposure to UVR (from natural or artificial sources) increases your chances of premature ageing and developing skin cancer. People with naturally tanned or darker skin have very limited protection to UVR (roughly equivalent to SPF2 sunscreen) and will still need to protect their skin when going outdoors. Fake tanning products do not offer protection against the risk of developing skin cancer. Some fake tanning products do contain sunscreen, but this will at most only offer protection for a few hours after application of the product.
Is it possible to safely obtain a tan from exposure to ultraviolet radiation?
No. Any form of a tan from UVR (whether from the sun or artificial devices such as solarium) will damage your skin and increase your risk of developing skin cancer.
Are solariums or sunbeds a safe way to tan?
No. Solariums and sunbeds emit UVR and increase your risk of developing skin cancer. (See fact sheet below.)
Do you only need to protect yourself from the sun when it is hot and sunny?
No. UVR, which causes sunburn and skin damage, cannot be felt or seen. It is not related to, or indicated by heat, high temperatures or light, and therefore can be present days when it is not hot and sunny (such as cloudy, hazy or breezy days).
Can you only be harmed by the sun during the middle of the day?
No. You can be harmed by the sun anytime during the day (especially when the UVR is high). In general, the most dangerous times to be out in the sun are 10am – 2pm (or 11am – 3pm during daylight savings), when the UVR level is at its highest.
Is it only old people that need to look for changes in their skin?
No. People of all ages need to regularly check their skin for changes as skin cancer does not affect only old people. In fact, melanoma is the most common cancer for the 15-24 year old age group; and are most prevalent in the 15-45 years age group.
How much sun exposure is required to maintain healthy levels of vitamin D?
It has been estimated that fair skinned people can achieve adequate vitamin D levels in summer by exposing the face, arms and hands or the equivalent area of skin to a few minutes of sunlight on either side of the peak UV periods on most days of the week. In winter, in the southern regions of Australia where UV radiation levels are less intense, maintenance of vitamin D levels may require 2-3 hours of sunlight exposure to the face, arms and hands or equivalent area of skin over a week. It is important to be adequately protected from the sun, whenever the UV Index is 3 or more and particularly during peak UVR times.
Basal cell carcinoma (BCC)
BCC arises from the cells at the bottom (or basal) part of the outer layer of the skin.
is known as a non-melanoma skin cancer (NMSC)
is the most common and least dangerous form of skin cancer
appears as a round or flattened lump or scaly area
is red, pale or pearly in colour
grows slowly, usually on the head, neck and upper torso
may become ulcerated as it grows
appears on skin most often exposed to ultraviolet radiation (UVR) - the head, neck, forearms and upper body
is usually able to be treated if detected early
Squamous cell carcinoma (SCC)
SCC arises in the outer layer of skin cells.
is known as a non-melanoma skin cancer (NMSC)
is the second most common form of skin cancer
is less common, but more dangerous than basal cell carcinoma
is not as dangerous as melanoma
appears as a thickened, red, scaly spot that may bleed easily, crust or ulcerate
appears on skin most often exposed to ultraviolet radiation (UVR) – the head, neck, forearms and upper body
normally grows over weeks to months, but may spread to other parts of the body if not treated promptly
Fact sheet on solariums
Solariums emit ultraviolet radiation (UVR) - both UVA and UVB. Both these forms of ultraviolet radiation are known to cause cancer.
The more your skin is exposed to UVR the greater your risk of developing skin and eye cancers. Risk is increased whether the UVR is from the sun or from artificial sources such as solariums, sunbeds or sunlamps.