What I am going to talk about today Moles Good, bad, ugly and ugliest skin lesions How to prevent skin cancer Sunscreens A word about Laser

Moles Most people have a few Most do not cause a problem Occasionally a nuisance!

Flat dark moles Junctional naevus – located at junction of outer and inner layer of skin More likely than other moles to cause a problem – so the one to watch for!

Raised skin coloured moles Dermal naevus – located in deeper layer of skin Very rare that they turn into melanoma

Slightly raised dark moles Raised in the middle Surrounding dark pigmentation Less likely to cause a problem

Looks ugly but good! Seborrhoeic keratosis Extremely common Rough top Usually do not need treatment Get them checked if any doubt

Sin tags Harmless but can irritate and aggravate Neck, chest, back, armpits or in the groin area Can be removed by cutting, freezing or burning

Warts Very common Nuisance but not a serious problem Treatment can be more uncomfortable and troublesome than the warts

Treating warts Number of treatments, none of them very successful Paints Freezing Duct tape!

How to cure your wart with duct tape! Cover the wart with duct tape for 6 days. If the tape falls off during this time, put on a fresh piece After 6 days, remove the tape and soak the wart in warm water for 5 minutes. After drying, rub gently with an emery board or pumice stone to get rid of dead tissue from the top of the wart Leave the wart uncovered overnight and put the tape on again the next day Continue for up to two months.

Actinic keratoses

Actinic keratoses Dry, scaly patches Form on sun exposed areas of the skin, including the scalp, face, forearms, and back of the hands Caused by years of excessive sun exposure. If you develop one you are likely to get another

Actinic keratoses Actinic keratoses on the lip Appear as cracking, dried lips

Actinic keratoses Actinic keratoses are considered PRECANCEROUS Important to treat them Treat by freezing, creams and sometimes surgery

Avoiding new Actinic keratoses AVOID SUN EXPOSURE The best way to avoid new actinic keratoses and skin cancer is to protect your skin from the sun and the damaging ultraviolet (UV) rays. If you can’t avoid spending time outdoors, make sun protection a priority. Use a broad-spectrum sunscreen with a minimum SPF of 30, and cover your skin with long-sleeved shirts, trousers, and a wide-brimmed hat.

Basal cell carcinoma Commonest type of cancer 80% of skin cancers NOT dangerous as does not spread beyond the skin

Basal cell carcinoma A sore that comes and goes but never completely heals A shiny bump or nodule, especially if it appears pearly or translucent

Treatment of basal cell carcinoma Creams for superficial ones Freezing for small ones Surgery for others

Squamous cell carcinoma 10% of skin cancers A dry, crusted, scaly patch of skin that is red and swollen at the base A sore that won’t heal Crusted skin

Squamous cell carcinoma Can sometimes spread beyond the skin Important to diagnose and treat early Main treatment is surgery Sometimes radiotherapy is used

The ugliest!

Melanoma 5% of skin cancers Most DANGEROUS SKIN CANCER A mole that changes in size, shape, colour, or feel A new mole that appears and continues to grow or change

The ABCDE rule Asymmetry. Does one half of a mole look different from the other? Border. Is the edge (border) of the mole ragged, notched, or blurred? Colour. Does the mole have a variety of hues or colours within the same lesion? Diameter. Is the mole wider than 6mm or 1/4 inch? Evolving. Does the mole or skin lesion look different from your other moles or has it changed in shape colour, size or other trait?

Key point If you notice a mole that is different from others, or which changes, itches, or bleeds even if it is smaller than 6 millimetre – GET ADVICE

Who is at risk? No one knows exact cause Fair skin Many moles especially more than 50 Severe, blistering sunburns: People who have had at least one severe, blistering sunburn as a child or teenager are at increased risk of melanoma Ultraviolet (UV) radiation – sunlight as well as tanning booths and sunlamps Family history or personal history of melanoma

Treatment of melanoma Surgery is main treatment Sometimes chemotherapy

How to prevent skin cancers? Minimize exposure to the sun at midday - between the hours of 10 a.m. and 4 p.m. Apply sunscreen, with at least an SPF-30 or higher that protects against both UVA and UVB rays, to all areas of the body that are exposed to the sun. Reapply sunscreen every two hours, even on cloudy days. Reapply after swimming or perspiring.

How to prevent skin cancers? Wear clothing that covers the body and shades the face – wear hat and sunglasses Avoid exposure to UV radiation from sunlamps or tanning parlours. Protect children. Keep them from excessive sun exposure when the sun is strongest (between 10 a.m. and 4 p.m.), and apply sunscreen liberally and frequently to children 6 months of age and older.

Skin self check Monthly check for changes in moles Stand in front of a mirror and check your skin for: Unusual discolorations Abnormal moles, looking for changes in: Colour Shape Size Check the hard-to-see areas: Under your arms The soles of your feet Between your toes Part your hair and check your scalp Have your partner check your back for skin discolorations and changing moles

About sunscreens Sunscreen protects your skin by absorbing and reflecting ultraviolet rays from the sun

Sunscreens All sunscreens have a sun protection factor (SPF) rating that indicates how long a sunscreen remains effective on the skin. If you normally develop a sunburn in 10 minutes without wearing a sunscreen, a sunscreen with an SPF of 15 will protect you for 150 minutes — 10 minutes multiplied by the SPF of 15.

Sunscreens Use a "broad spectrum" sunscreen – one that protects against ultraviolet A (UVA) and ultraviolet B (UVB) Use sunscreens with an SPF of at least 30. Adults should cover their bodies in enough sunscreen that would fill a shot glass and reapply every two hours.

Laser treatment Not generally on the NHS! Useful for hair removal, thread veins, skin blemishes and scars Important to select a clinic with good track record

Take Home Messages If you notice a new skin lesion that stays or an old one that starts changing GET ADVICE. Enjoy the Sun but with RESPECT IF you have a wart and you know it, make your way to the nearest DIY store and get some duct tape Above all, Smile a little and Keep Safe

Acknowledgement Some pictures from www.dermnetnz.org with thanks