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New NICE Guidance on sun exposure and the dangers of skin cancer and melanoma


    This blog considers the risks of sun exposure and developing skin cancer, the signs to look out for and why prompt diagnosis and treatment of skin cancer is so important.

    By Joachim Stanley

It is widely recognised that it is very important to be aware and vigilant of the risks of spending too long in the sun without adequate protection. The number of patients in the UK being diagnosed with skin cancer is reported to be increasing, so it is vital that both patients and medical professionals recognise the signs to ensure prompt diagnosis and treatment.

Recent guidance has been published by the National Institute for Health and Care Excellence (NICE)  – “Sunlight exposure: risks and benefits” – which states that there is no safe or healthy way to get a tan from sunlight. This guidance is particularly concerning as a large proportion of the population may be unaware of the dangers and leave themselves open to the risk of developing skin cancer, without taking the necessary precautions. It is vital that the issued guidance is understood and followed in order to reduce the risks posed by the sun.

It goes without saying that being diagnosed with skin cancer would be very distressing. It has been reported that the disease now causes about 2,100 deaths annually in the UK. The British Association of Dermatologists (BAD) have reported that more than 250,000 new cases of non-melanoma skin cancer (the most common type) are diagnosed each year, in addition to approximately 13,000 new cases of melanoma (the deadliest form). We should all therefore be doing everything we can to reduce the risk of developing skin cancer.

NICE Guidance

The recent NICE guidance outlines a number of recommendations in relation to sun exposure, including:

  • When applying sun cream people should use at least factor 15 sun creams, with adults urged to use 6-8 teaspoons (35ml) per application.
  • People should expose their arms and legs to the sun for short periods in order to build up vitamin D.
  • Babies and children, those with fair skin or hair, people with lots of moles or freckles and those with a family history of skin cancer should take extra care in the sun.
  • Higher factor sun creams – such as factor 30 – may offer better protection but do “not necessarily mean people can spend more time in the sun without the risk of burning”.
  • Applying sunscreen too thinly reduces the amount of protection it gives.
  • Sunscreens should be re-applied after being in the water, after towel drying, sweating or when it may have rubbed off.
  • Cream should also be applied twice – once half an hour before going out and again before going in the sun – if people are going out long enough to risk burning.
  • Babies under six months of age should be kept out of direct strong sunlight and children need sun protection between March and October.

Following the recommendations is likely to reduce the risk of developing skin cancer but it is important to remember that you need to stay vigilant as, unfortunately, these steps alone are unlikely to completely eliminate the risk. It is therefore important that you recognise the signs of skin cancer and seek medical attention at the earliest opportunity.

Signs of skin cancer or melanoma:

There are a number of signs to look out for if you are concerned about a mole or irregularity. There is a useful checklist on the NHS Choices website, the ABCDE checklist, to assist with telling the difference between a normal mole and one that may be a melanoma:

Asymmetrical – melanomas have two very different halves and are an irregular shape;
Border – unlike a normal mole, melanomas have a notched or ragged border;
Colours – melanomas will be a mix of two or more colours;
Diameter – unlike most moles, melanomas are larger than 6mm (0.25in);
Enlargement or elevation – a mole that changes characteristics and size over time is more likely to be a melanoma.

If, having considered the checklist, you are concerned about a particular mole, or any changes in your skin it is important to discuss it with your GP as they will be able to offer additional advice and assistance and, if necessary, referral for further investigations.

It is equally important that your GP recognise the signs of skin cancer and melanoma and be ready to take the necessary steps to make sure you receive appropriate treatment.

What are the potential consequences if skin cancer is not promptly diagnosed?

I and my colleagues have acted for clients with claims relating to substandard care in relation to skin cancer and melanoma. In many instances skin cancer has gone undiagnosed and untreated, which has resulted in significant issues for our clients.

One such case involves a client who suffered with a painful and uncomfortable rash for a number of months. At numerous appointments with his GP our client was prescribed with different creams which did nothing to treat his rash. The rash was allowed to spread and it was only after a number of months that he was eventually referred to a Dermatologist. At this point the Dermatologist diagnosed the rash as skin cancer and surgery to remove the cancer was performed.

This is an example of an occasion where our client’s injury could have been treated sooner had the appropriate checks and investigations been carried out. If he had been treated correctly, he would have avoided unnecessary pain and suffering. It is important that these types of failures are avoided at all costs, given the drastic impact it can have on people’s lives. However, we all also have a responsibility to take steps to reduce our risks of developing skin cancer, recognise the signs and seek medical treatment at the earliest opportunity and I hope that the new NICE guidance and the various checklists will provide positive assistance in respect of this.

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