Skin cancer prevention: How to apply sunscreen according to a skin expert | ‘The one thing you might be doing wrong when applying sunscreen” Exclusive

If, like me, you grew in the Aussie sun, chances are you got sunburnt as a child or teenager.

While for some, the dangers of sunburn were not as well known, others, myself included, were so intent on getting a tan that we threw caution to the wind.

Growing up very fair skinned in Australia meant I got sunburned fairly regularly.

My worst case occurred at a school swimming carnival where I sat in the blazing sun for an entire day. I was left with second-degree burns and spent the next week at home slathered in creams.

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Fast forward to my teenage years and I spent my school lunchbreaks slathering my legs in coconut oil looking for that elusive tan.

By my 30s, despite having become sun safe, I was beginning to see the consequences of my actions, with basal cell carcinomas (BCC) removed from my scalp and face.

Later, I had skin cancers removed from my back and leg. Two years ago, a large BCC was removed from my shoulder, requiring 20 internal and external stitches, and last year, a suspicious lump was removed from my leg which was later found to be a keratoacanthoma – a fast-growing skin cancer that is part of the squamous cell carcinoma family.

While I have been lucky that I have not needed any further treatment or been diagnosed with a much more serious melanoma, I am now extremely careful about sun exposure.

I regularly cover up and don a hat and sunscreen, and my face has gotten off relatively scot-free.

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That was until last week when I went to my annual skin check, where my doctor found a number of skin cancers on the area of my face between my nose and top lip.

While they have been caught early and will only require treatment with creams, I was shocked that this area of my face had been affected by skin cancer.

When I mentioned my surprise to my dermatologist, she told me this area of the face perspires a lot, which means sunscreen easily sweats off and needs to be applied more frequently.

But to be honest, I don’t even think it is an area where I have thought about applying sunscreen.

Dermatologist and Associate Professor Deshan Sebaratnam told 9honey two out of three Australians would be diagnosed with a skin cancer by retirement age.

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“Skin cancer rates are increasing as people are living longer, but we are also getting better at diagnosing skin cancers early on,” he said.

He said basal cell carcinoma was the most common type of skin cancer diagnosed in Australia.

While it is aggressive, it rarely spreads to other parts of the body.

The next most common form of skin cancer is cutaneous squamous cell carcinoma, which spreads infrequently but can be difficult to treat, especially on places like the scalp.

“There are many other, rarer forms of skin cancer,” he said.

“If you think about the skin, you have your skin cells, pigment cells, nerves, blood vessels, flesh, sweat glands etc. Any of these can become cancerous.”

Of course, the most deadly type of skin cancer is melanoma.

“Australia is the melanoma capital of the world,” Associate Professor Deshan Sebaratnam said.

“An Australian is diagnosed with a melanoma every 30 minutes and one Australian dies of melanoma every six hours.”

Sebaratnam said while the age-standardised incidence rate of melanoma was increasing, it had dropped for people aged less than 40, in part because of interventions such as ‘Slip Slop Slap’ [and] ‘No hat, no play’.

He said migration had also played a part because “darker-skinned people are less likely to develop skin cancer than fairer-skinned people”.

While he said millennials (those born between 1981-1996) who grew up with sun-safety messaging were getting less melanomas, older people who grew up “before we knew about how dangerous the sun was” were continuing to be diagnosed at higher rates.

He is concerned rates will increase amongst Generation Z (born 1997-2012), who are getting their sun-safety advice from social media and not doctors.

When and how to apply sunscreen

Associate Professor Deshan Sebaratnam recommends always applying sunscreen, especially whenever the UV index is three or more.

“Apply a generous amount 20 minutes before going outside,” he said.

“For your whole body, you need about a shot glass worth. Make sure your sunscreen is SPF50+ and broad spectrum.”

Associate Professor said while most people know to put sunscreen on their face, they often skip some areas or don’t reapply it often enough.

“People often remember the face, but forget their eyes and neck,” he said.

“[The] forehead is another tricky area because it often runs down with sweat and gets in your eyes. And then people don’t like wearing it at all.

“And for men, their bald spot.”

The correct way to apply sunscreen

According to Cancer Council, sunscreen should be applied to clean and dry skin, and then reapplied at least every two hours, even if it is water resistant.

“Swimming, sport, sweating and towel drying can reduce the effectiveness of the product, so sunscreen should always be reapplied after these activities,” it says. 

The five sun safety rules

Associate Professor Deshan Sebaratnam said the best way to safeguard against skin cancer was to follow the advice Slip Slop Slap Wrap Seek, also known as Slip, Slop, Slap, Seek, Slide.

“Slip on long-sleeved clothing, slop on sunscreen, slap on a broad-brimmed hat, wrap around sunglasses and seek shade in the middle of the day,” he said.

“If there’s a new mole or one that’s changed or you’re worried about, see your GP or a specialist dermatologist.”

Skin cancer symptoms

Skin cancers, including BCCs and SCCs can have varying symptoms, depending on the type, but according to Cancer Council, they can range in colour from light, pearl-like, pink or red lumps, lesions, or scaly patches of skin. They can be itchy or inflamed, and may ooze or bleed, and may appear as a sore that doesn’t heal.

They can be tender or cause no pain at all; and can be slow or fast growing.

Melanomas often appear as changes to an existing mole in relation to its colour, size, shape or elevation, or from symptoms such as itching or bleeding. They can appear anywhere on the body, including the soles of the feet, in the nail bed, or inside the eye.

Some skin cancers may spread to other parts of the body. When this happens with melanoma, it is known as metastatic melanoma, and can cause death.

Skin cancer treatment

According to Cancer Council, treatment varies depending on the type and severity.

Non-surgical treatments include topical (ointments), radiation therapy, cryotherapy, (rapid freezing), curettage (scraping) or cautery (burning).

Many skin cancers need to be surgically removed along with surrounding tissue.

Melanoma removal also often involves the removal of lymph nodes to check for spread.

Advanced skin cancers may include further treatment. Melanoma patients will often be referred to an oncologist to oversee treatment including radiotherapy and immunotherapy.

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