What I am going to talk What I am going to talk about todayabout today

MolesMoles Good, bad, ugly and ugliest skin Good, bad, ugly and ugliest skin

lesionslesions How to prevent skin cancerHow to prevent skin cancer SunscreensSunscreens A word about LaserA word about Laser

MolesMoles

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

Flat dark molesFlat dark moles

Junctional naevus – Junctional naevus – located at junction located at junction of outer and inner of outer and inner layer of skinlayer of skin

More likely than More likely than other moles to other moles to cause a problem – cause a problem – so the one to so the one to watch for!watch for!

Raised skin coloured Raised skin coloured molesmoles

Dermal naevus – Dermal naevus – located in deeper located in deeper layer of skinlayer of skin

Very rare that Very rare that they turn into they turn into melanomamelanoma

Slightly raised dark Slightly raised dark molesmoles

Raised in the Raised in the middlemiddle

Surrounding dark Surrounding dark pigmentation pigmentation

Less likely to Less likely to cause a problemcause a problem

Looks ugly but good!Looks ugly but good!

Seborrhoeic Seborrhoeic keratosiskeratosis

Extremely Extremely commoncommon

Rough topRough top Usually do not Usually do not

need treatmentneed treatment Get them checked Get them checked

if any doubtif any doubt

Sin tagsSin tags

Harmless but can Harmless but can irritate and irritate and aggravateaggravate

Neck, chest, back, Neck, chest, back, armpits or in the armpits or in the groin area groin area

Can be removed by Can be removed by cutting, freezing or cutting, freezing or burningburning

WartsWarts

Very commonVery common Nuisance but not a Nuisance but not a

serious problemserious problem Treatment can be Treatment can be

more more uncomfortable and uncomfortable and troublesome than troublesome than the wartsthe warts

Treating wartsTreating warts

Number of treatments, none of them Number of treatments, none of them very successfulvery successful

Paints Paints FreezingFreezing Duct tape!Duct tape!

How to cure your wart with How to cure your wart with duct tape!duct tape!

Cover the wart with duct tape for 6 days. Cover the wart with duct tape for 6 days. If the tape falls off during this time, put on If the tape falls off during this time, put on a fresh piecea fresh piece

After 6 days, remove the tape and soak After 6 days, remove the tape and soak the wart in warm water for 5 minutes. the wart in warm water for 5 minutes. After drying, rub gently with an emery After drying, rub gently with an emery board or pumice stone to get rid of dead board or pumice stone to get rid of dead tissue from the top of the warttissue from the top of the wart

Leave the wart uncovered overnight and Leave the wart uncovered overnight and put the tape on again the next dayput the tape on again the next day

Continue for up to two months. Continue for up to two months.

Actinic keratosesActinic keratoses

Actinic keratosesActinic keratoses

Dry, scaly patches Dry, scaly patches Form on sun exposed areas of the Form on sun exposed areas of the

skin, including the scalp, face, skin, including the scalp, face, forearms, and back of the handsforearms, and back of the hands

Caused by years of excessive sun Caused by years of excessive sun exposure. exposure.

If you develop one you are likely to If you develop one you are likely to get anotherget another

Actinic keratosesActinic keratoses

Actinic keratoses Actinic keratoses on the lipon the lip

Appear as Appear as cracking, dried lipscracking, dried lips

Actinic keratosesActinic keratoses

Actinic keratoses are considered Actinic keratoses are considered PRECANCEROUSPRECANCEROUS

Important to treat themImportant to treat them Treat by freezing, creams and Treat by freezing, creams and

sometimes surgerysometimes surgery

Avoiding new Actinic Avoiding new Actinic keratoseskeratoses

AVOID SUN EXPOSUREAVOID SUN EXPOSURE The best way to avoid new actinic The best way to avoid new actinic

keratoses and skin cancer is to keratoses and skin cancer is to protect your skin from the sun and protect your skin from the sun and the damaging ultraviolet (UV) rays.the damaging ultraviolet (UV) rays.

If you can’t avoid spending time outdoors, If you can’t avoid spending time outdoors, make sun protection a priority. Use a make sun protection a priority. Use a broad-spectrum sunscreen with a broad-spectrum sunscreen with a minimum SPF of 30, and cover your skin minimum SPF of 30, and cover your skin with long-sleeved shirts, trousers, and a with long-sleeved shirts, trousers, and a wide-brimmed hat. wide-brimmed hat.

Basal cell carcinomaBasal cell carcinoma

Commonest type of cancerCommonest type of cancer 80% of skin cancers80% of skin cancers NOT dangerous as does not spread NOT dangerous as does not spread

beyond the skinbeyond the skin

Basal cell carcinomaBasal cell carcinoma

A sore that comes A sore that comes and goes but never and goes but never completely heals completely heals

A shiny bump or A shiny bump or nodule, especially nodule, especially if it appears pearly if it appears pearly or translucent or translucent

Treatment of basal cell Treatment of basal cell carcinomacarcinoma

Creams for superficial onesCreams for superficial ones Freezing for small onesFreezing for small ones Surgery for othersSurgery for others

Squamous cell carcinomaSquamous cell carcinoma

10% of skin 10% of skin cancerscancers

A dry, crusted, A dry, crusted, scaly patch of skin scaly patch of skin that is red and that is red and swollen at the base swollen at the base

A sore that won’t A sore that won’t heal heal

Crusted skin Crusted skin

Squamous cell carcinomaSquamous cell carcinoma

Can sometimes spread beyond the Can sometimes spread beyond the skinskin

Important to diagnose and treat Important to diagnose and treat earlyearly

Main treatment is surgeryMain treatment is surgery Sometimes radiotherapy is usedSometimes radiotherapy is used

The ugliest!The ugliest!

MelanomaMelanoma

5% of skin cancers5% of skin cancers Most DANGEROUS Most DANGEROUS

SKIN CANCERSKIN CANCER A mole that changes A mole that changes

in size, shape, in size, shape, colour, or feel colour, or feel

A new mole that A new mole that appears and appears and continues to grow continues to grow or changeor change

The ABCDE ruleThe ABCDE rule AAsymmetry. Does one half of a mole look symmetry. Does one half of a mole look

different from the other? different from the other? BBorder. Is the edge (border) of the mole order. Is the edge (border) of the mole

ragged, notched, or blurred? ragged, notched, or blurred? CColour. Does the mole have a variety of olour. Does the mole have a variety of

hues or colours within the same lesion? hues or colours within the same lesion? DDiameter. Is the mole wider than 6mm or iameter. Is the mole wider than 6mm or

1/4 inch? 1/4 inch? EEvolving. Does the mole or skin lesion volving. Does the mole or skin lesion

look different from your other moles or look different from your other moles or has it changed in shape colour, size or has it changed in shape colour, size or other trait? other trait?

Key pointKey point

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

Who is at risk?Who is at risk? No one knows exact causeNo one knows exact cause Fair skinFair skin Many moles especially more than 50Many moles especially more than 50 Severe, blistering sunburnsSevere, blistering sunburns: People who : People who

have had at least one severe, blistering have had at least one severe, blistering sunburn as a child or teenager are at sunburn as a child or teenager are at increased risk of melanoma increased risk of melanoma

Ultraviolet (UV) radiationUltraviolet (UV) radiation – sunlight as – sunlight as well as tanning booths and sunlampswell as tanning booths and sunlamps

Family history or personal history of Family history or personal history of melanomamelanoma

Treatment of melanomaTreatment of melanoma

Surgery is main treatmentSurgery is main treatment Sometimes chemotherapySometimes chemotherapy

How to prevent skin How to prevent skin cancers?cancers?

Minimize exposure to the sun at Minimize exposure to the sun at midday - between the hours of 10 a.m. midday - between the hours of 10 a.m. and 4 p.m. and 4 p.m.

Apply sunscreen, with at least an SPF-Apply sunscreen, with at least an SPF-30 or higher that protects against 30 or higher that protects against both UVA and UVB rays, to all areas of both UVA and UVB rays, to all areas of the body that are exposed to the sun. the body that are exposed to the sun.

Reapply sunscreen every two hours, Reapply sunscreen every two hours, even on cloudy days. Reapply after even on cloudy days. Reapply after swimming or perspiring. swimming or perspiring.

How to prevent skin How to prevent skin cancers?cancers?

Wear clothing that covers the body and Wear clothing that covers the body and shades the face – wear hat and shades the face – wear hat and sunglassessunglasses

Avoid exposure to UV radiation from Avoid exposure to UV radiation from sunlamps or tanning parlours. sunlamps or tanning parlours.

Protect children. Keep them from Protect children. Keep them from excessive sun exposure when the sun is excessive sun exposure when the sun is strongest (between 10 a.m. and 4 p.m.), strongest (between 10 a.m. and 4 p.m.), and apply sunscreen liberally and and apply sunscreen liberally and frequently to children 6 months of age frequently to children 6 months of age and older. and older.

Skin self checkSkin self check Monthly check for changes in moles Monthly check for changes in moles Stand in front of a mirror and check your skin for: Stand in front of a mirror and check your skin for:

Unusual discolorations Unusual discolorations Abnormal moles, looking for changes in: Abnormal moles, looking for changes in:

Colour Colour Shape Shape SizeSize

Check the hard-to-see areas: Check the hard-to-see areas: Under your arms Under your arms The soles of your feet The soles of your feet Between your toes Between your toes

Part your hair and check your scalp Part your hair and check your scalp Have your partner check your back for skin discolorations Have your partner check your back for skin discolorations

and changing moles and changing moles

About sunscreensAbout sunscreens

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

SunscreensSunscreens

All sunscreens have a All sunscreens have a sun protection sun protection factor (SPF)factor (SPF) rating that indicates how rating that indicates how long a sunscreen remains effective on long a sunscreen remains effective on the skin. the skin.

If you normally develop a sunburn in 10 If you normally develop a sunburn in 10 minutes without wearing a sunscreen, a minutes without wearing a sunscreen, a sunscreen with an SPF of 15 will sunscreen with an SPF of 15 will protect you for 150 minutes — 10 protect you for 150 minutes — 10 minutes multiplied by the SPF of 15. minutes multiplied by the SPF of 15.

SunscreensSunscreens

Use a "broad spectrum" sunscreen – Use a "broad spectrum" sunscreen – one that protects against ultraviolet one that protects against ultraviolet A (UVA) and ultraviolet B (UVB) A (UVA) and ultraviolet B (UVB)

Use sunscreens with an SPF of at Use sunscreens with an SPF of at least 30. least 30.

Adults should cover their bodies in Adults should cover their bodies in enough sunscreen that would fill a enough sunscreen that would fill a shot glass and reapply every two shot glass and reapply every two hours. hours.

Laser treatmentLaser treatment

Not generally on the NHS!Not generally on the NHS! Useful for hair removal, thread Useful for hair removal, thread

veins, skin blemishes and scarsveins, skin blemishes and scars Important to select a clinic with Important to select a clinic with

good track recordgood track record

Take Home MessagesTake Home Messages

If you notice a new skin lesion that If you notice a new skin lesion that stays or an old one that starts stays or an old one that starts changing GET ADVICE.changing GET ADVICE.

Enjoy the Sun but with RESPECTEnjoy the Sun but with RESPECT IF you have a wart and you know it, IF you have a wart and you know it,

make your way to the nearest DIY make your way to the nearest DIY store and get some duct tapestore and get some duct tape

Above all, Smile a little andAbove all, Smile a little and Keep SafeKeep Safe

AcknowledgementAcknowledgement

Some pictures from Some pictures from www.dermnetnz.orgwww.dermnetnz.org with thanks with thanks