What I Should Do Before My Appointment for Skin Cancer Check?

We recommend you examine your scalp and areas covered by your undergarments prior to your appointment and try to locate any moles you want your doctor to examine during the mole check.

To allow us to perform a thorough and accurate skin cancer check, please avoid or remove make-up before your mole check. It is also preferable to remove your nail polish so your nails can be examined properly.

What Happens During a Skin Check up?

On arrival please report to the front reception desk
Ensure your contact details are up to date
Have your Medicare, Pension, Healthcare or Veteran Affairs cards handy
Your doctor will ask you questions to assess your skin cancer risk which may include family history, current level of sun exposure, sun exposure in childhood, frequency of sun protection, history of skin cancer in past especially melanoma and occupation. Your doctor may also ask you about your general health and any other illnesses.
Your doctor will ask you if you have any spots you are worried about.
Your doctor will perform a detailed total body skin examination (excluding undergarments) in a systematic way using high resolution imaging equipment and the specialized technique of dermoscopy.
For a full skin check you will need to remove clothing down to your underwear.
Remember to tell your doctor about any lesions of concern in areas that may be hard to see, such as your scalp or those concealed by underwear.
If you have had melanoma, your doctor may check your liver and lymph nodes (neck, armpits and groin) depending on the stage of melanoma.

A standard full skin assessment consultation is generally scheduled for 20 minutes. If a small procedure is required for diagnosis or treatment, this is often done during the same consultation. However, you will need a separate appointment for more complex procedures.

At your skin consultation you can ask for an assessment of a single mole. However, it is preferable to have a full body skin check as a significant number of the skin cancers detected during skin checks are lesions that the patients are not aware of, or they do not consider significant. Skin cancer can occur anywhere on the body, even where there has been no sun exposure.

We take maximum care to ensure your comfort, privacy and to protect your modesty.

How often I have check ups?

How often you need to have skin check will depend on your estimated risk of developing skin cancer. There are several factors taken into account when assessing your risk.

These include:

Degree of skin damage
Whether you have had skin cancer lesions in past, how long ago, and how many.
The type of cancer
The size and depth of the original cancer
The grade of the cancer (determined when cancer is examined under the microscope by pathologist)
Whether your immune system is weakened

In vast majority of cases, skin check ups are to prevent and detect future skin cancers early.

It is important to check your skin yourself. If you spot any signs of a new skin cancer or changes in an existing spot in between your check ups, you should contact us.

What do I need to do before surgery?

Preparation for your procedure:

All surgical procedures at EGSCC are performed under local anesthetic.

There is usually no special preparation required before surgery.

However we recommend:

being as fit as possible to help the recovery process
being well rested when possible
Arrive on time.
You may want to bring some reading or knitting material or music headsets. We make every effort to be on time, but delays sometimes occur
Take shower the night before or the morning of surgery, as your wound must remain covered with the initial dressing and dry for the first 48 hours or as directed by your doctor. If your are working on the day of your procedure and your workplace is dusty or hot-have a shower first
Smoking reduces blood flow to the skin and thus slows healing of the wound, causes more wound infections and results in worse scar that expected - consider stopping or reducing smoking for at least two weeks before surgery and until the wound is healed.
Heavy alcohol use is not advised at least for one week before surgery as it can cause more bleeding.
You may eat and drink as usual prior to your surgery. There is no need to fast.
We recommend you wear casual clean, loose fitting, comfortable clothes and footwear. If your surgery is on the head or neck consider wearing clean but older, darker clothes in case of bleeding during the procedure.
avoid any lotions, creams, or gels prior to surgery.
If you wish, take pain killers an hour or so before surgery. Avoid aspirin and anti-inflammatory medications.
You may be prescribed medicines to take before the surgery, such as antibiotics.
In most cases patients are able to drive home after most procedure and do not necessarily need a driver. However, you will not be able to drive home if your treatment has involved your hands, feet, if dressing has been applied over an eye, if your procedure needs more than usual amount of local anesthesia, your feel uncomfortable or there are unexpected complications. In such a case, have someone (a friend or relative) drive you home after surgery. If in doubt please seek advice from the doctor.
In some cases, someone should stay with you at home for at least 24 hours after your surgery. You may also need to prepare for recovery this may include taking time off work, prepare meals in advance, and prepare a ?recovery area? in your home which may include pillows, ice packs, walking aids and a telephone within easy reach.
Provide a complete medical history for your doctor including any health problems you have had, any medication you are taking or have taken, and any allergies you may have.
Please tell your doctor if your are diabetic or you have pacemaker or a heart problem that require antibiotics cover for dental and similar procedures.
Please take all medications that have been prescribed to you unless otherwise directed by Dr Alwyn. Most patients are able to continue all of their regular doctor prescribed medications including aspirin and any blood thinning medications. However if your are on bloood thinking medications, talk to Dr Alwyn to find if you need to stop certain medicines. It is important to not discontinue any medication without a doctor's specific instruction.
In particular, patients with history of, atrial fibrillation, lung clots, TIA ( mini strokes), stroke, heart attacks, stents, or even angina must not discontinue blood thinners e.g. aspirin/plavix/iscover/ asasantin/ warfarin/ xarelto, pradaxa/ eliquis without a doctor's specific instructions because of a potential greater risk of heart attacks, stroke and lung clot .
Your surgical procedure will happened under very sterile conditions. Surgical instruments are sterilised for each and every patient by Gippsland Lakes Community Health Centre. Other material used in our practice like needles, syringes and dressing packs are disposable and single use only.

For otherwise healthy patients aspirin used for primary prevention and nonessential medications that thin the blood such as non-steroidal anti-inflammatory drugs ( NSAIDS) like nurofen can be stopped at least one-two weeks before undertaking surgery to minimize bleeding or bruising. These medications can thin your blood and make you more prone to bleed during and after surgery.

If you take naturopathic substances such as garlic supplements, fish oil/krill oil, ginko, ginseng, St John's Wart or Vitamin E, please stop taking them at least one week before your surgery as they may affect clotting and anesthesia. Always tell your doctor everything you are taking.

Diabetic patients may need to be more cautious about maintaining good blood sugars.

If you are unable to sit in a chair or lie down for any length of time, please inform us, so alternative arrangements can be made. You may need to have your procedure under general anesthesia in a hospital.

How long will the procedure take?

Standard surgery usually takes between 15 -40 minutes. Some complex or larger procedures may take longer.

What to expect on the day of the procedure? Will I feel anything? Is surgery painful?

Surgical procedures at EGSCC are performed under local anesthetic which means you will be awake throughout the procedure and will not be sedated or feel drowsy. However, if you have anxiety or needle phobia, we may give you mild sedating medications. An injection will be given in to the skin at the site of the skin lesion before surgery. The injection will sting for seconds. However once the anesthetic has taken effect your skin will be numb, although you may still feel touching, pulling or pressure. We often use sodium bicarbonate with local anesthetic agent to reduce pain from local anastehtic injection.
If the surgical site is hairy your doctor may consider shaving the area just before the operation.
After your procedure, you will be able to walk out of the clinic. Rarely will you be asked to sit and relax until we are satisfied with your recovery from the surgical procedure performed. Our reception can call whoever you have arranged to drive you home when you are ready to leave if this is required.
You may have a pressure dressing on the surgery area for one day.
Wound care instructions will be discussed with you and your carer before you leave.
Rarely we perform what is called slow Mohs surgery. When margins of tumour which is located in crtical sites like nose, lips, eyelids, ears and fingers are not clearly defined visually even with the the aid of hand held miscroscopy( dermoscopy) the lesion may get excised and wound dressed but not sutured together untill histology result is availble which usually takes less than 24 hours.

Our aim is to make your experience with us as comfortable and pleasant as much as possible

What if the lesion appears to have disappeared?

Sometimes patients may find that the lesion appears to have disappeared or reduced significantly in size between the time diagnosis was made and the day of procedure especially if a biopsy had been taken from the lesion. It is not uncommon for some cancer to look as if they are gradually disappearing. This does not mean that a cancerous lesion is going away or has been completely excised through biopsy as the roots can sometimes burrow deeper into the skin and may not be visible on the surface. It is often a matter of time for cancer to reappear. It is important not to cancel your appointment, as your doctor will be able to better inform you as to whether the surgery is still necessary.

What to Expect After Surgery? What is the recovery time for surgery?

Following your operation, you can expect:

You may experience minimal pain and discomfort which can be managed by simple over the counter painkillers such as Panadol or Panadeine (avoid Aspirin and anti-inflammatory drugs (e.g. Nurofen). ?Applying a cool pack and pressure helps with the discomfort. If you are experiencing significant pain which is not controlled by simple pain killers and cool pack and pressure following a simple procedure, please contact us, it may indicate that there is complication. If a large skin cancer has been removed or skin graft performed, discomfort and pain may be significant. Prescription pain medications may be required for severe pain for several days. Your doctor will prescribe painkillers if required. If you have pain which requires pain killers, it might be better to take your pain killer at the first hint of discomfort instead of waiting until the pain builds up to an unbearable level.
You may experience mild oozing and bleeding especially the first few hours after surgery. Activity may aggravate this. Hot drinks or bending over at the waist can also initiate or worsen bleeding of face wounds. If this occurs you should apply Firm pressure with a cool pack over the dressing for 15 ? 20 minutes each hour. Keep the area elevated if possible. Most bleeding will stop if you apply enough pressure. However if the bleeding is not settling or blood soaks through the dressing, you should attend to the clinic for wound to be inspected and dressing to be changed. Rarely a visit to the hospital emergency room may be necessary for severe bleeding especially after hours.
You may experience some local swelling and bruising. This is particularly evident around the eyes with surgery on the face especially nose and forehead. Rarely the swelling around the eyes may result in closing the eyelids. Swelling and bruising may occur down the neck, and occasionally the chest, when surgery is performed on the lower part of face and upper part of neck. To help reduce swelling and bruising apply a cold pack (ice cubes or frozen peas in the bag) for 15-20 each hour while awake for the first eight to 24 hours after surgery. Sleeping propped up on a few pillows or in a reclining chair may help decrease swelling of the face after surgery of the head and face area. Swelling and bruising should improve 5-7 days after surgery.
Recovery is usually very straightforward. Overall, resting as much as possible the first few days after surgery is helpful.
Stitches (sutures) are usually removed at clinic anywhere from four to 14 days from the date of surgery. Your doctor will let you know what date to return for stitch removal. .
Most patients are able to return to work or school the next day after surgery.

What Things I Should Report to You After My Surgery?

If you experience any of the following symptoms, notify us immediately:

Temperature above 38, chills or shakings.
Nausea, vomiting, or shortness of breath
Heavy bleeding from the incisions.
Oozing of blood or fluid beyond the first day after surgery
Worsening and /or spreading redness around the incision sites
Increasing pain or tenderness after one to two days following your surgery
Any other concerns or problems regarding your surgery, particularly if it appears to be worsening.

In such cases, you will need to be seen at the clinic or go to emergency department if it is after hours. The surgical area may need to be checked for bleeding or infection.

Aftercare

How to care for my surgical site(s) following surgery and what do I need to do after surgery?

Postoperative care is extremely important for the wound healing and the scar that results. You have an important role in caring for your surgical wound. It is recommended to check with your doctor for specific post surgery wound-care instructions.

To make sure that your wound heals properly please follow these guidelines

General Instructions:

Take it easy for at least 24-48 hours after surgery. Strenuous activity may exacerbate bleeding or disrupt the wound.
Make sure that your activity does not impact on the wound. We recommend that you limit vigorous physical activity, excessive bending over or exercise for 7 days after surgery to allow your wound to heal and reduce the risk of wound disruption. Depending on the area and nature of surgery, you may be required to avoid heavy lifting, straining, or strenuous exercise for up to 21 days after surgery. Your doctor will advise you if specific activity precautions are required. Therefore, rarely, you may need to take time off work depending on the nature of your procedure, its location and type of work you do. Talk to your doctor.
Most patients will be able to resume their work the day after surgery as long as they avoid strenuous activity.
If the wound is on your limb, you may need to rest that limb for few days ( e.g. lying down or sitting with your leg elevated or having your arm in sling )
There will be a dressing / bandages covering the site. Most wounds should be kept dry and covered with the initial dressing for the first 2 days, but on certain sites like scalp 24 hours is usually sufficient. After the dressing is removed look after the wound until the stitches are removed. You may bath or shower at any time after surgery, as long as the wound is kept dry.
Dry dressing minimizes the risk of infection. If the wound dressing becomes wet, please change it or attend to clinic to be changed. Clean the area with cooled boiled water or normal saline and pat the area dry clean and apply another dressing if required.
Avoid direct water pressure on the bandage or surgical site until the wound is healed.
From day 3 or day 2 on sites like scalp daily showers aid the healing process. However it is best to avoid swimming pools, oceans and Jacuzzis until the stitches are removed. These may increase your chance of infection
Avoid using Soaps / Creams / Antiseptics (eg - Betadine?, Savlon?, Dettol?) on the wound as they can affect tissue and delay healing.
If the dressing remains clean and dry or you have been told to leave it in place, the dressing should be left in place until your stitches are removed.
You may be required to return to the clinic for dressing changes or for wound inspections depending on wound and as instructed by your doctor.
Stitches are usually removed after 5-14 days depending on the operation and its location.
When you are due for suture removal, we will check your wound to assure acceptable wound healing is happening. In some cases additional procedures are necessary for scar improvement.
Your doctor may give you specific instructions on post-operative care which may include keeping dressing for long period, changing dressing more frequently, applying ointment or taking medications orally to assist healing and minimize the risk of infection.
Avoid applying makeup or powder directly on a fresh wound unless the surface is fully healed
You and your carer will be provided with post-operative care and instructions.

If you have any further queries regarding your wound care please contact us on 0351558300

Will I have Scarring?

Scars are an inevitable part of any invasive surgery. You doctor will endeavour to minimize scarring and to keep your scars as inconspicuous as possible.

Will I need further surgery?

You may need to have further surgery later on. (Most lesions do not require any further surgery).

Follow-up Appointment

You will be advised when to return for dressing change ( if required) and removal of sutures before you leave the clinic.

Cancellation or Re-arrangement of Appointment

If you are unable to attend or no longer need your appointment then please telephone us on 0351558300 and let us know at least 24 hours before hand.

How will I hear about the outcome of the procedure?

You doctor will either write to you with the results when they become available, call you, or make a follow-up appointment for you in the clinic to discuss the results. It frequently takes several days for the skin specimen to be examined and a report to be issued by the laboratory.

What Follow up I Will have for Skin Cancer

You will have follow up appointments after treatment for skin cancer. This is so the doctor can look for signs of the cancer coming back, though this is rare occurrence. The doctor can check if you have had any problems following treatment. They can also examine you for signs of a new skin cancer, and give you preventative advice. Once you have had one skin cancer you are more at risk of getting another.

General Information

What changes to look out for? Skin cancer Warning Signs

¨ New moles, lump or freckles

¨ Change in size, shape or colour of an existing mole, e.g. lighter, darker and new shades

¨ A spot that develops a lump within it or becomes raised

¨ A spot or lump that bleeds or weeps

¨ A sore, cut, scratch or ulcer that does not heal

¨ Red/ Pink spot which persists after few weeks or bleeds without history of trauma

¨ Spot that Itches, burns, tingles or has foreign body sensation

¨ Spot that has irregular or notched border

¨ Changes in the surrounding area of moles, e.g. redness, white discolouration, swelling

¨ Spots that looks different from your other spots

¨ Rough, scaly or crusty spot that is sore or persists.

¨ If someone comments on a skin lesion in a place you can?t see yourself (especially the back)

If in doubt see a doctor sooner rather than later.

Are you a high ?risk patient?

If you answer ? yes? to any of these questions, you are at high risk of developing melanoma and you should have regular skin checks.

Did you have melanoma in past?
Do you have more than 5 atypical moles ( moles that are unusual and often larger than other moles and have irregular borders and color may not be uniform)?
Do you have more than 100 ordinary moles on your body or more than 10 moles on arms?
Do you have moles that have recently changed?
Have you already had any type of skin cancer?
Do you have fair skin that sunburns easily and never tans often in combination with freckles; do you have light hair colour (blonde or red) and/or light eye colour?
Do you have family history of melanoma? A close relative (father, mother, sibling or child) has been diagnosed with melanoma.
Have you been exposed to excessive sun intermittently or regularly as child or adolescent? Did you get sunburns and blistering as child or adolescent?
Are you intermittently exposed to strong sunlight?
Are you exposed to strong sunlight at regular intervals? You work outdoor.
Have you been exposed to sunbeds (tanning beds) especially before the age of 30?
Do you have a weakened immune system? Immune system may be weakened by certain cancers, illnesses or medications like certain chemotherapies, medications used after organ transplant (immunosuppressant) or those used for treatment of conditions like rheumatoid arthritis.
Are you a male over the age of 55?
Do you have large moles which were present at birth (congenital melanocytic nevi)?
Have worked in arc welding?

If you are a high-risk patient, you should:

¨ Examine your skin at least four times a year e.g. at the start of each new season.

¨ Have total body skin examination with medical professional at least once a year.

¨ Your doctor may also suggest you have mole map.

¨ If you do not know your risk, it is strongly recommended that you have a full skin check with an experienced doctor to assess your risk and develop an ongoing surveillance program.

Facts about Vitamin D & Sun Exposure:

The sun is the best natural source
Made when skin is exposed to UV
Difficult to get enough vitamin D from diet alone
Vitamin D has 30?60 days storage in the body
Exercise helps with production
Sunscreen use should not put people at risk of deficiency.

Who is at risk of deficiency?

Pigmented skin
Lack of skin exposure to sun
Age & Obesity
Treatments/medication affecting Vitamin D

Sept ? April (UV 3 and above)

Sun protection required.
Produce sufficient vitamin D from UV exposure received during typical outdoor activities.
Need a few minutes of mid-morning or mid-afternoon sun exposure.

May ? Aug (UV below 3)

Sun protection not required unless:

Near reflective surfaces (snow)

Outside for extended periods

Be physically active outdoors in the middle of the day, with some skin exposed, for most days of the week.

Skin and Mole Check - Why?

Early detection is the key!

Regular checks give you a good chance of detecting sun spots early which means potentially avoiding cancer.
Melanomas are potentially lethal cancers which can strike healthy individuals and at times can grow and spread rapidly. Most melanomas grow silently without symptoms. Regular skin examination will increase the probability of detecting melanoma at an early and treatable stage. Fortunately, with the use of dermoscopy, skin cancers can be detected now at an early stage.
Early detection improves the outcome for melanoma and other serious skin cancers. Skin cancer is curable if it is detected early enough. In fact 95% of skin cancers can be successfully treated if detected early.
Cancer can appear on parts of the body which are not exposed to the sun and that may be hard to see, so checking the whole skin regularly is important.
Skin checks will help you get to know your own skin and gain a greater understanding of what is normal on your skin and what is not, which will help you in identifying any new or changing areas of your skin

Why make skin cancer prevention a consideration?

Australia and New Zealand have the highest rate of skin cancer in the world
Two out of three Australians will develop some form of skin cancer before the age of 70
Skin Cancer is the most common cancer in Australia. In fact Australians are four times more likely to develop a skin cancer than any other form of cancer
Melanoma is the 3rd most common cancer in bothAustralian women & men & the most common cancer in Australians aged 15-44 year
Sun exposure has been identified as the cause of around 99% of non-melanoma skin cancers and 95% of melanoma
Skin cancers especially melanoma can be lethal cancers.
Skin cancer is largely preventable

When you?re in the sun& UV is 3 or higher don?t forget to:

Slip on a shirt: Cover up with protective clothing to guard.

Slap on a hat: Cover your head with a wide brimmed hat, shading your face, ears, and neck. If you choose baseball cap, remember to protect your ears and neck with sunscreen.

Slide on sunglasses: close fitting or wrap-around and meet Australian Standard rated for 99% to 100% UV absorption to provide optimal protection for the eyes and surrounding skin and to be worn all year round, where practical.

Slop on Sunscreen: use sunscreen and lip balm with a sun protection factor (SPF) 30 or higher, and should be water resistant, apply a generous amount, 20 minutes before going outside, reapply every two hours and after swimming, toweling dry, or sweating Use sunscreen even on hazy or cloudy days.

Seek shade: Shade can be natural (trees, shrubs etc), man ? made or a combination of both. Note: As a rule of thumb if you can see the sky, you are less than fully protected.

The following information is taken from Cancer Council Victoria and SUN SMART websites.

Skin cancer

What is skin cancer?

Skin cancer is the uncontrolled growth of abnormal cells in the skin.

Skin cancer occurs when skin cells are damaged, for example, by overexposure to ultraviolet (UV) radiation from the sun.

Anyone can be at risk of developing skin cancer, though the risk increases as you get older.

Skin cancer facts & stats

The incidence of skin cancer in Australia is one of the highest in the world, two to three times the rates in Canada, the US and the UK.
2 in 3 Australians will be diagnosed with skin cancer by the age of 70.
Around 2,000 Australians die from skin cancer each year. In 2012, 2,036 people died from skin cancer in Australia. The majority of these deaths were due to melanoma, with 1,515 deaths from melanoma that year, compared with 521 deaths from non-melanoma skin cancers. The five-year relative survival rate for melanoma is 90% for Australian men and 94% for Australian women.
between 95 and 99% of skin cancers are caused by exposure to the sun
GPs have over 1 million patient consultations per year for skin cancer
Skin cancers account for about 80% of all new cancers diagnosed each year in Australia. Each year, Australians are 4 times more likely to develop a common skin cancer than any other form of cancer.

Non-melanoma skin cancer is the most common type of skin cancer. This type of skin cancer is more common in men, with almost double the incidence compared to women. Over 434,000 people are treated for one or more non-melanoma skin cancers in Australia each year.
Excluding non-melanoma skin cancer, melanoma is the third most common cancer in both Australian women and men. The most commonly diagnosed cancer among adolescents and young adults is melanoma; it accounts for more than one-quarter of all cancers among Australians aged 15?29 years. In 2011, 11,570 people in Australia were diagnosed with melanoma.

Skin cancer already cost the health system around $300 million annually over a decade ago, the highest cost of all cancers. More recently it has been calculated that the total cost of skin cancers (other than melanoma) alone was $512.3 million in 2010 (diagnosis, treatment and pathology).
It is estimated that approximately 200 melanomas and 34,000 other skin cancer types per year are caused by occupational exposures in Australia.
In 2013, 374 Victorians died from melanoma.
Eighty-nine per cent of Victorians are alive five years following a diagnosis of melanoma. This has improved significantly from 85% in 1985.
In Victoria, melanoma is the fifth most common cancer overall. 2,307 Victorians were diagnosed with melanoma in 2013 (that is equivalent to six diagnoses every day).
Melanoma is the fourth most common cancer for Victorian women (behind breast, bowel and lung).
Melanoma is the fourth most common cancer in Victorian men (behind prostate, bowel and lung).
Research shows that using solariums before the age of 35 boosts the risk of melanoma by 59%.
Over the past decades, the incidence of skin cancer has risen in Australia. From 1982 to 2010 melanoma diagnoses increased by around 60%. From 1998 to 2007, GP consultations to treat non-melanoma skin cancer increased by 14%, to reach 950,000 visits each year.

What causes skin cancer?

The main cause of skin cancer is exposure to ultraviolet (UV) radiation. The sun produces UV radiation but it can also come from other sources, such as solarium tanning machines

Most parts of Australia have high levels of UV radiation all year round.

This radiation cannot be seen or felt but can cause:

sunburn
skin and eye damage
premature ageing of the skin
damage to the skin cells, which leads to skin cancer.

Each time your unprotected skin is exposed to UV radiation, it changes the structure of cells and affects what they do.

Exposure to UV radiation permanently damages the skin. This damage adds up over time. The most important years for sun protection are during childhood. However, increased protection against sun exposure will help prevent skin cancer at whatever age it's used.

Skin cancer is related to two factors: a person?s total lifetime exposure to UV radiation and the pattern of exposure they have had. Research suggests that while skin cells are often damaged in childhood, it may be sun exposure in adulthood that triggers these damaged cells to turn cancerous.

Sometimes melanoma happens by chance and isn't linked to sun exposure, but this is uncommon.

Sunburn

Sunburn causes 95% of melanomas, the most deadly form of skin cancer.
In Australia, almost 14% of adults, 24% of teenagers and 8% of children are sunburnt on an average summer weekend. Many people get sunburnt when they are taking part in water sports and activities at the beach or a pool, as well gardening or having a barbeque.
Sunburn is also common on cooler or overcast days as many people mistakenly believe UV radiation is not as strong. This is untrue ? you can still be sunburnt when the temperature is cool.
Sun exposure that doesn't result in burning can still cause damage to skin cells and increase your risk of developing skin cancer. Evidence suggests that regular exposure to UV radiation year after year can also lead to skin cancer.

Solariums

The major cause of skin cancer is exposure to UV radiation from the sun and artificial sources, including solariums. The levels of UV radiation emitted from solariums can be up to six times as strong as the midday summer sun.

Solariums emit UVA and UVB radiation, both known causes of cancer. Cancer Council Australia does not recommend solarium use for cosmetic tanning under any circumstances.

*Research shows that people who first use tanning machines (solariums) before the age of 35 have an 87%** higher risk of developing melanoma.

In 2009, the International Agency for Research on Cancer re-classified solariums as a Group 1 carcinogen ? in the same category as tobacco and asbestos.

Research published in 2008 found that 281 melanomas, 43 deaths, and 2,572 squamous cell carcinomas were attributable to solarium use in Australia each year, at a cost to the health system of around $3 million.

Tanning

A tan is not a sign of good health or wellbeing, despite many Australians referring to a ?healthy tan?. There is no such thing as a safe tan ? whether from the sun or a solarium. Tanning is a sign your skin cells are in trauma and the more that your skin is overexposed to UV radiation, the greater your risk of skin cancer.

Almost half of Australian adults still hold the misguided belief that a tan looks healthy.
Tanning is a sign that you have been exposed to enough UV radiation (from the sun or solarium) to damage your skin. This will eventually cause loss of elasticity (wrinkles), sagging, yellowish discolouration and even brown patches to appear on your skin. Worst of all, it increases your risk of skin cancer.
A tan will offer limited protection from sunburn, but usually no more than SPF4, depending on your skin type. It does not protect from DNA damage, which can lead to skin cancer.
Some people who use fake tans mistakenly believe that a tan will provide them with protection against UV radiation. As a result, they may not take sun protection measures, putting them at greater risk of skin cancer.
If you must have a tan, then use fake tan, but remember that sun protection is still required.

Risk factors

People at higher risk of skin cancer

Anyone can develop skin cancer, regardless of their skin colour or general health. However, the risk is higher for people who:

Have a large number of moles on their skin. Adults with more than 10 moles on their arms and more than 100 on their body should have their skin checked regularly by their GP or a skin specialist (dermatologist).
have dysplastic naevi
have previously had a skin cancer and/or have a family history of skin cancer
have actively tanned or used solariums or sun beds
have skin that's more sensitive to UV radiation. This includes people who have pale or fair skin; people who burn easily and don't tan; and people with light-coloured eyes.
have experienced short, intense periods of exposure to UV radiation (such as on holidays or during sport). People who occasionally get heavy sun exposure (e.g. on weekends or on holidays) may be more at risk, especially if they get sunburnt.
have a history of severe/blistering sunburns especially in childhood. Too much sun exposure before the age of 15 greatly increases the chance of getting melanoma in later life because damaged cells have more time to develop into cancer. Studies show that people who move during adolescence from low to high UV radiation countries, such as England to Australia, develop melanoma at a lower rate than people born there.
have worked outdoors. People who are frequently exposed to UV rays through regular sun exposure or solarium use are also at risk.
have a weakened immune system, which could be due to taking certain drugs that suppress the immune system.
Are over 50 years of age

People with olive or very dark skin have more natural protection against skin cancer because their skin produces more melanin than fair-skinned people. However, because UV radiation is so strong in Australia, very dark and olive-skinned people still need to protect their skin.

Talk to your doctor about your risks for skin cancer. Your GP can give you advice about checking your skin.

Family history

Sometimes melanoma runs in families. For most people this is due to factors such as similar skin type or too much sun exposure in childhood. However, in a small number of people (5% to 10%), melanoma may be caused by an inherited faulty gene.

Risk factors for family skin cancer include:

a personal history of melanoma at an early age; the average age to be diagnosed with melanoma is 33 years
a personal history of more than one melanoma
many moles on your skin; more than 10 on the arms and 200 on the body
many unusual moles
a blood relative diagnosed with melanoma at an early age
a blood relative diagnosed with more than one melanoma
a blood relative diagnosed with melanoma of the eye.

If you're concerned that you have family risk factors, talk to your doctor about having regular skin checks. To find out more call Cancer Council on 13 11 20.

A large number of moles

The more moles you have on your skin, the higher the risk of the most dangerous type of skin cancer ? melanoma.

Moles are overgrowths of melanocytes (a type of skin cell). We are not normally born with moles, but most of us will develop some on our skin by 15 years of age.

The number of moles we develop is determined by genetic (inherited) factors and exposure to ultraviolet (UV) radiation.

Australians tend to have more moles than people living in other countries, possibly because of childhood sun exposure.

Useful links

http://www.cancervic.org.au/

http://www.sunsmart.com.au/

http://www.cancer.org.au/

http://www.melanoma.org.au/

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