Skin cancer prevention

Sunburn is painful. That is one good reason to try to prevent it. An increased future risk of skin cancer is another. Sunburn can double your risk of skin cancer. It is important to avoid the sun when it is at its most intense. Sunbeds are not a safe alternative to tanning outdoors. Remember to

• Spend time in the shade between 11 and 3
• Make sure you never burn
• Aim to cover up with a T shirt, hat and sunglasses
• Remember to take extra care with children
• Then use factor 15+ sunscreen

People most at risk are those with fair skins, lots of moles or freckles, or a family history of skin cancer. The SunSmart website has lots of information about protecting you and your children in the UK and abroad.

The sun is at its strongest in the middle of the day, between 11am and 3pm. During this time, stay in the shade when you can. If there's no shade, the best way to protect your skin is with clothing. At least wear a T shirt, hat and sunglasses. Remember that the sun will reflect from the surface of water. So you are much more likely to burn if you are in or near water. You should cover up or use sunscreen that is at least factor 15 and preferably water resistant.

The amount of protection you get from your clothes varies depending on the type of material. The closer the weave of the fabric, the more likely it is to keep the sun off. Thin, loose weave fabrics such as cheesecloth give very little protection. Close weave cotton (T shirt material) gives quite good protection.

In the UK manufacturers of clothing (particularly children's clothing) are beginning to put sun protection factor labels in their clothes. The higher the number the more protection the clothing will give. Wet fabric can stretch and lose some of its ability to protect from the sun. There are now sunsuits available to give children and adults greater protection on the beach.

Wear a hat with a brim to protect both your face and the back of your neck. Babies and children should always wear brimmed hats in the sun. Baseball caps may look good, but they leave the back of your neck and ears completely exposed. Much better is the foreign legion type, with a cloth flap that covers the back of your neck. These are now widely available for babies and young children.

Don't forget to protect your eyes. Wear good quality, wrap around sunglasses. Wrap arounds stop the sun from getting in at the sides. Buy these for children too – toy sunglasses can do more harm than good. When choosing sunglasses, look out for

• Either the CE mark or British Standard mark (BS EN 1836: 1997)
• A UV 400 label
• A label saying the glasses give 100% UV protection

This is becoming a subject of more and more debate. There are doctors and researchers who are beginning to think that sunscreens could be harmful because they encourage people to stay out in the sunshine for longer. They think that the protection the sunscreens give you against burning may not actually stop people increasing their risk of skin cancer. The only way to be absolutely sure of reducing skin cancer risk is to avoid over exposing your skin to the sun. If you must get a tan, do it gradually so that you minimise the damage to your skin.

Using a sunscreen is better than getting burnt so here is what we know about them.

Sunscreens are all tested the same way. It is the the level of protection they give you against the sun that matters more than the price. This is the sun protection factor or SPF. The SPF tells you the amount of protection the sunscreen gives against UVB radiation. We recommend at least factor 15. 

Choose a sunscreen that says it is broad spectrum. This means it protects against both UVA and UVB radiation from the sun. In the UK we measure UVA protection with the star system. So you will see UVA protection on your sun cream measured between 0 to 5 stars. But, this is only a rough guide because the number of stars depends on how much UVB protection the sunscreen offers. For example, an SPF 25 with 3 stars may screen out more UVA overall than an SPF 10 with 4 stars.

Don't assume that because you have put on sunscreen, you can stay out without burning. Keep an eye on your skin (and your children's skin) at all times. Children have thinner, more delicate skins than adults and are at higher risk of burning. It is best to use waterproof sunscreen because it is less likely to be sweated or washed off.

Do check the use by date. Most sunscreens will last about 12 to 18 months after opening  ̶̶  so it is fine to use last year's, but not a bottle from 5 years ago!

You should put your sunscreen on before you go in the sun. Then put on another layer to make sure you haven't missed any bits. Put it on before anything else so it is next to your skin. If needed you should apply moisturiser, insect repellant or make up afterwards. This is particularly important if you are using an organic (chemical) sunscreen. Most sunscreens now include a moisturiser and some also include an insect repellant.

It is crucial that you apply sunscreens generously and regularly. Sunscreens do rub off. Even if they say they are waterproof, they may come off when you are swimming. In order to get the best protection, you must re apply them often – at least every two hours. And more frequently if it is washed, rubbed or sweated off.

Sunscreens only work if you use enough. Nearly everyone puts them on much too thinly. Thinly applied sunscreens don't give as much protection as it says on the bottle. You should be able to see it and spread it very easily. If it all disappears as soon as you start rubbing it on, you haven't used enough. About a golf ball sized dollop should do for small children.

If your whole family only uses one bottle throughout a 2 week holiday, you definitely aren't putting it on thickly enough. It can be expensive, but it is worth it as protection against skin cancer.

Usually, the higher the SPF, the more the product costs. We recommend using at least factor 15.

There are no laws that the people who make the sunscreens must test them. But there are laws about what they can say about them. If they say a sunscreen has a particular SPF, it has to have been tested. And the companies have to be able to show the evidence that this is true. There is more information about choosing a sunscreen in our cancer questions and answers section. The European Commission is looking at the information people who make sunscreens must provide to try and make it easier for people to understand.

Some people worry that they may not get enough vitamin D if they don't sunbathe. In fact, a fair skinned adult will make enough vitamin D with only 15 minutes in the sun, 2 or 3 times a week. Spending longer in the sun won't help you make more. Once you have healthy levels, the body just gets rid of any extra.

Most of us will make enough during the summer to last the winter. Some people are more at risk of low vitamin D levels such as those with darker skins and older people. There is more about vitamin D on Cancer Research UK's SunSmart website. If you are worried that you may be lacking vitamin D, talk to your GP.

Babies and young children have thinner and more delicate skin than adults. So their risk of getting sunburnt is much higher. The information under covering up in the sun will give you the main tips on how to protect babies and children in the sun. But there are other things to think about.

There is more information in the schools section of the SunSmart website. Schools can help to protect children by

• Developing their own school sun protection policy
• Including sun protection into the school curriculum
• Making sure they provide enough shade in the school grounds

Parents

Children are often too busy running around to worry about looking after their skin. But as a parent you can really reduce the amount of skin damage your children receive early in life. You can

• Find out why it is important for parents to protect their children's skin
• Read tips about how you can keep children safe from the sun

It is also important that you make a habit of checking your own skin. If you find any new abnormalities on the skin that don’t go away after 4 to 6 weeks or existing ones that are getting bigger you need to get your GP to look at them. This is especially important if you are at a high risk of getting skin cancer or have had treatment for a previous skin cancer.

Look at the page on symptoms and risk factors in this section of CancerHelp UK and make sure you know if you are at risk and what to look out for.

If your GP is worried that a skin abnormality may be a skin cancer they will refer you to a skin specialist. How quickly you get a referral will depend on the type of skin cancer your GP thinks you may have. Depending on local NHS services you may be referred to a rapid access suspected skin cancer clinic. The National Institute for Health and Clinic Excellence (NICE) have written guidelines for GPs so they know when to refer someone with a suspected skin cancer to a specialist. You can look at these guidelines for seeing a specialist in this section of CancerHelp UK.

There are private walk in skin clinics in the UK. But before you pay for this type of service, do make sure you know exactly what method of screening they use and whether it is reliable. Check if the people carrying out the screening are medically qualified – sometimes they are not. If you want a skin lesion checked then it is best to see your GP.