I’m not worried about skin cancer because I tan easily… Besides a good tan protects me from being sunburnt 

We have all heard the slogan “there is nothing safe about a tan”. A tan is your body’s response to damage caused by UV radiation. This is true even if there is no redness, peeling or pain. Tan is your body trying to protect itself by making the skin thicker and darker through the deposition of melanin. The protection afforded is minimal and far outweighed by the harmful UV damage required to induce the production of melanin. Even if you tan easily, you are at risk of skin cancer. 

I don't need sunscreen as my makeup protects my skin 

Makeup is not sufficient to protect skin from prolonged sun exposure. Most cosmetics are not designed to protect from UV radiation and do not have a sun protection factor.  Some cosmetics such as foundation and moisturizers do contain sunscreen. It is important to ensure the SPF is high enough (recommendation is SPF >30), and that the product is applied with enough volume, and reapplied regularly enough to provide adequate protection.  

I put on SPF 50+ this morning so I can stay in the sun all day 

Sunscreen does not provide complete protection from sun damage. SPF 30 filters roughly 96.7% of UV radiation whilst SPF 50 filters 98%. Skin protection benefit is marginal above SPF 50. 

Most people don't put on enough sunscreen and don't reapply sunscreen often enough to achieve the quoted protection factor. Even with the regular application of sunscreen, if you are in the sun too long you can still cause skin damage and still burn. 

I don’t need to wear sunscreen in winter or on cool cloudy days 

UV rays are present all year round. UV radiation cannot be seen or felt. It is UV radiation that causes cellular damage, not temperature. Short periods of intense sun exposure, as well as cumulative sun exposure, are associated with skin cancer and ageing. The UV index on cool cloudy winter’s day can be as high as on a hot summer’s day. UV radiation can travel through or be reflected by clouds. This can result in the UV index being higher on a cloudy day compared to if the skies were clear.  

Skin cancer is not a big deal, it’s easy to treat and not very dangerous 

More than 2000 Australians die each year from skin cancer. It is important to address any suspicious skin lesions early. In addition to being life-threatening, skin cancer causes significant morbidity. Roughly 60% of Australians will develop skin cancer before the age of 70. The treatment of skin cancer is diverse and may involve topical creams, surgical excision, radiation or various medications.  These treatments all have side effects. Surgery can be disfiguring, radiation can cause long-term tissue damage and medications can cause adverse reactions. The morbidity associated with skin cancer is significant and impossible to quantify. 

I’m too young to worry about skin cancer 

Australia has the highest rates of melanoma in the world. This aggressive skin cancer is the most deadly of all types of skin cancer. In Australia melanoma is the most common form of cancer in adults aged 15-39. It is the third most common cancer in Australian men and women.

I need to go to a "skin clinic" for the best treatment 

There are several avenues to get treated. General practitioners treat many skin cancers in Australia. Skin clinics are often run by general practitioners with an interest in skin cancer. Beyond this, the majority of skin cancers are treated by plastic surgeons, general surgeons, dermatologists and radiation oncologists. These groups all have an overlap in the treatment of skin cancer with different skill sets. It is not uncommon for complex cases to be treated by multidisciplinary teams involving a group of specialists with different specialities and skills. 

Marc Langbart.png

By Marc Langbart
Specialist Plastic and Reconstructive Surgeon
Prince of Wales Private Hospital
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Dr Langbart is a specialist plastic surgeon with an interest in skin cancer and head and neck cancer. After gaining a fellowship from the college of surgeons he underwent further fellowship training in microsurgery at Guy’s and St Thomas’ Hospital in London. This focused on the treatment and reconstruction of advanced head and neck malignancy.

He is a member of the Head and Neck as well as complex skin multidisciplinary teams at the Prince of Wales and Liverpool hospitals. He operates in private and public hospitals in both Randwick (Prince of Wales Private and Prince of Wales Public Hospitals) and Liverpool (Sydney Southwest Private and Liverpool Public hospitals.) 

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