Skin Enemy Number One – The Truth About Hidden Skin Cancers

Living in forever sunny South Africa means we’re all skin cancer aware right?
Not always. Incidental UV exposure can be just as damaging and dangerous as beach days.


What’s the last thing you do before leaving the house for school drop off?
Sunscreen on the kids?
And what about slathering it on your arms and hands that are going to rest on the wheel for thenext 20 minutes?

While car windows may protect you from UVB rays (these are responsible for sunburn), they can’t cut UVA. Those are the ones that penetrate the skin more deeper, leading to sun damage – which means skin ageing and sometimes, skin cancer.
This type of accidental or incidental exposure means that the UV rays hit the skin and we’re not even aware of it; or, simply haven’t planned for it. “Typical examples include walking the dogs, walking to and from the car, sitting next to a window (unless UV resistant treated), driving our cars, reflection off surfaces and so on,” explains aesthetic medical practitioner Dr Alek Nikolic, founder of SkinMiles and While we typically do most of our damage in our younger years, the issue is – even if you think that brisk oncearound the block with Max wasn’t for very long – all sun exposure adds up.

What Lies Beneath
Apart from protecting yourself every time you encounter the sun, what’s the best way to ensure you’re ahead of potentially
devasting skin cancers? “Visit a dermatologist yearly for a full skin analysis,” advises Dr Nikolic. Your healthcare professional will also know where to look for what’s known in dermatology as “atypical places” for skin cancers. These include under finger or toenails, in the mouth, on the scalp, on the palms of hands or soles of feet, in the groin area and even under the arms. While keeping checks on moles is very important, you may not see changes as a doctor does and inspections are an ongoing
process. “For most of us, sun exposure and damage tend to be accumulative; however, just having a few severe exposures,
still leads to sun damage and increases the risk of skin cancer,” says Dr Nikolic.

Common Ground
According to reports by CANSA, “Skin cancer is the most common cancer worldwide and South Africa has one of the highest
monitored ultraviolet (UV) levels in the world, resulting in one of the highest skin cancer rates globally.”
“Skin cancer, however, means different diagnoses for different people, and with different outcomes. The most common types are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma,” reports CANSA. “Most patients are
surprised with a BCC diagnosis, “says Dr Nikolic, and he urges those diagnosed to treat these seemingly non-threatening spots. “They tend to grow slowly and do not spread or cause death; however, they do cause local skin destruction. If left untreated it will eventually need surgical excision with a skin flap that will leave scarring.”

Stranger Things
What if you hear terms like Merkel cell carcinoma from your doctor after your skin cancer check-up?
This lesser-known type (Kaposi’s sarcoma and cutaneous T-cell lymphoma are others) may just look like a pink, red or purple
bump. Not to be mistaken for a sore or cyst, this skin cancer needs treatment too. While it’s rare it can be fatal, so those body scans with your dermatologist are vital, especially if you’re seeing marks on your skin that weren’t there before.
It’s the same with cutaneous T-cell lymphoma. Patches or bumps of unexplained rough, scaly skin?

Get them checked. Kaposi’s sarcoma may not be something you’re aware of at all. It crops up in intimate spots like the genitals
and mouth (thanks to the underlying cause of cancer that forms in the lining of blood and lymph vessels). A gynae appointment is a good time to ask about the appearance of any purplish skin spots down there.

EVERY DAY, all day
Sunscreen at the ready? Every day, no matter the weather (“cloudy days can be just as damaging as sunny days,” says Dr Nikolic), apply an SPF 30 or higher that contains zinc oxide and/or titanium dioxide. Reapply every two hours. For make up
wearers, try a mineral SPF brush that doesn’t cause greasiness or shine. Neither does it interfere with your products.