Mr. Paul Banwell is one of the UK’s leading plastic surgeons and world-wide authority on skin cancer. He has a specialist interest in skin cancer and is the Head of the Melanoma and Skin Cancer Unit (MASCU) at the Queen Victoria Hospital.
Q: Can Nutrition Boost Levels of Sun Protection?
A good diet with plenty of healthy fruit and vegetables will ensure maximum benefit from antioxidants – try goji berries or blueberry smoothies for a tasty antioxidant fix that will help to strengthen skin. It has also been shown that oral Vitamin D might be beneficial to guard against melanoma, a potentially lethal form of skin cancer. A large clinical trial is currently looking at a variety of lifestyle factors to determine which are most important, but we will not know the results for a couple of years.
Obviously sun protection factors are also essential to boost your level of sun protection and an SPF of 30+ should be ‘de rigueur’. And don’t forget to try sunscreens with a tint. Remember that SPFs not only protect against skin cancer they also minimise the effects of photo-ageing. The only other beneficial method to improve your sun protection is to use the immune protectant Niacinamide. This is a vitamin B3 complex and has been shown in scientific studies to confer benefits against skin cancer formation (it also has benefits for acne sufferers too). Topical pharmaceutical grade Vitamin C contained in cosmeceutical products has also been shown to enhance sunscreen protection against free radical damage. I recommend trying products from Medik8 or Rationale Skin Care.
Q: Can Self Tan Provide Protection?
A lesser known fact is that some self tanning agents contain compounds DHA (dihydroxyacetone) and riboflavin that protect the skin from visible light damage. They create opaque chromophores (filters) on the surface of the skin which guard against potential damage, but remember that you should not substitute SPF protection for a self tanning product.
Q: Can Sunbeds ever be Beneficial?
No, no and no again! Getting some natural sun is fine as long as it is in moderation – we need it for vitamin D and also psychologically it is beneficial.
The facts about Skin Cancer
Q: Tell us a Little Bit about Skin Cancer
Skin cancer is now the most common cancer in the world. There are essentially two different types: non-melanoma skin cancer (NMSC) and melanoma. The latter is less common, but has the highest mortality and unfortunately it can affect younger people. The lifetime risk of developing skin cancer in Australia is one in three, compared to about one in 40 in the UK. While the incidence of skin cancer in the UK is significantly less than Australia, our mortality figures are higher and the number of people who have skin cancer in this country is expected to dramatically increase in the next decade. Raising awareness is therefore vital, as early prevention and diagnosis is the key to successful treatment. Getting a tan is no longer cool and the attitude ‘it won’t happen to me’ just doesn’t cut anymore – for instance, in Kent and Sussex we have seen an alarming trend in skin cancers affecting the younger age-groups. Changing behavior and educating parents and their children is vital.
Q: What signs should we Look out for regarding skin cancer?
Look out for new or existing moles that are darkly pigmented, change in colour and/or size, have an irregular outline and itch, bleed or crust. If you are unsure or concerned that you may have one or more of these symptoms, visit your GP. He or she will examine your skin and would be able to refer you to a Plastic Surgeon with a specialist interest in skin cancer.
Q: How can we Reduce the Risk of Developing Skin Cancer?
Australia has dramatically decreased rates of skin cancer with the introduction of sun protection programmes such as the ‘slip, slop, slap, now wrap’ campaign. Sun awareness is vital and really does have an effect. Avoid the hottest part of the day (between 11am and 3pm), apply liberal amounts of sunscreen with a Sun Protection Factor (SPF) of 30+ and wear a hat, loose clothes (tightly woven) and sunglasses. The face and neck are the areas most commonly affected by sun damage, so be sure to apply sunscreen to lips, ears, around eyes, neck and scalp if your hair is thinning.
A history of sunburn when young puts people at an increased risk of developing skin cancer later in life. Fifty per cent of total lifetime sunlight exposure occurs in childhood, so be particularly careful with children too; if they are exposed to the sun, dress them in sun-suits or long-sleeves, hats and sunglasses and apply a liberal amount of high SPF sunscreen regularly. Schools are becoming increasingly aware of the darker side of the sun and are introducing stricter rules and regulations in the summer months.
Q: And What about Our Eyes?
Sunnies are an essential fashion (and health) item and it is very good idea to wear sunglasses at all times. A great excuse to be a diva!!! It definitely increases protection and can prevent direct UV damage to the eyes (Peratitis, Cataracts, Pterygium and Macular Degeneration) as well as helping to prevent skin cancer around the eyes (Periocular). Interestingly the incidence of Periocular skin cancer is rising and I am treating more patients with this every year.
Good lenses are also advisable. Pilots especially have recognised the importance of good eye lenses (a new company www.bigatmo.com, owned by a pilot is just launching some fashionable eyewear with top quality lenses).
Q: Why do we have such a Massive Vitamin D Deficiency in the UK? Does This Mean we Need a Certain Amount of Sun? If so, how much?
Around 50% of the adult population in the UK have sub-optimal levels of vitamin D and about 15% have ‘severe’ deficiency during winter and spring. The average British worker nowadays will work indoors, not out in the field (outdoors) as in previous generations. With modern technology turning our homes into high-tech zones, many adults and children will choose to stay at home watching television or playing on computer games as opposed going out for walks, gardening or playing outdoor sports.
Exposure to the sun is essential for production of vitamin D by the skin (rickets is seen is adults and children who do not have sufficient sun exposure) but it is important, as with all things that you do not have excessive sun exposure. It is fine to have 20 to 30 minutes of exposure to the sun two to three times a week, after which you can put on a hat or sunscreen.
Mr Paul Banwell is a Consultant Plastic and Cosmetic Surgeon. He has a specialist interest in skin cancer and is the Head of the Melanoma and Skin Cancer Unit (MASCU) at the Queen Victoria Hospital. He consults privately in East Grinstead, Brighton, Tunbridge Wells and London.