The ‘over 50’ years are regarded as the time to consider reaping your lifestyle dividend. These years are characterised by an increase in recreational time and they are also years when skin can be easily neglected.
It is never too late to take steps to protect your skin. Every time we go into the sun our skin cells are bombarded with radiation that damages their DNA. Some of that is repaired but some remain, and as we age that damage steadily accumulates so that each dose of sunlight becomes more and more critical and every hit increases the risk of cancer.
Studies have shown that when adult sunscreen users are compared with non-users the two groups separate in only a matter of months in terms of the development of new sunspots.
I have often been asked, “What are the best skin products I can buy for my skin?” Regardless of age, my answer is “A good quality broad-spectrum 50+ sunscreen.”
I am also often asked about vitamin D deficiency and the role of sunscreens. Bone health has become a major focus for the over-50s. As we age, the building blocks for vitamin production in our skin lessen, reducing our ability to make it. Because sunscreens reduce UV on the skin, it is not surprising that they may reduce Vitamin D production. This means that we need a safe strategy to aid our vitamin D levels.
Because of the way that vitamin D is produced in our skin, the most efficient way to naturally top up our levels is with small amounts of sun exposure regularly. This is also the safest. It doesn’t take very long with the sun on our uncovered arms in the mid-morning to give the boost we need. Big hits of sun just don’t work. In fact, once your skin cells have produced their vitamin D from the stored precursor in the skin, the sunlight actually burns up and degrades that vitamin D, as well as the skin.
For some people, even this careful sun exposure may not be worth the risk. If you are taking immunosuppressant drugs, or if you have a particular predisposition to developing skin cancers then you should consider instead taking a vitamin D supplement. You should discuss this with your family doctor.
Skin cancer is the most common type of cancer treated in Australia every year and the incidence rises with age. By the age of 75, 1 in 3 Australian men and 1 in 4 women, will be diagnosed with some form of skin cancer.
Prevention is down to taking care in the sun. With sensible use of sunscreens, choice of activities and clothing we can do a great deal to reduce our risk.
The next step is detecting precancerous and cancerous lesions. It seems only logical that the best way to go about this would be communitywide screening, but the evidence shows that this is wasteful of resources and doesn’t materially improve detection and survival over targeted checking.
Dermatologists are trained in all facets of skin disease management including skin cancer and to see one you will need a referral from your family doctor. Family doctors are ideally placed to initially assess and advise regarding your skin cancer risk. If that risk is high or you have complex health needs they may refer you to a dermatologist.
You can also effectively check yourself for worrying changes. This is especially effective if you have a full skin check from a doctor as your “baseline.” To do this you need a full-length mirror, a handheld mirror and good light. An observant partner also helps. You check your front facing the full-length mirror. To check your back you stand with your back towards the full-length mirror and use the handheld mirror to check your reflection from all angles. Your hairdresser or partner may help you with your scalp – ask them if they see anything there.
What you look for is anything that seems unusual on your skin, a spot that looks like none of your others, or spots that are growing or changing and of course any sores that don’t heal. With moles, we look for “lone rangers” – moles that have no similar appearing partner. Once you do this a few times you will become familiar with your body and be able to recognise these changes. You should do this regularly, about every three to four months. If you find something, go to a doctor for a trained opinion.
Your skin should not be taken for granted. It is not just a wrapping, but an important organ whose health and wellbeing will have a direct impact on every aspect of your life.
Dr Andrew Miller, President of the Australasian College of Dermatologists