Skin cancer: Busting myths

Skin cancer, while highly survivable, does occur in sunny Singapore, with over 4,100 cases of non-melanoma skin cancer (the most common type locally) diagnosed from 2019 to 2023, according to figures from the Singapore Cancer Registry. 

Clin Assoc Prof Claramae Chia, Senior Consultant, Dept of Sarcoma, Peritoneal and Rare Tumours, SGH and NCCS, debunks common skin cancer myths. 

To celebrate Skin Cancer Awareness Month this May, Clinical Associate Professor Claramae Chia, Senior Consultant, Department of Sarcoma, Peritoneal and Rare Tumours, Division of Surgery and Surgical Oncology, Singapore General Hospital (SGH) and National Cancer Centre Singapore (NCCS), and dermatologists from the SGH Department of Dermatology debunk common skin cancer myths and share ways we can protect ourselves. 

Myth 1: Skin cancer only affects those with lighter skin 

Skin cancer can occur in people with any skin tone (Credit: iStock.com/Meeko Media) 

Fact: People can get skin cancer regardless of how pale or dark their skin tone is. While it is true that having more melanin (the natural pigment found in the skin) confers some protection, people with darker skin tones can develop certain types of skin cancer, including melanoma, basal cell carcinoma, and squamous cell carcinoma. In particular, acral melanoma, which affects the palms, nail beds and soles of feet, occurs at similar rates across all skin types. 

Alarmingly, because many people believe this myth, skin cancer is often diagnosed late in people with darker skin. 

What you can do:

- Look out for common symptoms by using the following ABCDE acronym to monitor existing spots or moles for suspicious changes: 

Asymmetry or irregularity in shape

Border irregularity

Colour changes

Diameter growth to larger than 6mm

Evolution or changes, which can include bleeding 

Look out for common symptoms of skin cancer using the acronym ABCDE (Credit: iStock.com/colematt) 

- Also look out for new spots that appear suddenly and increase in size. 

Myth 2: Skin cancer always looks like a dark, irregular mole

Fact: Skin cancer presents in different ways. It can appear as a dark or irregular mole, pink or red patches, scaly skin, or more subtle changes to normal-looking skin. 

What you can do:

- Check your skin regularly (e.g. once a month) for the following:

1.      A mole that is changing (follow the ABCDE rule above) or looks different from other spots on your body

2.      A new growth or lump

3.      A sore that won’t heal

4.      A persistent rough, scaly patch

Myth 3: Sunscreen is only necessary when you’re at the beach or on sunny days

Sun protection is needed every day for protection against UV radiation exposure. (Credit: iStock.com/krungchingpixs) 

Fact: Daily activities that involve sun exposure like walking outdoors or sitting near a window can contribute to cumulative ultraviolet (UV) radiation exposure, the primary cause of skin cancer. Up to 80 to 90% of UV rays can penetrate cloud cover, which makes sun protection important even on cloudy, overcast days. 

What you can do:

- Always apply sunscreen in the daytime. Remember, UV rays can also penetrate glass (e.g. windows and windscreens). Use sunscreen that is at least SPF50 and contains broad UVA protection.

- Reapply sunscreen every 2 hours when outdoors for long periods, as sweat and water can wash away sunscreen.

- Wear a hat, sun-protective clothing and use a UV-resistant umbrella when outdoors. 

Myth 4: Laser treatments will increase your risk of skin cancer 

Fact: Laser treatments that are used for dermatology and cosmetic procedures do not increase skin cancer risk. These treatments use focused light energy to target the skin and do not use radiation which can cause cancer. 

What you can do:

- Visit qualified and reputable professionals to receive laser treatments to avoid burns, scarring or unwanted changes in pigmentation

- Find out which procedures make the skin more sensitive to UV radiation, and use additional sun protection after those procedures

- Know that sun exposure or the use of tanning beds are primary contributors to skin cancer 

Myth 5: Gel manicures and pedicures DO NOT increase my risk of skin cancer

The UV lamps often used to set nail polish used in gel manicure and pedicures emit radiation that contributes to skin cancer and skin ageing. (Credit: iStock.com/Serhii Sobolevskyi) 

Fact: Getting a gel manicure or pedicure does increase your risk of getting skin cancer, as the gel nail polish is set for several minutes under UV lamps which emit the same radiation that contributes to skin cancer and premature skin ageing. 

While UV exposure from a single gel manicure session is relatively low, there have been documented cases of skin cancer in the fingers and hands of people who regularly use UV nail lamps. 

What you can do:

- Apply sunscreen to hands, fingers, feet and toes, or wear fingerless UV-protective gloves when undergoing gel manicures and pedicures

- Limit the frequency of going for gel manicures and pedicures

- Visit salons with LED lamps instead of UV lamps, as LED lamps pose a lower risk of causing skin cancer 

If in doubt about worrying spots, lesions on your skin or unusual changes to your skin, consult a qualified dermatologist.