As we welcome the start of the summer season, many of us will be looking forward to getting some much needed sun therapy. Yet despite numerous awareness campaigns and warnings issued over the last ten years over the safety of exposure to the sun and the emphasis on protecting our skin against harmful UV rays, for some of us the safety advice has arrived too late. Sun damage accumulates over time so skin damage caused by the sun is usually a result of repeated over-exposure and burning as opposed to a recent sunbathing episode, meaning it might only be as you get older that the signs become apparent.

So how do you recognise the signs of sun damage? And how can you tell the difference between old age spots and symptoms of what is commonly known as Solar Keratosis?

Well the latter can often present itself as raised, red areas of skin which are itchy, prickly or tender, and as it develops over time as crusty, scaly lesions which won’t heal. It is more likely to appear on areas exposed to the sun, such as the face, arms and even on the lower half of the neck.

It is vital to regularly check your skin for any changes. Whilst damage is less obvious in the winter, if left unchecked the most serious cases can lead to a form of skin cancer, known as non-malignant melanoma.

Fortunately the condition is treatable, so don’t panic, just make sure that you seek medical advice as early diagnosis is important. If you are concerned about yourself or a loved one then log onto this live webTV show where Dr Rob Hicks will be revealing the facts about sun damaged skin and what you should look out for.

Dr Rob Hicks joins us live online at www.studiotalk.tv on Friday 18^th June at 3.30pm to discuss skin damage

For more information visit www.sundamagedskin.co.uk

Sun Damaged Skin

H: Lis Speight, host

A: Dr Rob Hicks, health expert

H: Hello and welcome to Health and Wellbeing, I’m Lis Speight. Now here is an image of normal skin. But here is what skin affected by a condition called Solar Keratosis looks like which often presents itself as crusty or scaly lesions on the skin that won’t heal. Now don’t panic because the condition is treatable and we have some expert advice to help you. Coming up on today’s show: time to change your sunbathing routine, how to recognise the signs of sun damage and advice for diagnosis and treatment. Well joining me in the studio today is health expert Dr Rob Hicks, welcome along Rob, really great to see you today. And now don’t forget this is a live show so if you have any questions or comments for Rob at all please use the box on the screen, click send an it’ll come through to us here in the studio and we really do wnat you to get involved, we really do want to hear from you. Now Rob there’s been plenty of advice and warnings over the last 10 years or so about protecting yourself when it comes to protecting your skin against harmful UV rays. Is sun damage still a major problem and at what age does the problem normally present itself?

A: Sadly it still is a very major problem, we still see people who suffer sunburn, you only have to go out on a sunny day and you’ll see people with the very red marks on their skin that are really going to hurt later on, in general practice we see people with sun damaged skin, with the signs of sun damaged skin, and the Solar Keratosis for example, and every now and then we come across people who have a skin cancer, all of which is down to too much sun. We are getting better at looking

H: Right

A: After our skin

H: Because we do know don’t we? Don’t we?

A: We do know but it’s always that battle, somebody says they feel better with a tan or it’s not going to happen to me or I’m too young. And the bottom line is the damage to the skin starts in childhood

H: Right

A: You get sunburnt when you’re in your childhood years or your teenage years, and that really sets you up for problems in later life. Saying that, you can damage the skin at any time in your life and it’s never too late really to start looking after your skin properly

H: Right. Ok. So we listen to the messages, we don’t always here them. What should we be doing to protect ourselves from the sun?

A: Well I think the first thing is you know to protect the skin from the sun by actually seeking the shade in the middle of the day, so we talk about finding the shade between 11 in the morning and 3 in the afternoon. That’s when the rays are at their most powerful. Using a good sun protection scream, at least factor 15

H: Yes

A: And being liberal with the application. Far too many people don’t put enough on an they don’t put it on regularly enough

H: Right

A: When they’re outside

H: So you can’t just put it on in the morning and then think that’s it I’m done for the rest of the day

A: No if you think about it, in hot weather we sweat so you’re going to be wiping off the cream in that way. If you go in and out of the pool on holiday or the sea on holiday it might get washed off, so these are the times when you need to reapply. And think about sunglasses, a wide-brimmed floppy cap or hat, a peaked cap and sleeves again to protect the skin and one of the important things is not to burn, of course that’s the important thing with regards skin cancers

H: So that’s the main thing is it, burning? So if you don’t burn you should be ok?

A: No the damage will still occur and if you look at the signs – a tan, any level of tan is saying that the skin is damaged

H: Right

A: So that’s how the skin responds when it’s damaged. If you look at wrinkles in the skin, you know you might have a friend whose actually only in their late 20s but look like they’re in their mid 40s, that’s probably down to the fact that they’ve got sun-damaged skin

H: Right

A: So it’s not just the wrinkles but the premature ageing. Then of course we’ve got things like solar keratosis, these sort of rough, often very small areas of skin. I mean they can be as small as a pinhead or as big as a centimetre or two in diameter, and they may be different colours. They may be red, pink, brown – they could be the natural skin colour. And they’re usually, they feel rough like sandpaper

H: Right

A: And what you find is people notice them first off when they’re washing or putting cream on, they think oh there’s something not quite right there, and then they have a good old look and they see that there’s this skin lesion, the solar keratosis

H: Now we have some images actually that we can show you, and many people do have dark spots on their skin, sometimes known as liver spots, and how can they tell the difference between those and solar keratosis? Let’s have a look at some of these images. We’ve got someone’s head here, we’ve got some sort of scabby bits, is that it?

A: Yes, they’re solar keratoses and this is a very, very common place. Obviously that’s exposed. I mean these things develop on exposed areas of the body primarily. They can affect anywhere but the areas that are often exposed to UV, in any sort of weather, the scalp is the perfect example. The hands and the arms and the lower legs, the ear, you see there on the back of this gentleman’s ear, that’s a solar keratosis, the one right at the back there and what’s the area that people forget to protect? They don’t put the creams on their ear, they might do everywhere else

H: Yes

A: But they forget their ears. So again look out for these things on your friend’s and family’s skin behind them, because of course they can’t see these things

H: Yes

A: They may have – this gentleman, he may have been scratching at it, picking at it, he may have noticed it and thought well there’s nothing to worry about, but with the solar keratosis what happens is – is that some of them disappear but they come back, some look like they’re healing but they never quite go away

H: Right. So you know it’s something a little bit different then, really?

A: Yes something that doesn’t disappear within four weeks really deserves a check-up

H: There’s another image here of hands, and of course your hands are always out in the sun, you know even in the winter you don’t tend to put sun cream on your hands do you?

A: No and I think people focus in the summer about looking after their skin, they forget that they may go on holiday or we might get some good weather in the springtime

H: Yes

A: When they should be looking after their skin as well, you see on this person’s hand there’s a brown mark just back from the middle finger. Now that’s, that’s what we call a liver spot or actually more correct an age spot

H: Right

A: Because it’s got nothing to do with the liver whatsoever, it’s just one of those -

H: It just looks like a liver I suppose

A: Old wives’ – yes and then you see the one that’s directly above it, below the ring finger there, that’s likely to be a solar keratosis there. It’s slightly more raised

H: Right

A: And it looks crusty. It doesn’t look like it’s part of the skin, it looks like it’s grown on the skin, and that’s really the marker. But I say to people look, they are difficult even for really trained doctors to identify -

H: Right

A: And distinguish, so if you’re at all worried, come in and get it checked. No doctor’s going to mind

H: No

A: If they say well actually it’s nothing to worry about. They’d rather you come in, be reassured it’s all ok or if it’s not and it is a solar keratosis, we can treat it

H: Yes. We’ll talk about treatment a little bit later on in the show. But a lot of these photos are of older people. Is that when it normally presents itself?

A: The older you get the more likely you are to develop a solar keratosis, purely because it’s down to the amount of UV radiation exposure you’ve had over the years, so it might be that you’re a sun worshipper, but we’ll often see it because people’s occupations have meant that they spend a lot of time outdoors

H: Right

A: Farming, building trade, looking after gardens for example. They may have spent lots of time doing hobbies and leisure pursuits – golf, cricket, bowls, walking

H: Yes

A: Again when they’re outside

H: And in the winter or the autumn, you don’t’ necessarily think about it do you, but if you’re out all the time in the sun you’re going to catch it aren’t you?

A: Absolutely right I mean if people focus on – it’s nice to hear that people do take note in the sunshine, but even on cloudy days those UV rays can get through, and cause you problems. So you always need to be aware and alert to what might be going on, and if you see any change in the skin that you can’t 100% say I know what this is and I know why this has happened, don’t hesitate to get it checked out

H: Ok. Good advice then. And we’ve had some of your questions coming in, I’ve had one in from Peter – sounds quite worried actually. He says “my girlfriend is obsessed with the sunbed. Surely she must be increasing her chances of long term skin damage? What can I do to persuade her to stop it?” Now are sunbeds still dangerous? Haven’t they filtered out all that dangerous stuff?

A: I think the problem is that anybody who exposes their skin to excessive amounts of UV radiation, whether that’s from sunbeds or the sun itself, are increasing their risk of sun damage and the consequences. One of the reasons we focus on the solar keratosis is although it’s not a cancer, some of them have the potential to turn into cancer

H: Right

A: We don’t know which ones are going to do that so we recommend that they get treated. What he can do to encourage his girlfriend, I think is probably go down the route of the wrinkles of the skin -

H: Yes - “you’ll look old love if you keep doing that”

A: That’s – we all would like healthy, glowing skin forever but you know you’re going to curtail that process if you spend a lot of time exposing yourself to UV radiation so you know cut it down

H: Yes ok. Or maybe use the fake tans – they’re ok

A: What I say to people, if you really, really want a tan, fake it. And there’s so many options these days. Gone are the days when you’re going to be left streaky and -

H: Orange and smelly

A: Smelling of cabbage

H: Yes I mean that’s definitely an option isn’t it, so maybe suggest that instead. Because we all do like to have a bit of a tan because we all feel better and do look healthier don’t you?

A: I think people feel better but the thing is they say they look healthier but of course as we say, a tan means the skin is damaged, it’s your skin crying out saying “please don’t do this to me” - you know, I’m hurting

H: Ok. Another question in from Sylvia – she says “can doctors look at your DNA to see if you’re at high risk?” That’s a good point actually because different skins, different – you know blue eyes, fair skin

A: You can do and there are some genes that have been identified that say that somebody’s more at risk of certain cancers like malignant melanoma, but bottom line is you don’t need to do a DNA test, you can just look at a person. So the fairer the skin they have, the fairer the hair, or red hair, the more freckles they have, the more moles they have, the greater their risk of problems in the future. You know the more likely they have had a lot of – you ask them questions, have you spent a lot of time working abroad, have you spent a lot of time in hot weather? Have you spent a lot of time outdoors getting sunburnt? You know have you got a tan and wrinkly skin? It all adds up

H: Yes

A: To increasing the risk and that’s what I would look at and discuss with a patient

H: Right ok. So if you’re fair skinned – well you know you shouldn’t go out in the sun anyway really, but if you are dark-skinned can you still get solar keratosis?

A: Yes you can, you can, it’s one of these myths that you can’t get damage, you’re less likely to suffer damage but it’s still possible. And so every skin colour, every skin tone needs to take great care

H: Ok. On that sort of same topic really, question in says “I think my grandfather had this condition. Am I more prone to it as a result?” So again a sort of DNA question

A: Yes I mean the solar keratosis is not inherited but the genes that increase the risk of skin damage, so being fair-skinned, lots of freckles and the colour of the hair obviously you do inherit, so if you’ve got somebody in the family who – if you are following that pattern then you are at risk of sun damage but the solar keratosis isn’t directly inherited, no

H: Right well that’s good news, so it’s not too late to protect yourself and stop -

A: No it’s a clear message – protect yourself

H: Yes

A: If somebody in your family’s got it they’ve done something – too much sun, think about that, protect your own skin

H: Yes. Ok well thanks very much for that information. Now we’re talking about solar keratosis and we’re going to be talking about how to recognise it and how to treat it a little bit later in the show, so stay with us

Break

H: Now if you’ve just joined us we’re talking about a condition known as solar keratosis with Dr Rob Hicks. Now more of your questions coming up but first people are often concerned about moles they have on their skin, and ways in which their size and colour changes. Is this an area related to solar keratosis or something completely different?

A: Well it’s related in that the damage to the skin is down to too much UV and it’s very important still for people to keep an eye on moles, they’re looking for changes such as changes in size, colour, shape. If they start to become crusty or itchy or bleed they should promptly get medical advice. What’s very interesting about the solar keratosis is that in a recent survey around about 84% of people asked had no idea what a solar keratosis is

H: Right I hadn’t heard of it actually

A: And the bottom line is -

H: Until this show, I have to say so you know

A: You’re in the majority and this is why it’s so important to raise awareness because a lot of people see these spots, or these rough areas and they just think it’s part of getting older

H: Yes well that’s it because older men do tend to have these scabby bits on their head and what have you, you just do think that’s what your skin does as it ages

A: And for some people it’s not a solar keratosis, it’s a change, maybe it’s a form of dermatitis, or you know, eczema

H: Yes

A: But the important thing is that we just don’t know which ones of these solar keratoses may progress, may change into this squamous cell carcinoma which is why it’s important to recognise them, get them assessed and then get them treated

H: Ok. Question from Darren Mays, he says “I have a lot of moles on my back. What sun factor should I use on them?” Well it sounds like he’s aware which is a start isn’t it? So what should he be doing to protect those?

A: Well I think he should protect those like he protects the rest of his skin. You know you use at least a factor of 15, and higher if you think it’s appropriate. You cover your back and the rest of your body in sleeves and a top when you’re out in the sun, you go into the shade in the middle of the day and the important thing about moles on your back is you can’t monitor them yourself easily

H: No

A: So you need somebody to keep an eye on them. In days gone by we would have said well get somebody to trace the moles so you can look to see if it’s changing shape or it’s outline

H: Right

A: Nowadays of course with digital photography you -

H: That’s easy yes

A: You can do that yourself

H: Yes that’s a good idea

A: And particularly if he’s got a lot of moles and if he’s concerned it might be worthwhile him having them checked every 6-12 months by his doctor, providing they’re not changing in any way. If they change that should prompt a new consultation to have them checked

H: Right ok. Now we’ve all heard about melanoma, but what’s non-malignant melanoma then?

A:Well melanoma – malignant melanoma is the melanoma type of skin cancer, but you get non-melanoma type of skin cancers. The two major types are the basal cell carcinoma and also the squamous cell carcinoma. Both – well all 3 types are caused by excessive UV exposure

H: Right

A: The squamous cell carcinoma tends to affect people in older age, as does the basal cell carcinoma from you know cumulative exposure to sun

H: Yes

A: We see these people, you know people who live a lot of their lives outdoors, whether it’s through work commitments or through leisure commitments. Again they affect the exposed parts of the body, lots on the face, sometimes in the ears, and on the scalp as well. And of course the squamous cell carcinoma is the type of skin cancer that the solar keratosis – may turn into if it’s not treated

H: Right. So we’ve got a question in from Sandra on that actually. She says “is solar keratosis life-threatening?”

A: Well solar keratosis is not life-threatening

H: Right, even though it could turn into cancer?

A: Well even if it turns into cancer the type of cancer, the squamous cell carcinoma tends not to be life-threatening

H: Right

A: However you know if it’s left sometimes the surgery needed to treat it can be quite disfiguring

H: Right

A: And therefore affect a person’s quality of life. But I hasten to add, just because the solar keratosis isn’t life-threatening doesn’t mean that you should leave it alone, ignore it and think it’s nothing to be bothered about. I would always suggest getting it treated so that you reduce that risk, you eliminate that risk of the opportunity of it turning into a squamous cell carcinoma

H: Something worse. Ok now how often should we be checking our skin for signs of change? Is it something people tend to do in the summer more isn’t it, when they traditionally spend more time out in the sun. When should we be checking our skin

A: I think that’s down to an individual really but I think it should be throughout the year and probably you should check your moles and your skin, you know at least once a month if you’ve already got moles. I mean you probably don’t want to be checking every day because that can become a little bit obsessive

H: Yes, yes

A: But generally speaking, you know we do see our skin a lot, when we look in the mirror, when we’re washing or applying moisturiser or indeed sun cream, we feel our skin and so we’ll often noticed, particularly with a solar keratosis, we feel it, we feel that rough, sand-papery texture before we actually even see it

H: Yes

A: Either because the colour is similar to our skin colour or because it’s so small

H: You don’t always look at the back of your arms and -

A: No

H: You know you don’t always look at those bits do you?

A: No and that’s why we should rely on our, you know the members of our family or friends who do get to see the backs of our arms or heads and stuff

H: Poor them really

A: And for them not to be – not to feel awkward about saying -

H: Yes – that looks a bit strange

A: Do you know you’ve got this spot there? If the person knows it’s been checked, fine, but it might be actually that they’re identifying it for the first time which could be very, very important

H: Ok. We’re talking now a little bit about treatments and the importance of early diagnosis, and we have a question in from Frances – she says “is there a way to get rid of sun spots? Is there a cream or something ? What is the safest way to do?” So sun spots or age spots again it’s sun damage. Can she get rid of them?

A: It’s very difficult to get rid of the age spots, like we saw earlier on the gentleman’s hands. Basically sometimes you can use a sort of – a cover up is probably the best option for those

H: Yes

A: Obviously you want to stay out of the sun and protect your skin so they don’t get worse and you don’t get more of them. Solar keratosis relatively easy to treat, they can be frozen with liquid nitrogen, must as we use to treat warts on the skin and varrucas

H: Right

A: They can be sort of scooped out using a local anaesthetic or nowadays we have the benefit of creams and gels that the person can put onto the solar keratosis themself

H: Ok well that sounds a bit of an easier option doesn’t it?

A: Yes I mean well it depends on the individual really what they’re happiest doing but it’s nice to have the choice and the most important thing is these things can be treated

H: Yes which is good news really isn’t it, so don’t be frightened, go to your doctor about it

A: Yes, yes

H: Ok another question in from Giddy Limits – “we are aware that the incidents of skin cancers increase with age. What are the range of options available or is surgery the only option for skin cancer?”

A: Surgery is one of the major options, some people need radiotherapy, some people need chemotherapy as well and of course some people may need the more extensive treatments if – one of the concerns of the dangerous form of skin cancer, malignant melanoma is it spreads round the body so they – people may need chemotherapy if they’ve had a cancer that spread. But again malignant melanoma, and other skin cancers, the sooner they’re diagnosed the earlier they’re diagnosed the better the chance of a complete cure

H: Right

A: One of the problems with these cancers is people ignore them

H: Yes

A: And they don’t come soon enough

H: They hope they’ll go away

A: Yes

H: And the don’t

A: And men tend to be far worse than women at this

H: Yes

A: Because men tend to bury their head in the sand and they think oh it’s nothing to worry about or they are terrified that it is something serious and then they just say well I’m not going to go anywhere near a doctor which is not the right thing to do

H: Yes but solar keratosis certainly can be treated

A: Easily treated

H: But if you do find it, try and get it treated early

A: Yes get along and get it sorted. The sooner it’s done, it’s sorted and the less worry you’re likely to have

H: And are you likely to get more if you have -

A: Yes

H: Right

A: Yes, yes. Even if you’ve had one treated or even if one has gone away on its own, as many of them do, many of them disappear on their own, they do come back sometimes in the same place if they’ve gone away on their own, or if you’ve had them treated you may find that you’ve got another one

H: Right

A: People often find once they’ve found one

H: They’re popping up all over the place!

A: They think oh I’ve got another one! And what’s that I’ve got another one

H: Because they can recognise it

A: Because they’re now familiar, they think well actually that thing that I’ve been scratching at the back of my head, I’ve had checked now and it is a solar keratosis, and a doctor may have said well look you’ve got one there, there, there, there

H: Yes

A: So they often – you often get a handful of them

H: Yes but it can be treated so don’t panic

A: Yes. It’s about not being frightened, it’s getting down there, seeing your doctor, getting the treatment sorted

H: Ok well Dr Rob Hicks thanks so much for coming in and talking us through that, if you want further information you can visit the website which is sundamagedskin.co.uk. And just be safe in the sun, we all love to get out in it don’t we, but put on your hat, slap on your sunscreen and you should be safe. Well thanks to all of you who sent your questions in and we’ll see you next time. Bye bye

Still got a question or comment?

Name

Your question Question

Enter code