- By Arwen Mohr
It can be alarming to find a spot on your skin that might be something worrisome, especially if you have had a lot of sun exposure, someone in your family has had skin cancer, or you have had skin cancer yourself.  One common question is: how do I know if a spot could be skin cancer? This can be especially important for people who have many moles, especially since having many moles can also increase skin cancer risk.
The Skin Cancer College of Australasia has a helpful way to remember what signs to look for to determine if a skin spot is worrisome: SCAN your skin.
S - Sore - is the spot painful, tender, burning, itchy, bleeding, scaly or showing symptoms in another way?  This is especially important if the spot doesn't heal in six weeks.  
C - Changing - it can be hard to tell if a spot is changing (size, shape, colour, texture) so taking a photo to compare one to three months later can be helpful. If you decide to see a healthcare professional for the spot, the photo could also be helpful for them to see and compare your photo to how the spot looks when they examine it.
A - Abnormal - is the spot different than the other ones on your body? 
N - New - any new mole especially after the age of 40 should be checked. There are skin spots that can be confusing because they do appear after age 40 and are harmless, so if you are unsure, the best way to know if a spot is worrisome is to have it looked at by a skin cancer medicine doctor. This can be done as a single mole check, but it’s often better to have a full skin check since that one concerning mole may actually be one of many that might be discovered. Now is a good time because in winter and early Spring  it’s easier to cover up after needing a skin biopsy, excision, or topical treatment. Even if that concerning spot ends up being nothing to worry about, it will be a relief to know!

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By Dr Arwen Mohr
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We know that sunscreen lowers the risk of melanoma and non-melanoma skin cancers.  We also know that more people die from skin cancers than from road deaths each year in New Zealand.  We should all be using sunscreen then, right?  But what about in winter months?  What kind of sunscreen is best?  What if I hate wearing sunscreen – what do I do then?  These are all common questions that are important.
For the first question, the easiest way to know if you need sun protection is to check the UV Index.  If this is 3 or above, you should have sun protection to protect you from skin cancer.    In the winter months when the UV Index is 2 or less, you don’t need to worry as much about protecting your skin from the sun.  It’s always good to check the UV Index.  There are apps such as the Sunsmart app and UVNZ that can tell you this information quickly.  If the UV Index is 3 or above, it’s important to protect every part of your body that could contact sunlight.  This is commonly done with sunscreen.  Even if you’re great about applying sunscreen, it’s important to make sure you apply it before you are in the sun and reapply it regularly – think about sweat, clothing friction, swimming, and ingredient breakdown due to exposure to sunlight (which means it’s working).   
There are many different types of sunscreen available, such as fragrance-free, and alternatives to cream such as gels.  Since 2022 all sunscreen creams in NZ are regulated under the Sunscreen (Product Safety Standard) Act so you can trust the product to do what it says on the label. As long as it is SPF 30 or higher, the best sunscreen is the one that you will use, so it’s good to find one that you like.  You can also choose to avoid the sun during the time that the UV Index is 3 or above by spending time in the shade, or wearing clothing, hats and sunglasses that protect against the UV effect of the sun.  There are many options for UV-protective clothing and hats that are lightweight and comfortable even in warm weather.  
UV radiation can begin to damage your skin in as little as 5-15 minutes, and this skin damage isn’t just skin cancer, but includes photoaging such as wrinkles and pigment changes.  Whilst the cancer causing UV levels go up and down, the lightwaves that contribute to aging and wrinkles are present all day, year round.  This is a great reason to make broad spectrum UV protection part of your daily routine every day. Your future self will thank you for protecting your skin!

 One question that medical professionals are often asked is "do I need a full skin check?".  For some people there is an easy answer: if you have ever had a skin cancer (eg. BCC, SCC or melanoma), then you should have a full skin check every year
to check for new skin cancers.  People who have had a skin cancer are at higher risk of developing another and it is better to catch any new skin cancers early.

For those without a personal history of skin cancer, the ones who would benefit most from a full skin check are those with a higher than average risk. This includes people with a strong family history of skin cancers (especially melanoma), lots of spots, high-risk skin types (i.e. fair complexions), a history of significant sun
damage, and those who have worked predominantly outdoors for more than 10 years. 

There are a few tools you can use which can help determine your risk of developing melanoma and they are worth a look.
The Skin Cancer College of Australasia has a tool for calculating skin cancer risk:
www.scanyourskin.org/risk-prediction-tool
The Melanoma Institute of Australia also has a calculator for melanoma risk:
www.melanomarisk.org.au/FirstMelLand
(select Tasmania as a similar latitude location to us here in New Zealand).

At Nelson Skin Doctors our team of expert clinicians are able to provide full body skin examinations to check for skin cancer, or we can provide an opinion on a spot or two.  We offer a range of treatment options for concerning spots including freezing with liquid nitrogen, treatment with chemotherapy creams and surgical excision of lesions in our dedicated procedure room.  Please contact us so we can discuss which option will work best for you.

We've hit the ground running!  We had an excellent response to our opening special with appointments booking out.  We've seen a large number of skin cancers detected and removed already with more scheduled for removal in the coming days.  A huge thank you to all the team - Caroline on reception (both in the office and remotely), and Bridget and Sally our amazing nurses (and Jills of all trades), it really been a team effort.   6 weeks in and it's been a rollercoaster but so many smiles and always a happy and relaxed vibe.  The word is getting out and we're getting an increasing number of referrals by word-of-mouth which we take as a big compliment.  A big thank you to everyone who has been supporting us and everyone who has come through the doors.  We feel honoured to be able to provide this service for our community.  Remember that coming into winter is a great time to get your skin checked as many treatments for sun-damage are best done when the sun isn't as strong.   Book in today - we'd love to welcome you in to our fantastic clinic.

We are so proud to finally have the doors open and be offering high quality skin cancer services right in the heart of Nelson.  It's been a busy week and we feel really honoured to have had so many people through the doors.  We've had great feedback on our friendly and welcoming space and our love of Lego flowers has been appreciated.  Thank you to all our supporters.