Life after treatment for skin cancer

Will I get more skin cancers?

If you’ve had skin cancer, you have a higher risk of getting more. You’ll need regular checks-ups to see if the cancer has come back and check for new ones. It’s common to have check-ups every 3–6 months if you had a high-risk cancer, and every year for low-risk cancers. People who have a weakened immune system may have more frequent check-ups. Your doctor will tell you how often they need to examine you.

It’s very important to avoid more skin damage, check your skin often, and see your doctor if you notice a change.

Sun protection and UV

After a skin cancer diagnosis, you need to take special care to protect your skin from the sun’s UV radiation. UV radiation is not the same as sunshine – UV levels can be high on a cloudy day or at the snowfields.

The UV index shows the intensity of the sun’s UV radiation. It can help you work out when to use sun protection. An index of 3 or above means that UV levels are high enough to damage unprotected skin. Using a sunscreen daily when the UV level is forecast to be 3 or above has been shown to reduce the risk of skin cancer. But when UV levels are 3 or more, you need to use more than one type of sun protection, including protective clothing, a hat, sunscreen, sunglasses and seeking shade.

The recommended daily sun protection times are the times of day the UV levels are expected to be 3 or higher. The daily sun protection times will vary according to where you live and the time of year.

Some medicines and health conditions may make the skin more sensitive to UV radiation, causing it to burn or be damaged by the sun more quickly or easily. Ask your doctor if this applies to you and if there are any extra things you should do to protect your skin. You may need to use sun protection all the time, whatever the UV level is.

Vitamin D

UV radiation from the sun causes skin cancer, but it is also the best source of vitamin D. People need vitamin D to develop and maintain strong, healthy bones. The body can absorb only a set amount of vitamin D at a time. Most people can get enough vitamin D through incidental exposure to the sun, while using sun protection. When the UV index is 3 or above, this may mean spending just a few minutes outdoors on most days of the week, depending on where in Australia you live and the time of year. However, people with naturally very dark skin tones, who do not burn, may need longer sun exposure to get enough vitamin D.

After a diagnosis of skin cancer, talk to your doctor about the best ways to get enough vitamin D while reducing your risk of getting more skin cancers. Your doctor may advise you to limit your sun exposure as much as possible when the UV index is 3 or above. In some cases, this may mean you don’t get enough sun exposure to maintain your vitamin D levels. Your doctor may advise you to take a supplement. Overexposure to UV is never recommended.

How to protect your skin from the sun

Most skin cancers are caused by exposure to the sun’s UV radiation. When UV levels are 3 or above, use all or as many of the following ways to protect your skin as possible. After a diagnosis of skin cancer, it is especially important to check your skin regularly and follow SunSmart behaviour.

Slip on clothing

Wear clothing that covers your shoulders, neck, arms, legs and body. Choose closely woven fabric or fabric with a high ultraviolet protection factor (UPF) rating, and darker fabrics where possible.

Slop on sunscreen

Use SPF 50 or SPF 50+ broad-spectrum, water-resistant sunscreen and apply every morning. Apply 20 minutes before going outside and reapply every 2 hours, or after swimming, sweating or activity that rubs it off. For an adult, use about 7 teaspoons of sunscreen to cover the full body. If you’re wearing protective clothing, use 1 teaspoon for each exposed arm, leg, or face, neck and ears.

Slap on a hat

Wear a hat that shades your face, neck and ears, such as a legionnaire, broad-brimmed or bucket hat. Check that the hat meets the Australian Standard. Choose fabric with a close weave that doesn’t let light through. Baseball caps and sun visors don’t offer full protection.

Slide on sunglasses

Protect your eyes with sunglasses that meet the Australian Standard (with a lens category of 2, 3 or 4). Wraparound styles are best. Sunglasses should be worn all year round to protect both the eyes and the delicate skin around the eyes.

Seek shade

Use shade from trees, umbrellas, buildings or any type of canopy. UV radiation is reflective and bounces off surfaces, such as concrete, water, sand and snow, so shade should never be the only form of sun protection you use. If you can see the sky through the shade, even if the direct sun is blocked, the shade will not completely protect you from UV radiation.

Don’t use solariums

It is not safe to use solariums. Also known as tanning beds or sun lamps, solariums give off artificial UV radiation and are banned for commercial use in Australia.

Check daily sun protection times

Each day, use the free SunSmart Global UV app to check the recommended sun protection times in your local area, and use sun protection when the UV is 3 or above. For more information, visit SunSmart. You can also find sun protection times at the Bureau of Meteorology or the BOM Weather app or in the weather section of daily newspapers.

Changes to your appearance

Skin cancer treatments such as surgery, curettage and electrodesiccation, and cryotherapy often leave a scar. In most cases, your doctor will do everything they can to make the scar less noticeable. Most scars will fade with time. Skin treated with radiation therapy may change in colour, and appear lighter or darker depending on your skin tone. Talk to your radiation therapy team about the best options for skincare.

Talk to your doctor or nurse about treatments that can help improve the appearance of scars, such as silicone gels and tapes and non-perfumed creams (e.g. sorbolene). Steroid injections to flatten out lumpy scars may also be an option for some people.

You may worry about how scars look, especially on the face. Cosmetics, your hairstyle or clothing may help. You can talk to a counsellor, friend or family member about how the changes make you feel.

I had skin cancer removed from my arm followed by a skin graft from the same arm. I have a large ‘indent’ from the removal of the cancer and a large scar at the donor site. I didn’t expect the amount of pain and appearance changes.

David