Skin Cancer and Primary Care Dermatology

The skin is the largest organ in the human body that has the vital role of protecting the rest of our body from the external environment.  The skin is vital to regulating your body temperature, protecting you from physical and chemical injury and keeping out microbes that would otherwise cause serious infection. It also stops water from getting in and getting out of your body and allows you to sense things in the external environment.  So looking after your skin contributes significantly to your health and wellbeing.

There are hundreds of various medical conditions that can affect the skin. Many of these are rare conditions and others very common.  They can generally be grouped into categories including:

  • Genetic – an abnormality in your genes that can cause or predispose to a skin condition
  • Autoimmune – your body’s own immune system causes skin problems
  • Infective – skin manifestations of an infective illness (e.g. viral rash) or infections of the skin itself.
  • Allergic – skin reactions to the external environment (e.g. contact dermatitis, eczema)
  • Malignant (Cancer) – Most often caused by UV light exposure (the sun and tanning beds) but can also be caused by some diseases, genetic predisposition and some medical treatments.
  • Aging – as we age skin becomes thinner and provides less of a barrier.  It can also be injured easily and often takes longer to heal than when we were younger
  • Chronic disease – many chronic diseases such as blockages of blood vessels, varicose veins and diabetes (to name just a couple) can also affect our skin in various ways.

At EMC our GPs can assist in identifying many skin issues and providing timely advice, treatment and/or referral.  A number of our doctors have additional training in skin cancer identification and treatment and are available to perform full skin checks.  Our receptionists will be able to tell your which of our doctors offer this service and book you in for a regular skin check.

In addition, Dr Graeme Fearns has formal qualifications in primary care dermatology and is able to offer advanced dermatology assessment and advice.  

Skin Cancer

We live in a country with a warm climate and high levels of UV radiation from the sun.  Sun exposure is responsible for about 99% of non-melanoma type skin cancers and about 95% of melanoma in Australia.  About two-thirds of Australians are diagnosed with skin cancer before the age of 70 and about 400,000 Australians are treated for skin cancer each year. Over 1800 Australians die from skin cancer each year.  We can address these issues through prevention and early detection:

  • Prevention has had major coverage through the media since the early 1980s with the “slip, slop, slap” campaign. This is especially important with increasing UV levels over recent decades.  Preventing harmful UV rays from contacting the skin will markedly reduce the risk of skin cancers in most people.  In people with light skin, 10 minutes of sunlight each day in the mid-morning on the face, neck and arms is sufficient for adequate levels of Vitamin D in most people.  For people with darker skin little longer is required.  Using sunscreen does not markedly affect your Vitamin D production so this should not be a reason not to use it.
  • A self-check of your skin should be done at least every 3 months.  This can be done in good lighting in front of a mirror.  It also helps if you have someone that can help you check hard-to-see areas on your body.  There are a few things that you should look for that would prompt you to see your GP for a check:
  • About 80% of melanoma type skin cancers do not arise from an existing spot (i.e. they arise anew), which means about 20% do.  Even though sun exposure is a big risk factor, melanomas can also arise anywhere, not just in sun-exposed areas.  You should have any pigmented spots that worry you checked by your GP, however, a good assessment tool such as the ABCDE methods can assist and if any of these qualities are present it should prompt a GP review:
  • A – Asymmetry: when you imagine a line down the middle of the lesion and one side of the line is not a similar shape to the other, it is asymmetrical.
  • B – Border irregularity: when you look at the border, it is irregularly if there is not a nice neat curve at the edges.
  • C – Colour variation: if the colour varies within the lesion.
  • D – Diameter: if the diameter is over 6mm.
  • E – Evolution: if it is changing or growing larger.
  • Other skin cancers can be pink, red or skin coloured an commonly are found in sun exposed areas.  Important things to look for are:
  • Change in size, shape or elevation above the surrounding skin.
  • Tenderness of the lesion and surrounding skin.
  • Bleeding, especially recurrent bleeding.
  • Not resolving over an extended period.
  • An annual skin-check by an experienced doctor.  This interval may be shorter if you have had previous skin cancers and this would be discussed with you at the time of diagnosis.  All other people should have an annual skin check.  We have several of our GPs that offer full skin checks and all of them can assess any specific lesions of concern.  Most of our GPs are also skilled in minor skin surgery and some are skilled at more advanced surgery such as skin flaps and skin graft procedures. More information can be provided by our reception staff of by checking our doctor profiles.