You most likely know if you are prone to high or low blood pressure; have a history of heart disease in your family; or whether or not you are diabetic.
But knowing your exact skin type is just as important, says Dr Neil Reddy, the Medical Director of Precision Healthcare.

“The fact is that people with pale skin tend to burn more easily than those with darker skin, and need to take extra precautions in the sun,” he explains. “In Ireland, we are traditionally pale and tend to burn more easily than many other races.”

Yet every year when the sun shines, we ignore the fact, peel off our clothes and expose our delicate translucent skin to the sun, heightening the risk of skin cancer later in life.

And you don’t have to be lying on a beach to burn. A recent study by the Irish Cancer Society found that the largest increase in sunburn is amongst affluent city dwellers from repeated exposure to the sun – most likely when they are going about their everyday business.

In fact, skin cancer is the most common form of cancer in Ireland with over 10,000 new cases diagnosed in men and women in 2013. In the same year there were 2,983 cases of breast cancer.  

The National Cancer Registry of Ireland (NCRI) expects this number to double by 2040.

And the rate of Melanoma (skin cancer) is doubling year-on-year in both Ireland the UK says Dr Reddy.

He points out that skin cancer typically presents years after the damage has been done so much of it has to do with the fact that we exposed our skin on foreign holidays from the late 70's on.

“After the 1960s we had more disposable income and for first time in history, we had the chance to go abroad on package holidays to hot countries like Spain,” he explains.

“The culture at the time was to acquire a tan. But unfortunately most Irish skin is simply not made to take the sun and as a result we collectively did a lot of damage to our skin and we’re seeing the results now.”

In fact there are six different types of skin pigment, which respond differently to Ultra violet (UV) light. These are known as the Fitzpatrick Scale and most Irish people fit into the top three types.

Type I always burns and never tans. It’s usual in people with pale, white, blonde or red hair and blue, grey eyes.

Type II usually burns, tans minimally and is found in people with white, fair, blonde, brown or red hair and blue, green, or hazel eyes.

Type III meanwhile, burns mildly and tans uniformly and is found in people with any hair color and usually brown eyes.

Of course, as the demographic of Ireland has changed and other nationalities have come to live in our country, it’s now possible to find all six skin types anywhere in the country. 

But by knowing your skin type, you will know how tolerant you are to the sun and it could save your life.

“I would go so far as to say that everyone should be made aware of their skin type and how to protect it in school,” says Dr Reddy.

“Some people for example will simply never tan and they should mostly avoid the sun as it will simply cause damage later in life.

“It’s similar to smoking: if you know what your are getting into, you won’t start.”

He adds that a certain amount of sun exposure is necessary as we all need Vitamin D.

“Interestingly those with the palest skin have an evolutionary advantage in that they absorb Vitamin D faster than other skin types and so need the least amount of sun exposure. Just 10 to 15 minutes a day will do for someone with pale skin,” he says.

“After that you need to cover up or at least protect your skin with a high factor sun cream. Even wearing a hat can make a huge difference.”

People with darker skin though need longer in the sun to absorb the right amount of Vitamin D and also need to wear a lower factor sun cream.

“It’s about knowing your skin type and the sooner we become aware of it the better,” says Dr Reddy.

About Dr. Neil Reddy
MB BCh BAO (Hons), B.Med.Sci, LFOM, MSc (Health Informatics), MSc (Clinical Education)

Dr. Neil Reddy of Precision Healthcare is a Licentiate of the Faculty of Occupational Medicine of the Royal College of Physicians of Ireland. He has extensive experience in the design and delivery of health screening and wellness programmes for small and large clients, including several multinational companies.

As the weather improves and government restrictions ease, we are spending more time outside.  It is important to remember to protect your skin from the sun.  Dr. Neil Reddy from Precision Healthcare  speaks to us about the signs of melanoma skin cancer and reminds us that there is no such thing as a healthy tan.

The Truth about a Tan

Skin Cancer is one of the most common forms of cancer in Ireland and even a short time spent in the sun without protection is risky.  There is no such thing as a healthy tan. A suntan may be cosmetically desirable, but in fact it is a sign that your skin has been damaged and has attempted to protect itself. Here is what you need to know –

UVA activates melanin pigment already present in the upper skin cells. It creates a tan that appears quickly but is also lost quickly. UVB stimulates the production of new melanin, which leads to an increase in pigment within a few days. Some UV radiation is essential to the body as it stimulates the production of Vitamin D.

Knowing your skin type and checking your skin for changes is important.

It is important to check your moles

Ideally, check your moles every 3-6 months or if your attention is drawn to the mole incidentally by itching or bleeding. You may have to enlist some help when checking moles on your back. When looking at a mole, you should take note of some important signs. These are easy to remember by thinking of ABCDE –

Asymmetry - when one part of a mole grows faster than another, the mole becomes irregular in shape.
Border - when the faster-growing part of the mole reaches the edge, the border will become irregular, rather than the smooth edge of a stable mole.
Colour - abnormal growth in a mole may cause irregularity in colour, with some light parts, some dark parts, and even some blue or grey parts.
Diameter - a mole that measures more than 6mm in diameter (more than the base of a pencil) should be checked by your GP.
Evolution - any recent changes should be reviewed. A large, irregular, strangely-shaped mole that has been the same since childhood is not a reason for worry. A small mole on a sun exposed area that appeared recently or has begun to grow rapidly is much more concerning.

Tracking and reviewing your moles

It may be difficult to keep track of your moles, especially if you have many, but there are simple ways to manage it.Take photos (with a ruler or a coin for scale) and save to your phone or cloud account. Compare with the previous photos every 6 months –

•    Use an app (such as Mole Monitor) to record the anatomical site of each mole and set reminders to retake the photo every 6 months
•    Attend a clinic for mole mapping. This involves a technician taking magnified photos of all of your moles with a high resolution camera and recording the images on a disk for review at future consultations
•    Attend a healthcare professional for dermoscopy. This involves viewing all of your moles through a magnifying lens with a polarised light and observing for tell-tale signs of abnormal growth

Dermoscopy can be done by some GPs, by specialist screening clinics or by dermatologists.You can get a referral for a mole check with a dermatologist or screening clinic by contacting the Irish Life Health Digital Doctor Service for a video consultation.

Diagnosing Melanoma

If a suspicious mole is identified, your healthcare professional will discuss three options with you:

1. Monitor a review in 3 months - If the mole continues to change, it will be removed. This is generally employed where the mole is on an area not readily amenable to surgery for example on the face.
2. Biopsy - A small (punch) biopsy may be taken of the suspicious mole. This will be analysed by a pathologist and recommendation issued for removal or monitoring. This has the advantage of being less invasive but needs follow-up because of a risk of missing the cancer.
3. Excision of the mole may be the best option where the mole is on an area with few cosmetic risks or the mole is on an area that would be difficult for the person to monitor themselves such as on the lower back.

Read more about skin cancer prevention or visit Irish Cancer Society for more information and a helpful diagram of ABCDE.

Useful Links

Irish Life Health Digital Doctor 

Marie Keating Foundation 

As we move into another balmy summer, it’s worth taking the time to carefully examine our skin for signs of damage. Though it’s lovely to soak up sunshine, even a short time spent under UV rays without protection is risky. We caught up with Dr. Neil Reddy of Precision Healthcare, who explains the different types of skin cancer, shares helpful advice on looking after your skin, and outlines some helpful skin cancer prevention tips and strategies.

What is Melanoma?

You may have heard of the term ‘melanoma’. As Neil explains, it signals a cancer that’s likely to spread quickly, so requires quick action. “Most melanomas are pigmented (dark) spots”, he begins, “occurring on any part of the body. Melanoma tends to spread early, so has a high mortality rate. Surviving it is about detecting it as early as possible.” Non-melanoma cancers meanwhile look distinctly different. In fact, you might not recognise them as an urgent threat at all. “They’re generally non-pigmented red or pink spots (with some exceptions)”, says Neil, “and are more likely to occur on sun-exposed skin like head neck, arms and legs. They don’t spread as easily though, so can normally be cured by simple surgery.”

What to Look Out For

As Neil notes, regularly checking skin is a must, especially looking out for changes. “Melanoma can be recognised as a changing, pigmented spot. The change might be getting bigger, changing shape or colour, or just looking different from neighbouring spots.”

Though non-melanoma is less easy to detect, it’s just as important you detect it. “It’s recognised as a red/pink spot or area of irritated skin that hasn’t gone away for two to three months.” If in doubt, always seek professional advice; it could save your life. “There are many other skin conditions that may look like non-melanoma skin cancer, so it’s always best to check a suspicious spot with your GP, says Neil.” In fact, many GPs are now trained to examine your spots through a handheld microscope called a dermoscope. This will quickly let them know if a spot is benign and doesn’t need removal.

Who’s Most at Risk

Given that we’re such a fair-skinned race here in Ireland, it’s no surprise we’re more susceptible to sun damage and skin cancer. “The people most at risk have blue eyes, red/blonde hair and pale skin”, says Neil. “They usually burn easily or never tan. Those with a family history of melanoma are also more at risk, as are people who take medications that reduce their immune system.” We often have great intentions of applying the factor 50, but surprise sunshine can catch us off guard. “Where many pale-skinned people get caught out is being exposed to sudden, unaccustomed, high levels of sun”, says Neil, “like going on holiday, or attending a once-off outdoor event.” It makes sense then to be prepared for sun, even if you’re not expecting intense heat.

Useful Advice

First up, “know your own skin type”, Neil urges, “especially how long it takes you to burn.” If you’re going to be outdoors for longer than that exposure limit, cover up with long sleeves and a hat. “If that’s not possible”, says Neil, “sunscreen may help protect against UV exposure.” He also recommends a handy app that can be used to monitor moles. “Knowing whether a spot has changed requires paying attention. This can be done by taking photos and comparing the photos every three or six months, or using a specifically-designed app, like Mole Monitor.”

About Dr. Neil Reddy
MB BCh BAO (Hons), B.Med.Sci, LFOM, MSc (Health Informatics), MSc (Clinical Education)

Dr. Neil Reddy of Precision Healthcare is a Licentiate of the Faculty of Occupational Medicine of the Royal College of Physicians of Ireland. He has extensive experience in the design and delivery of health screening and wellness programmes for small and large clients, including several multinational companies.