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Sun, sense and suspicious moles

Nurturing

KNOW YOUR SKIN If you have any of the risk factors, especially fair skin and more than 50 moles, it is worth considering mole-mapping.

Health

Andrew O'Brien

Did anyone notice that strange yellow thing in the sky over the bank holiday weekend? I believe it was a relative of the sun. It couldn’t have been the real thing; that much sun and only 14 degrees? Come on! Still, it was great to see it.
We took advantage of the combination of days off and sunshine and headed out to Diamond Hill and Connemara National Park at Letterfrack. I assume most of the wonderfully active folks around here know the place, but if you haven’t been either recently or at all, then I suggest you take a drive. Unfortunately, the good folks at The Mayo News haven’t signed me up for my travel advice though, so instead I’m going to get in early and talk about the risks of the sun.
Skin cancer awareness has risen significantly in Ireland in the last ten years, probably because the number of diagnoses has risen. It is reported that in 2015, there were 11,785 cases of skin cancer in Ireland. Of these, 1,118 were melanoma, the most serious form of skin cancer. The number of skin cancer cases is due to rise to 18,989 by 2040, at a conservative estimate. While it should be noted that while many skin cancers are relatively benign, melanoma is an extremely serious issue that demands immediate attention.

Risk factors
Melanomas can develop anywhere on your body, and typically look like a mole. They most often develop in areas that have had exposure to the sun, such as your back, legs, arms and face, but can also occur in areas that don’t receive much sun exposure, such as the soles of your feet, palms of your hands and fingernail beds.
Most people have between ten and 45 moles, which have generally appeared (and even disappeared) by the age of 50. People at greater risk of melanoma include those with fair skin, a high number of moles (more than 50), a history of severe, blistering sunburn, excessive exposure to UV light through sun exposure or tanning beds, a family history of melanoma and a weakened immune system.
If you have any of the risk factors above, especially fair skin and more than 50 moles, it is worth considering mole-mapping, where all of your moles a measured and photographed. This gives you a reference point if anything changes over time.

What to look for
Are all moles a problem, then? Not always. Normal moles are generally a uniform colour with a distinct border separating the mole from the surrounding skin. They’re oval or round and usually smaller than half a centimetre in diameter. To identify abnormal moles that may be melanomas, the letters ABCDE are useful.

A is for asymmetrical shape; moles with irregular shapes, such as two very different-looking halves.
B is for border; irregular, notched or scalloped borders are characteristics of melanomas.
C is for changes in colour; look for growths that have many colours or an uneven distribution of colour.
D is for diameter; be aware of any change in size of a mole, especially already large moles.
E is for evolving; look for changes over time, be that size and shape as above, or new symptoms, such as itchiness or bleeding.
I often add another category to the list above. Ugliness. Yes, I know beauty is in the eye of the beholder and all that, but if you see a mole that is ugly or angry looking, or that ticks any of the ABCDE signs, don’t waste any time getting it checked.

Slip, slop, slap
While it isn’t technically a physiotherapist’s job to diagnose skin cancers, we tend to see areas of peoples bodies that don’t always get looked at, and thus become de-facto mole mappers. I have sent numerous people to their GPs over the years to get moles checked. In the space of a month some years ago I told three different men to make immediate appointments with their doctors. Two were diagnosed with melanoma and the third had a particularly nasty looking mole that the doctors chose to remove just in case.
How do you protect yourself from skin cancer and melanoma then? If you don’t know the answer to that, I would suggest the rock you have been living under may well protect you from skin cancer as well! For those that have forgotten though, I will use the 1980s Australian advertising campaign slogan: slip, slop, slap. Slip on a shirt, slop on some sunscreen and slap on a hat.

Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.