Lets Talk Melanoma

In recognition of Melanoma Awareness Month, Dr Farah Mydin explores the facts about melanoma, the most serious form of skin cancer.

Learn how to spot the warning signs, understand your risk factors, and discover why regular skin checks and early detection are so important. This episode is packed with expert advice to help you stay informed, protect your skin, and take action if something doesn't look quite right.

An essential listen for anyone who wants to be more skin aware.

Transcript

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So, welcome back to Let's Talk Skin. I'm Dr. Far, and if you're joining us for the very first time, you picked a good one to start with. Honestly, this episode might just change how you look at your skin forever. No pressure. For my regulars, hello, I've missed you. And yes, if anyone asks, I am still SPFing every single morning, even on the days I'm running late, even the days it's raining in Ireland, which is, let's be honest, most days. So it's May, and which means it's melanoma prevention month. And I felt really strongly about dedicating this whole episode to it. Because this is a topic that sits very close to my heart as a doctor. Melanoma is one of those things that people have heard of but don't always fully understand. And I think that gap in knowledge is costing people their health. Today we're going to fix that. We're going to talk about what melanoma actually is, how to spot it, who's most at risk, how to genuinely protect yourself, and I'll be busting some SPF myths along the way that make me twitch every time I hear them. So get comfy, grab whatever you're drinking, and let's get into it. Okay, so what actually is melanoma? Let's start from scratch because I think it's worth really understanding this properly. Your skin has special cells called melanocytes. Think of them as tiny little artists. Their whole job is to produce melanin, which is the pigment that gives your skin its color. When UV hits your skin, these cells kick into gear and produce more melanin. That's what a tan is. It's your skin's way of trying to protect itself from damage. So when people say, Oh, I just tan so easily, yes, and your skin is basically screaming, please stop, I'm trying my best here. Now, most of the time melanocytes behave perfectly well. But when they're exposed to repeated UV damage from the sun or from sunbeds, they can start to mutate and grow in an unquote uncontrolled way. That's melanoma, and it's a cancer that starts in these pigment-producing cells. What makes melanoma particularly serious is its potential to spread to lymph nodes to other organs if it's not caught early. But here's the genuinely good news. When melanoma is detected at its earliest stage, survival rates are over 98%. Over 98%. That number should feel both reassuring and motivating because it means catching it early is everything. Now, here in Ireland, we actually have some of the highest melanoma rates in Europe, which might seem surprising given that we are we're not exactly known for our tropical weather. We get approximately 11 sunny days a year, and somehow we still manage to burn. It's a gift, really, but the reason is partially genetic. Most of us here, um except me, uh, have fair skin, and that's more vulnerable to UV damage and partly cultural. We're so excited when the sun appears and we tend to just go for it. Sleeves off, garden chairs out, factor zero, full commitment. I understand the impulse completely, but I want to make a case today for why a little preparation can make all the difference. Right. So now we know what melanoma is. Let's talk about how to spot it. Because early detection is where we can genuinely make a life-saving difference. There's a really useful tool called the ABCDE rule. It's a checklist. Five things to look for when you're examining a mole or a spot or skin. I want you to actually remember this. So let's go through it properly. A asymmetry. If you drew an imaginary line straight down the middle of a mole, both halves should roughly mirror each other. If one side is noticeably different from the other, that's worth getting looked at. B is border. A healthy mole has a smooth, well-defined edge. If the border is ragged, notched, blurry, or uneven, pay attention to that. C, color. Most normal moles are a fairly consistent shade of brown. If you're seeing variation, patches of black, different shades of brown, areas of red, white, or even blue, that's a red flag. D is diameter. Melanomas are often larger than six millimeters. That's actually the size of a pencil eraser, if you want a reference point. Um an E is evolution. And honestly, this might be the most important one. If a mole is changing, getting bigger, shifting shape, changing color, or if it started to itch, bleed, or crust, please get it seen. Change is a word. If something on your skin is evolving when it wasn't before, your body is trying to tell you something. Now I want to add one more because some people use A, B, C, D, E, and F. An F stands for funny feeling. I know that sounds unscientific. It is unscientific, but I genuinely mean it. If something on your skin just doesn't feel right to you, it looks different, it feels different, it wasn't there before. Trust your instincts and get it checked. You know your body better than anyone else. My recommendation is to do a self-check once a month. Pick a date, maybe the first of every month, maybe your birthday each month. Your, you know, maybe it's your birthday date each month, something you'll actually remember. Good lighting, a full-length mirror, and if you need to check your back or scalp, rope in a partner or friend. And yes, asking your partner to examine your back for suspicious molds is absolutely a valid form of quality time together. You're welcome. So who is most at risk? Okay, let's talk about this. The risk factors. Because I think understanding your own risk profile really helps you take it seriously. It makes it personal rather than something that happens to other people. People with fair skin, light eyes, and lighter hair are generally at higher risk. If you burn before you tan, or if you just burn and never really tan at all, you fall into this category. Less melanin means less natural protection from UV radiation. A history of sunburn significantly increases your risk. And this is especially true for sunburns in childhood and adolescence. The damage done early in life has a cumulative effect. This is why I feel so passionately about protecting children from sun exposure. Even one or two really bad blistering sunburns in childhood can increase melanoma risk in adulthood. It's not about ruining anyone's summer, it's about protecting them for the long term. Having a large number of moles also puts you in a higher risk group, especially if you have what are called atypical moles, which look a little unusual compared to regular moles. Family history of melanoma is another significant factor. If a close family member has it, has had it, please mention that to your doctor and make sure you're getting regular skin checks. And sunbeds. I have to talk about sunbeds. There is no safe level of sunbed use. Not one session, not just for a special occasion, not I use the lowest session, or I only do it before holidays. The evidence is absolutely unambiguous. Sunbed use increases your risk of melanoma. A spray tan gives you the glow with zero UV damage, so it's genuinely one of the easiest swaps you can make. And I hear more modern spray tans are incredible now. None of that streaky orange situation from the early millennium. We've all grown and technology has grown. Now I want to address something that I think is really important and it's misconception that genuinely causes harm. Melanoma can and does affect people of all skin tones. The idea that people with darker skin are somehow immune is simply not true. What is true is that melanoma in people with darker skin often appears in less obvious places, under the nails, on the palms of the hands, on the soles of the feet, and inside the mouth. And because of the assumption that this doesn't happen to people who look like me, it can go unnoticed for longer, which means it's sometimes diagnosed at a later, hard-to-treat stage. So, regardless of your skin tone, please check your skin, all of it, including those less obvious areas. You deserve the same level of care and vigilance as anyone else. And here's the practical stuff. This is this is my favorite part because this is where we actually do something about all of this. Prevention. Let's talk about what genuinely works. Step one, SPF. Every single day. I can't say this enough times. UV rays don't take days off. They penetrate cloud cover, they come through car windows, they present year-round, even in Irish January. I recommend SPF 30 as a minimum, but SPF 50 is what I personally use and what I recommend to my patients. Apply it to your face, neck, decollottage, and hands. The areas with the highest cumulative sun exposure over a lifetime. Step two, this is one where everybody forgets, including myself, reapply. This is the step that most people skip, and it's such a big one. SPF breaks down with sun exposure, sweat, and water. If you're spending any significant time outdoors, reapply every two hours. There are brilliant SPF mists and sprays that you can that that just really helps reapplying over makeup genuinely easy. So there's no excuses. Problem solved. You're welcome. Next question. Step three, cover up. A white-brimmed hat is honestly one of the most underrated sun protection tools. It protects your scalp, which a lot of people forget is skin too, as well as your ears, your forehead, and the tops of your cheeks. UV protection sunglasses protect the delicate skin around your eyes and reduce your risk of eye-related UV damage also. Lightweight, long, long sleeved layers on a very sunny day are not being dramatic, they're being smart. Step four, seek you need to seek shade between 11 and 3 p.m. This is the window where UV radiation is at its strongest. You don't have to be indoors, just be mindful. Sit under a parasol, find a shaded spot, have your lunch in the shade. You can still enjoy being outside, just not in direct sun during those peak hours if you can avoid it. Step five, ditch the sunbed for good. We've covered this. Embrace it. Step six, get a professional skin check, especially if you're over 30. Have a lot of moles, have a family history of skin cancer, or just haven't had one before. A doctor trained in dermoscopy. A doctor trained in dermatoscopy can examine your moles using a specialized light that allows them to see things invisible to the naked eye. It's quick, it's painless, and it genuinely could save your life. It's the one appointment where promise no one is going to tell you to cut down on sugar or drink more water or well, I am going to tell you to use more SBF. So it's just about your skin and it takes about 20 minutes. Absolutely worth it. So here is the okay, now is the myth basting busting time. There, this is genuinely one of my favorite things to do because some of these myths are so persistent and so widespread that they're doing real damage. Myth one, I don't need SPF because I have dark skin. We do, we've covered this in depth. Melanoma doesn't discriminate by skin tone, and even setting melanoma aside entirely, UV damage contributes to hyperpigmentation, uneven skin tone, and premature aging in all skin tones. SPF is for everyone. Full stop. Myth 2: My foundation has SPF in it, so I'm covered. I hear this one so often. I love the intention behind this, I really do, but no. The SPF rating on a foundation assumes you're applying it in a quantity that nobody actually applies foundation. We're talking a thick, even layer, which would look absolutely frightening. Nobody's doing that. The SPF in your makeup is a lovely bonus, but it's not your primary protection. Wear a dedicated SPF underneath your makeup every single morning. Think of the SBF in your foundation as a little extra rather than your main defense. Myth tree. I only need SBF in the summer. UVB rays, the ones that cause burning, are stronger in the summer, yes. But UVA rays, the ones associated with aging and deep DNA damage, are consistent throughout the entire year. They're present in January, they're present on overcast days, they're come through your office window and you're sitting at your desk. SBF is a daily habit, not a seasonal one. Myth 4. A base tan will protect me before my holiday. Oh my gosh, this one. A base hand. The idea that you're going to damage your skin slightly in advance to protect it from being damaged more. I mean, I do admire the creativity, but a tan is not protection. It's evidence of damage. Your skin has been stressed and it's responding by producing more melanin. A tan gives you the equivalent of about SPF 2 to 4. That is genuinely nothing. Please don't go in a sunbed before your holiday thinking you're protecting yourself. You're not. Put on your SPF 50. Myth 5. Mineral SPF is always better than chemical SPF. This is a newer myth that's gained a lot of traction on social media, and the truth is more nuanced. Both types are effective and used correctly. Mineral SPF, zinc oxide and titanium dioxide sit on top of the skin and physically deflect UV. Chemical SPFs absorb into the skin and convert UV energy into heat. Both work. The best SPF is the one you'll actually use every day. The one with the texture you like, that doesn't leave a white cast, that sits well under your makeup. Don't let perfection be the enemy of protection. So I thought this might be helpful and hopefully a little reassuring to walk you through what my own sun protection routine actually looks like. Because I'm not standing here claiming to be perfect. I'm a doctor and a human being, which means I have good days and I have bad days, where I'm running out the door with my SBF half blended and one earring in. In the morning after cleansing and any serums, I apply my SBF 50 to my face, neck, and chest. I give it a minute to settle. I usually use that time to do something else. Make my tea, check my phone, and then I apply my makeup on top if I'm using makeup that day. I keep an SBF mist in my bag for reapplication during the day, especially when I'm with kids or with my kids. So on clinic days when I'm mostly indoors, I try and reapply at lunchtime. On days where I'm outside more, I'm more diligent about reapplying, especially after a swim. And that, my friends, is everything I wanted to share with you today. Melanoma is serious. People can die from it, but it is also one of the most preventable and when caught early, most treatable cancers we know of. The combination of facts is genuinely powerful if we use it right. So here is my challenge for you this week. One thing, do a skin self-check. Five minutes, good lighting. The A, B, C, D, E checklist we went through. That's it. If you find something that worries you, book an appointment. If everything looks fine, brilliant. Just keep checking. And if you'd like to come into a clinic, whether for a professional check or a skincare consult, or just have a conversation about your skin, you can book online at medicalskinclinic.ie. I would genuinely love to see you there. If this episode resonated with you, please share it. Send it to a friend who never wears SPF, send it to your mom, send it to that person in your life who thinks it's a a base hand is a good idea. You might just be doing them the biggest favor. Thank you so much for spending the time with me. I really do appreciate everyone of you who tunes in. Take care, take care of your skin. It is quite literally the only one you'll ever have. Until next time, I'm Dr. Farah. Talk soon.