September 7, 2025 • 19 mins
New Zealand has one of the highest rates of melanoma in the world, but this is something we really don't want to be leaders at. Our largely fair-skinned population along with the kiwi love for the outdoors goes some of the way to explaining why skin cancer is so prevalent in Aotearoa.
MoleMap's Chief Medical Officer Dr Lorna Claydon joins Toni to discuss why Kiwi's need to be extra vigilant when it comes to sun safety, the differences between the three types of skin cancer, and how to know when it's time to talk to a professional.
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Episode Transcript
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Speaker 1 (00:00):
We need to talk conversations on wellness with Coast FM's
Tony Street.
Speaker 2 (00:06):
Hello, it's great to have you with us today on
we need to talk. New Zealand has one of the
highest rates of melanoma in the world, but despite being
preventable and treatable of court early melanoma still accounts for
sixty five percent of all skin cancer deaths in alted or.
I think most of us know that our son is
particularly harsh, but key We's are also sun lovers, so
how do we strike that right balance? So why is
(00:28):
the message not getting through and what can we change
in our own lives, hopefully small steps to avoid becoming
a statistic doctor. Lorna Claydon is mole NAP's New Zealand
chief medical officer and she's here to educate us on
all things skin cancer and melanoma. And my first question
is I get a little bit confused with the different
types of skin cancer and melanoma and which ones relate
(00:50):
to the sun and which ones don't. Can you just
clear that up for us?
Speaker 3 (00:53):
Hi, Tony yep, thank you so much for having me on.
And that is a really great question to start because
it is confusing for a lot of people. Most people
have heard of melanoma skin cancer because that's the scary
one and it's the one that makes the news headlines
and sadly in New Zealand and Australia, as you know,
we are world leaders, not a title we want. But
so if melanoma is like the shark of the skin
(01:16):
cancer world, it's fast moving and it can be deadly,
we also have a goldfish. We have basl cell skin cancers.
They're way more common, but they tend to stay where
they are and slowly grow larger on the skin until
they start to cause a problem. And in between the
basil cell skin cancers and the melanomas sit the squamer's
cell skin cancers and they can spread and they can
(01:37):
be deadly, but they're much less so than the melanomas.
So those are the three common types of skin cancer
that you'll hear about in New Zealand. They are all
related to sun and exposure in the majority of cases.
But you are right to say that there are some
melanomas that can occur on skin that hasn't had any
sun exposure, on the soles of the feet, under fingernails,
(01:59):
back of the eyeball, and even in our intestinal mucosa,
they're much less common. More than ninety five percent of
melanomas are related to sun exposure.
Speaker 2 (02:08):
And who is particularly at rusk here in New Zealand
Is there a particular age group or demographic.
Speaker 3 (02:14):
So as we get older, our risk of cancers always
goes up, So most skin cancers are in our older
patient But we are seeing a worrisome trend in our
under thirties of getting more melanomas diagnosed. We're not really
sure why that is. It could because we're getting better
at diagnosing them, it could be related to trends in
sun related behavior, that kind of thing. It's a real
(02:36):
worry for us because that's a frightening statistic, one that
we're keen to see people change their risk factors. One
of the things about New Zealand is that we have
a large population of very fair skin people whose skin
tends to burn in the sun very easily, and they
have a very higher risk of skin cancer. Every time
you get a sun burn, your risk of skin cancer
(02:57):
goes up quite significantly, and particularly when they happen in
your early like between under twenty wow. So making sure
our kids are protective from sunburn and we're teaching them
about sun's safety is super important.
Speaker 2 (03:07):
It's really interesting and I want to talk about my
own example here with the trend side of things. So
I've got a twelve year old going on thirteen and
the other the other day we were on holiday and
she goes, oh, yes, I've got a tan line, and
I win, oh, because it just took me by surprise,
because I know that I was like that at her age.
(03:28):
I mean, gosh, I come from the era of sun
bedding and all of those horrible things. And you know,
in the era before me was putting the oil on
to burn faster. I thought that had changed and there
was a complete flip that they didn't go near the sun.
But it's obviously not the case.
Speaker 3 (03:44):
It's an interesting trend, and just in the last year
or two, we've seen this kind of micro trend really
of young adults and teenagers wanting to tan for a
visible tan line that shows, you know, when they change swimsuits.
It breaks my heart because you know, all day with
patients who are often older and say, if only we'd known,
And now we have a generation that do know and
(04:06):
still can't see the risk. And it's really hard when
you're young to take a risk that mostly to affect
you and you're older and make it immediate. But what
I say to parents is, look what you're doing. Your
education that you're doing will eventually have an impact, and
it will change behavior. And every change in behavior makes
it different. It is never too late to improve your
(04:26):
sun smartness around it only sunsafe behavior. People often ask me,
you know I've got all this some damage. Is it
too late to start using sunscreen? And the answer to
that is no, It's never too late. And one of
the reasons is not only are we accumulating some damage
from sunlight, but when the sun shines on our skin,
it makes the immune cells in our skin sleepy and sluggish.
And so when we protect our skin from sunlight, we
(04:49):
allow those immune cells to wake up, look for damage
in our skin, and be more effective at dealing with
that damage before it becomes a skin cancer. So, yes,
you are a parent to teenage children who are finding
it hard to be sensible in the sun. Just to
hold in there, keep going with your sun smart messages
and your role modeling super important, and they will come.
(05:10):
They will come to see the wisdom of your ways
in time.
Speaker 2 (05:14):
How do you balance that messaging around not being the
sun and all the positives with the mental health messaging.
Often get outside. You need some fresh air, you know,
you need the vitamins from the sun to make you
feel better and not get into that I forget what
the condition's called when it's in the middle of winter
and you haven't had any sunlight.
Speaker 3 (05:34):
Seasible effective disorder. Yeah, because that's the real epidemic that's
affecting our young people with mental health issues. So it
just comes to being a bit aware of good times
to be in the sun. So you know a lot
of young people have trouble with sleeping as well, right,
So what you want to do is get out in
that sunshine early, gets sunlight on the back of your
(05:55):
eyeballs earlier in the day, so when they wake up,
go outside, maybe have their morning that you know, serious
outside and get your dose of sunlight. Then that's really
going to help you go to sleep at the end
of the day. Especially important also for menopausal women and
other people that might struggle with sleep. Early morning the
UV index is pretty low, so that's a safe time
to be out getting some sunshine. Making small doses of
(06:16):
sunlight through the day is much safer than prolonged exposure.
And you know, if you do want to get out
and have a walk in nature, then getting in under
the shade of the bush, you know, that's a perfect
place to go for a walk. Clothing can be really
important helping protect us from sunlight whilst enjoy the benefits
of being outside so longer sleeves, you know, wearing a hat,
being just a little bit smart about what we do.
(06:39):
The old slip stop slap is just as relevant today
as it ever was. You know, we can have the
best of both worlds.
Speaker 2 (06:44):
Yeah, so we've I talked about this trend and I'm
glad you knew about it as well, with those visual
visible ten lines. But on the flip side of that,
I feel like the beauty industry is helping in a
way because there are so many products now if you
want to have that sort of tend or glowy look
you can put on out having to go and the sun.
I'm guessing from your perspective you'd be quite pro that.
Speaker 1 (07:04):
I am.
Speaker 3 (07:05):
I really like those kind of products. That means that
you can have the best of both worlds. The only
thing we do say is if you're coming in for
a skin check, just try not to use them in
the immediate run up to the skin check because it
makes it a little bit difficult for us doing our
job when we're looking with the demanoscopes the magnifiers for
looking at skin. But as a way of giving you
that kind of glow without the harm, definitely that's a
(07:25):
good way to go. The other thing is just shifting
Western society perception that brown is necessarily you know what
we're aiming for. We have a natural skin color. It's
different from one person to the next, and can we
just learn to appreciate that natural skin color.
Speaker 2 (07:39):
Yes, that would definitely be the messaging you brought up
the skin checks, So let's talk about that now. When
should you be getting them? At what age and at
what frequency?
Speaker 3 (07:48):
So that very much depends on your skin type. Who
in your family has been affected by skin cancer. So
you know, as I've mentioned, skin cancers are so common
in New Zealand that two out of three New Zealanders
are going to have a skin cancer in their lifetime.
If you've got a family where that's affecting people in
your family, then you should start thinking about having a
skin check when you become an adult. If your skin
(08:09):
boons easily in the sun. That puts your higher risk.
If you've got more than one hundred moles or freckles,
that puts your higher risk. If your moles or freckles
are slightly funny looking, so you've got larger ones, ones
that look different from each other, that puts your high risk.
Anyone who falls into that higher risk category, so think
about getting at least a baseline top to toe skin
check done and then your practitioner will talk to you
(08:30):
about how frequently you should do skin checks after that.
But for most people who fall into that slightly higher
risk group, it should be an annual skin check. In
between that you can be doing self checking. A self
checking super important in picking up things early, and that's
as simple as using a full length mirror and a
handheld mirror just to look at the skin on your body.
(08:51):
You're going to look at the front of your skin,
use the handheld mirror to look at your back, the
top of your scalp if you can. Don't forget to
check palms of your hands, soles of your feet, in
between you and tone under toenails, and you're just really
looking for anything that catches the eye. I use the
acronym scan your skin. It's it's a really good simple
acronym for knowing what to look out for on self checking.
(09:13):
The S stands for sore spots, So anything that's itching, bleeding,
not healing. Pimples that don't heal within six weeks, they
should get a check. The C stands for changing. Any
spot that's changing in color, shape, sized, texture needs to check.
The A stands for abnormal. We sometimes call it the
ugly duckling or the standout. This is the one the
family members pick up on. They're really good at farnding
(09:35):
skin cancers. You know when Nana says to you, oh,
if you had that one check, do you pay attention
to that. Platners are really good too, they need a check.
And N stands for new moles. So any new mole
in someone who's over forty probably just needs to check
more often than not. They're not a skin cancer. But
that's how you pick skin cancer up early, and that's
how you make it treatable.
Speaker 1 (09:57):
Now that and we need to talk with Tony Street.
Speaker 2 (10:01):
And you mentioned that it's high in New Zealand. Is
that purely down to our ozone.
Speaker 3 (10:05):
Layer combination of factors, the tilt of the Earth's axis
means that we get closer to the sun, so we
get high intensity UV. The ozone layer is a bit
thinner over New Zealand and Australia, so we get more
penetration of those UV A and B rays coming through
that ozone layer. We also just love the outdoors. You know,
(10:25):
we just won an award for being the top work
life balance country of the world. You know, we spend
a lot of time outdoors. We have a big farming population,
big horticulture population, fishing, all the things we love to
do give us high exposure. And then we have that
fair skin portion of the population that we're a little
bit more vulnerable anyways, so combination of effects.
Speaker 2 (10:45):
Let's talk about sunscreen now. I feel like over the
last three or four years there's been quite a lot
of negative press around sunscreens and them not doing the
right job, and them saying they're fifty plus but they're
actually not. Instead alarming for you in the field you
work in.
Speaker 3 (11:03):
It's certainly a challenge on a number of basis. The
first one is trying to educate people, encourage people to
use sunscreens as a hard job already, and you know,
people often come and say, you know, what's the best
sunscreen to use, and we'll the response is usually whatever
works for you. Everybody's needs for sunscreen are slightly different,
everybody's issues with sunscreen are different, but you know, coming
(11:24):
to someone a skin doctor is a really good way
to kind of that person can help you direct you
towards the right product for you. In terms of testing,
there's a couple of factors. One is that the difference
between an SPF fifty at an SPF thirty in protection
is only one or two percent difference in terms of
how much UV it blocks out. So sometimes you'll see
(11:47):
testing where it claims to be an SPF fifty and
it's falling a little bit below that, but not significantly.
That is still going to give you really good protection.
The difference between an SPF thirty and an SPF fifteen
is significant. It's a big drop. So it's not a
flat line, it's a curved line, okay, And so you
really want to be buying sunscreen that is an SPF
(12:07):
fifty your plus because you've got a much bigger safety margin.
And the biggest factor in sunscreen is not actually production variability,
it's our ability to put it on well and as
per the instructions on the packet, right. Do you know
how they test for SPF and how they do these
lab testing?
Speaker 1 (12:23):
No?
Speaker 2 (12:23):
I don't, but I've always thought to myself, why would
you not just get the fifty SPF. I know, initially
it was all white and thick, and that's why I
maybe didn't. But it's changed now you can get a
fifty plus and it glides on nicely, so there's no
excuse now, and I.
Speaker 3 (12:37):
Feel no excuse. Yeah, I mean I was fascinated to
find out how they do these tests. Basically, they take
human volunteers and they find a little bit of non
sun damaged skin, which is usually low down on the back,
and they put a circle of sunscreen on it, a
particular dose two milligrams per centimeter square, and then then
they leave the other skin unprotected and then they shine
UV lights on it and they see how long it
(12:57):
takes that skin to start to go red on the
tected skin and how long on the area with sunscreen.
So that's how you do SPF testing. It's not it's
not a lab and a culture cells in a dish.
It's humans, right, So there is some variability in how
often and when this testing was done, and on variability
and on who. But the biggest variability is we don't
(13:19):
sit there and go I'm going to put two milligrams
put send me to Squared on us. We put a
little screw it in our hands, we rub it, we
make it go as far as we possibly can, and
we're out the door. We forgot to do the back
of the neck. We forgot to do the back of
our arms. We don't even think about putting sunscreen on
our lower legs. For some reason in New Zealand, it's
like we finish at the waist, we don't do our legs,
and so out the door we go. It's a concern,
but the quality of the product is not as big
(13:40):
of an impact as the ability of people to actually
put it on right, reapply it after two hours, put
it on fifteen minutes before you go out, use it
every day, you know, even for that minor sun exposure
when we're hanging out the Washington and getting the shopping
in and running the kids to and from school, those
factors are probably more important.
Speaker 2 (13:59):
Going back to what you just said about where we
apply sunscreen, and I absolutely agree with you. I think
people know it's most precious on their face, probably for aging,
selfish vanity reasons, and then you sort of move down
the body and the leagues do get forgotten. So do
you see then a clear link in the statistics around
where the melanoma is found because of that.
Speaker 3 (14:21):
Yeah, So melanoma in men most common on the back,
melanoma in women most common on the back of the legs.
It's really interesting, it's frightening a yeah, And that's theory
we forget. Now you'd mentioned faces. Get outdoor exposure three
hundred and sixty five days all year round. We see
the most of our non melanoma skin cancers on the faces.
(14:43):
So your squamous cell skin cancers and your basal cells
of by far the most common there. And so sunscreen
is not only protecting from melanoma, it's also about protecting
you from those skin cancers which are much less related
to burns and much more related to that low grade
everyday exposure. So not only is that sunscreen great for
preventing aging, it's also going to stop you getting your
square my cells and basil cell carcinomas. And a lot
(15:05):
of times when people think about skin cancer, they're thinking
about their parents, their older parents or their grandparents who
might be missing half an ear or had quite disfiguring
souderi on noses and things, and that is usually those
non melanoma skin cancers. So it's super important we don't
need to get those ones. We can we can protect
ourselves with good practices.
Speaker 2 (15:21):
How much of it is genetic?
Speaker 3 (15:23):
Basil cells a little bit more than square cells. They
SQUAMU cell is almost entirely related to your skin type
and your outdoor exposure. Basil cell less, so it has
some stronger genetic components. If you've got family members whove
had basil cells, you're much more likely to get them.
And for people who have that genetic tendency to basil cells,
it could be hugely boodensome because they can literally be
(15:44):
growing half a dozen basil cell skin cancers between every
skin check. I mean, it's huge for those patients, and
it's really really challenging to manage when they're growing skin
cancers at that frequency.
Speaker 2 (15:57):
What would you say to the people that are a
little bit reticent to get the check because they feel
like it's invasive and the process is going to be hard.
Speaker 3 (16:03):
There are different types of skin checks and I totally
get that. I remember putting off my first skin check
myself because I didn't want to stand in a paper
pants and stand in the different poses and have the photographs. Look,
if you talk to your practitioner, they'll make your skin
check fit you and fit what your needs are. But
you don't always have to be fully exposed. We can
use gowning blankets to cover up the skin and just
(16:25):
expose the section that we need to. And at the
end of the day, catching things early means you're spending
a lot less time with you in the doctor's clinic
in places where you don't necessarily feel that comfortable. So
it is one of those things where you kind of
have to bite the bullet and go and get it done.
But do talk to your practitioner, tell them that it
makes you feel like just an uncomfortable and they will
(16:46):
do everything they can to make you feel comfortable. It's
what we do every day, and so I think we'd
a pretty good job of making it easy for patients.
I know I've certainly had people feedback to me, Oh gosh,
I've been so nervous about coming to see you, and
now I'm so pleased I come it was nowhere near
as bad as I thought it was going to be.
It was really easy and I've learned a lot, So.
Speaker 2 (17:03):
Yeah, I feel like that was my experience. I had
a molemet done maybe two years ago. Now, can you
just talk us through the process of how you make
it easy for people to get checks? Like do you
get text follow ups? How does that process work?
Speaker 3 (17:16):
So we're getting more and more ability to book online now,
which I find that really helpful. I'm terrible at making
phone calls. I'm pretty good if I can click and
book online. So you can do all of that now.
Then you'll get a text reminder about your appointment coming up,
and then you chin up on the day and you
come in your skin check. Now there's different types of
skin checks, obviously, but if you're having a full body check,
then you usually will undress down to your underwear and
(17:38):
you'll have a gown or a blanket to cover up
the skin that's not being checked. And basically what we'll
do is photograph each section of your body, which records
where the spots and moles are. And then with the dematoscope,
so the magnifying lens that looks into the skin, we'll
look at individual spots and moles, and we'll often photograph
those through that lens, and that records exactly how the
appearance of that looks at that time, can identify risk
(18:01):
features if you like off skin cancer, and you'll get
recommendations on the basis of that. But those photographs are
then stored and when you go for your next skin check,
we're comparing those sets of photographs. We're looking for new
moles and we're looking for changes in existing moles, and
that's one of the ways that we can pick skin
cancers up early.
Speaker 2 (18:19):
Laurna. Just finally, if you had one message to give
to people listening today, whether it's for them or their kids,
what would that be.
Speaker 3 (18:27):
Two things, so smart, slip, slop, slap, all of that
stuff's really important. It's important to teach our kids and
to model it for our kids. And two is, if
you're in that high risk group, go and get a
skin check done. Just get your first one done and
then you'll know whether you need to be doing regular
checking or not. So don't be shy about it. If
you've got a family member who's been affected by skin cancer,
(18:48):
you will know the heartbreak that that causes. And there
is you know, we just don't need to. We need
to be getting out there and preventing cancers from progressing,
treating them early.
Speaker 2 (18:58):
Well, thank you so much for joining me today and
for the refresh and the reminder I think for a
lot of people that think they know the risks but
perhaps aren't following through entirely how we should be.
Speaker 3 (19:09):
Thank you so much for having me, Tony.
Speaker 1 (19:11):
We need to talk with Coast FM's Tony Street. If
you enjoyed the podcast, click to share with family or friends.
To get in touch, email we need to talk at
cost online dot co dot nz
We need to talk conversations on wellness with Coast FM's
Tony Street.
Speaker 2 (00:06):
Hello, it's great to have you with us today on
we need to talk. New Zealand has one of the
highest rates of melanoma in the world, but despite being
preventable and treatable of court early melanoma still accounts for
sixty five percent of all skin cancer deaths in alted or.
I think most of us know that our son is
particularly harsh, but key We's are also sun lovers, so
how do we strike that right balance? So why is
(00:28):
the message not getting through and what can we change
in our own lives, hopefully small steps to avoid becoming
a statistic doctor. Lorna Claydon is mole NAP's New Zealand
chief medical officer and she's here to educate us on
all things skin cancer and melanoma. And my first question
is I get a little bit confused with the different
types of skin cancer and melanoma and which ones relate
(00:50):
to the sun and which ones don't. Can you just
clear that up for us?
Speaker 3 (00:53):
Hi, Tony yep, thank you so much for having me on.
And that is a really great question to start because
it is confusing for a lot of people. Most people
have heard of melanoma skin cancer because that's the scary
one and it's the one that makes the news headlines
and sadly in New Zealand and Australia, as you know,
we are world leaders, not a title we want. But
so if melanoma is like the shark of the skin
(01:16):
cancer world, it's fast moving and it can be deadly,
we also have a goldfish. We have basl cell skin cancers.
They're way more common, but they tend to stay where
they are and slowly grow larger on the skin until
they start to cause a problem. And in between the
basil cell skin cancers and the melanomas sit the squamer's
cell skin cancers and they can spread and they can
(01:37):
be deadly, but they're much less so than the melanomas.
So those are the three common types of skin cancer
that you'll hear about in New Zealand. They are all
related to sun and exposure in the majority of cases.
But you are right to say that there are some
melanomas that can occur on skin that hasn't had any
sun exposure, on the soles of the feet, under fingernails,
(01:59):
back of the eyeball, and even in our intestinal mucosa,
they're much less common. More than ninety five percent of
melanomas are related to sun exposure.
Speaker 2 (02:08):
And who is particularly at rusk here in New Zealand
Is there a particular age group or demographic.
Speaker 3 (02:14):
So as we get older, our risk of cancers always
goes up, So most skin cancers are in our older
patient But we are seeing a worrisome trend in our
under thirties of getting more melanomas diagnosed. We're not really
sure why that is. It could because we're getting better
at diagnosing them, it could be related to trends in
sun related behavior, that kind of thing. It's a real
(02:36):
worry for us because that's a frightening statistic, one that
we're keen to see people change their risk factors. One
of the things about New Zealand is that we have
a large population of very fair skin people whose skin
tends to burn in the sun very easily, and they
have a very higher risk of skin cancer. Every time
you get a sun burn, your risk of skin cancer
(02:57):
goes up quite significantly, and particularly when they happen in
your early like between under twenty wow. So making sure
our kids are protective from sunburn and we're teaching them
about sun's safety is super important.
Speaker 2 (03:07):
It's really interesting and I want to talk about my
own example here with the trend side of things. So
I've got a twelve year old going on thirteen and
the other the other day we were on holiday and
she goes, oh, yes, I've got a tan line, and
I win, oh, because it just took me by surprise,
because I know that I was like that at her age.
(03:28):
I mean, gosh, I come from the era of sun
bedding and all of those horrible things. And you know,
in the era before me was putting the oil on
to burn faster. I thought that had changed and there
was a complete flip that they didn't go near the sun.
But it's obviously not the case.
Speaker 3 (03:44):
It's an interesting trend, and just in the last year
or two, we've seen this kind of micro trend really
of young adults and teenagers wanting to tan for a
visible tan line that shows, you know, when they change swimsuits.
It breaks my heart because you know, all day with
patients who are often older and say, if only we'd known,
And now we have a generation that do know and
(04:06):
still can't see the risk. And it's really hard when
you're young to take a risk that mostly to affect
you and you're older and make it immediate. But what
I say to parents is, look what you're doing. Your
education that you're doing will eventually have an impact, and
it will change behavior. And every change in behavior makes
it different. It is never too late to improve your
(04:26):
sun smartness around it only sunsafe behavior. People often ask me,
you know I've got all this some damage. Is it
too late to start using sunscreen? And the answer to
that is no, It's never too late. And one of
the reasons is not only are we accumulating some damage
from sunlight, but when the sun shines on our skin,
it makes the immune cells in our skin sleepy and sluggish.
And so when we protect our skin from sunlight, we
(04:49):
allow those immune cells to wake up, look for damage
in our skin, and be more effective at dealing with
that damage before it becomes a skin cancer. So, yes,
you are a parent to teenage children who are finding
it hard to be sensible in the sun. Just to
hold in there, keep going with your sun smart messages
and your role modeling super important, and they will come.
(05:10):
They will come to see the wisdom of your ways
in time.
Speaker 2 (05:14):
How do you balance that messaging around not being the
sun and all the positives with the mental health messaging.
Often get outside. You need some fresh air, you know,
you need the vitamins from the sun to make you
feel better and not get into that I forget what
the condition's called when it's in the middle of winter
and you haven't had any sunlight.
Speaker 3 (05:34):
Seasible effective disorder. Yeah, because that's the real epidemic that's
affecting our young people with mental health issues. So it
just comes to being a bit aware of good times
to be in the sun. So you know a lot
of young people have trouble with sleeping as well, right,
So what you want to do is get out in
that sunshine early, gets sunlight on the back of your
(05:55):
eyeballs earlier in the day, so when they wake up,
go outside, maybe have their morning that you know, serious
outside and get your dose of sunlight. Then that's really
going to help you go to sleep at the end
of the day. Especially important also for menopausal women and
other people that might struggle with sleep. Early morning the
UV index is pretty low, so that's a safe time
to be out getting some sunshine. Making small doses of
(06:16):
sunlight through the day is much safer than prolonged exposure.
And you know, if you do want to get out
and have a walk in nature, then getting in under
the shade of the bush, you know, that's a perfect
place to go for a walk. Clothing can be really
important helping protect us from sunlight whilst enjoy the benefits
of being outside so longer sleeves, you know, wearing a hat,
being just a little bit smart about what we do.
(06:39):
The old slip stop slap is just as relevant today
as it ever was. You know, we can have the
best of both worlds.
Speaker 2 (06:44):
Yeah, so we've I talked about this trend and I'm
glad you knew about it as well, with those visual
visible ten lines. But on the flip side of that,
I feel like the beauty industry is helping in a
way because there are so many products now if you
want to have that sort of tend or glowy look
you can put on out having to go and the sun.
I'm guessing from your perspective you'd be quite pro that.
Speaker 1 (07:04):
I am.
Speaker 3 (07:05):
I really like those kind of products. That means that
you can have the best of both worlds. The only
thing we do say is if you're coming in for
a skin check, just try not to use them in
the immediate run up to the skin check because it
makes it a little bit difficult for us doing our
job when we're looking with the demanoscopes the magnifiers for
looking at skin. But as a way of giving you
that kind of glow without the harm, definitely that's a
(07:25):
good way to go. The other thing is just shifting
Western society perception that brown is necessarily you know what
we're aiming for. We have a natural skin color. It's
different from one person to the next, and can we
just learn to appreciate that natural skin color.
Speaker 2 (07:39):
Yes, that would definitely be the messaging you brought up
the skin checks, So let's talk about that now. When
should you be getting them? At what age and at
what frequency?
Speaker 3 (07:48):
So that very much depends on your skin type. Who
in your family has been affected by skin cancer. So
you know, as I've mentioned, skin cancers are so common
in New Zealand that two out of three New Zealanders
are going to have a skin cancer in their lifetime.
If you've got a family where that's affecting people in
your family, then you should start thinking about having a
skin check when you become an adult. If your skin
(08:09):
boons easily in the sun. That puts your higher risk.
If you've got more than one hundred moles or freckles,
that puts your higher risk. If your moles or freckles
are slightly funny looking, so you've got larger ones, ones
that look different from each other, that puts your high risk.
Anyone who falls into that higher risk category, so think
about getting at least a baseline top to toe skin
check done and then your practitioner will talk to you
(08:30):
about how frequently you should do skin checks after that.
But for most people who fall into that slightly higher
risk group, it should be an annual skin check. In
between that you can be doing self checking. A self
checking super important in picking up things early, and that's
as simple as using a full length mirror and a
handheld mirror just to look at the skin on your body.
(08:51):
You're going to look at the front of your skin,
use the handheld mirror to look at your back, the
top of your scalp if you can. Don't forget to
check palms of your hands, soles of your feet, in
between you and tone under toenails, and you're just really
looking for anything that catches the eye. I use the
acronym scan your skin. It's it's a really good simple
acronym for knowing what to look out for on self checking.
(09:13):
The S stands for sore spots, So anything that's itching, bleeding,
not healing. Pimples that don't heal within six weeks, they
should get a check. The C stands for changing. Any
spot that's changing in color, shape, sized, texture needs to check.
The A stands for abnormal. We sometimes call it the
ugly duckling or the standout. This is the one the
family members pick up on. They're really good at farnding
(09:35):
skin cancers. You know when Nana says to you, oh,
if you had that one check, do you pay attention
to that. Platners are really good too, they need a check.
And N stands for new moles. So any new mole
in someone who's over forty probably just needs to check
more often than not. They're not a skin cancer. But
that's how you pick skin cancer up early, and that's
how you make it treatable.
Speaker 1 (09:57):
Now that and we need to talk with Tony Street.
Speaker 2 (10:01):
And you mentioned that it's high in New Zealand. Is
that purely down to our ozone.
Speaker 3 (10:05):
Layer combination of factors, the tilt of the Earth's axis
means that we get closer to the sun, so we
get high intensity UV. The ozone layer is a bit
thinner over New Zealand and Australia, so we get more
penetration of those UV A and B rays coming through
that ozone layer. We also just love the outdoors. You know,
(10:25):
we just won an award for being the top work
life balance country of the world. You know, we spend
a lot of time outdoors. We have a big farming population,
big horticulture population, fishing, all the things we love to
do give us high exposure. And then we have that
fair skin portion of the population that we're a little
bit more vulnerable anyways, so combination of effects.
Speaker 2 (10:45):
Let's talk about sunscreen now. I feel like over the
last three or four years there's been quite a lot
of negative press around sunscreens and them not doing the
right job, and them saying they're fifty plus but they're
actually not. Instead alarming for you in the field you
work in.
Speaker 3 (11:03):
It's certainly a challenge on a number of basis. The
first one is trying to educate people, encourage people to
use sunscreens as a hard job already, and you know,
people often come and say, you know, what's the best
sunscreen to use, and we'll the response is usually whatever
works for you. Everybody's needs for sunscreen are slightly different,
everybody's issues with sunscreen are different, but you know, coming
(11:24):
to someone a skin doctor is a really good way
to kind of that person can help you direct you
towards the right product for you. In terms of testing,
there's a couple of factors. One is that the difference
between an SPF fifty at an SPF thirty in protection
is only one or two percent difference in terms of
how much UV it blocks out. So sometimes you'll see
(11:47):
testing where it claims to be an SPF fifty and
it's falling a little bit below that, but not significantly.
That is still going to give you really good protection.
The difference between an SPF thirty and an SPF fifteen
is significant. It's a big drop. So it's not a
flat line, it's a curved line, okay, And so you
really want to be buying sunscreen that is an SPF
(12:07):
fifty your plus because you've got a much bigger safety margin.
And the biggest factor in sunscreen is not actually production variability,
it's our ability to put it on well and as
per the instructions on the packet, right. Do you know
how they test for SPF and how they do these
lab testing?
Speaker 1 (12:23):
No?
Speaker 2 (12:23):
I don't, but I've always thought to myself, why would
you not just get the fifty SPF. I know, initially
it was all white and thick, and that's why I
maybe didn't. But it's changed now you can get a
fifty plus and it glides on nicely, so there's no
excuse now, and I.
Speaker 3 (12:37):
Feel no excuse. Yeah, I mean I was fascinated to
find out how they do these tests. Basically, they take
human volunteers and they find a little bit of non
sun damaged skin, which is usually low down on the back,
and they put a circle of sunscreen on it, a
particular dose two milligrams per centimeter square, and then then
they leave the other skin unprotected and then they shine
UV lights on it and they see how long it
(12:57):
takes that skin to start to go red on the
tected skin and how long on the area with sunscreen.
So that's how you do SPF testing. It's not it's
not a lab and a culture cells in a dish.
It's humans, right, So there is some variability in how
often and when this testing was done, and on variability
and on who. But the biggest variability is we don't
(13:19):
sit there and go I'm going to put two milligrams
put send me to Squared on us. We put a
little screw it in our hands, we rub it, we
make it go as far as we possibly can, and
we're out the door. We forgot to do the back
of the neck. We forgot to do the back of
our arms. We don't even think about putting sunscreen on
our lower legs. For some reason in New Zealand, it's
like we finish at the waist, we don't do our legs,
and so out the door we go. It's a concern,
but the quality of the product is not as big
(13:40):
of an impact as the ability of people to actually
put it on right, reapply it after two hours, put
it on fifteen minutes before you go out, use it
every day, you know, even for that minor sun exposure
when we're hanging out the Washington and getting the shopping
in and running the kids to and from school, those
factors are probably more important.
Speaker 2 (13:59):
Going back to what you just said about where we
apply sunscreen, and I absolutely agree with you. I think
people know it's most precious on their face, probably for aging,
selfish vanity reasons, and then you sort of move down
the body and the leagues do get forgotten. So do
you see then a clear link in the statistics around
where the melanoma is found because of that.
Speaker 3 (14:21):
Yeah, So melanoma in men most common on the back,
melanoma in women most common on the back of the legs.
It's really interesting, it's frightening a yeah, And that's theory
we forget. Now you'd mentioned faces. Get outdoor exposure three
hundred and sixty five days all year round. We see
the most of our non melanoma skin cancers on the faces.
(14:43):
So your squamous cell skin cancers and your basal cells
of by far the most common there. And so sunscreen
is not only protecting from melanoma, it's also about protecting
you from those skin cancers which are much less related
to burns and much more related to that low grade
everyday exposure. So not only is that sunscreen great for
preventing aging, it's also going to stop you getting your
square my cells and basil cell carcinomas. And a lot
(15:05):
of times when people think about skin cancer, they're thinking
about their parents, their older parents or their grandparents who
might be missing half an ear or had quite disfiguring
souderi on noses and things, and that is usually those
non melanoma skin cancers. So it's super important we don't
need to get those ones. We can we can protect
ourselves with good practices.
Speaker 2 (15:21):
How much of it is genetic?
Speaker 3 (15:23):
Basil cells a little bit more than square cells. They
SQUAMU cell is almost entirely related to your skin type
and your outdoor exposure. Basil cell less, so it has
some stronger genetic components. If you've got family members whove
had basil cells, you're much more likely to get them.
And for people who have that genetic tendency to basil cells,
it could be hugely boodensome because they can literally be
(15:44):
growing half a dozen basil cell skin cancers between every
skin check. I mean, it's huge for those patients, and
it's really really challenging to manage when they're growing skin
cancers at that frequency.
Speaker 2 (15:57):
What would you say to the people that are a
little bit reticent to get the check because they feel
like it's invasive and the process is going to be hard.
Speaker 3 (16:03):
There are different types of skin checks and I totally
get that. I remember putting off my first skin check
myself because I didn't want to stand in a paper
pants and stand in the different poses and have the photographs. Look,
if you talk to your practitioner, they'll make your skin
check fit you and fit what your needs are. But
you don't always have to be fully exposed. We can
use gowning blankets to cover up the skin and just
(16:25):
expose the section that we need to. And at the
end of the day, catching things early means you're spending
a lot less time with you in the doctor's clinic
in places where you don't necessarily feel that comfortable. So
it is one of those things where you kind of
have to bite the bullet and go and get it done.
But do talk to your practitioner, tell them that it
makes you feel like just an uncomfortable and they will
(16:46):
do everything they can to make you feel comfortable. It's
what we do every day, and so I think we'd
a pretty good job of making it easy for patients.
I know I've certainly had people feedback to me, Oh gosh,
I've been so nervous about coming to see you, and
now I'm so pleased I come it was nowhere near
as bad as I thought it was going to be.
It was really easy and I've learned a lot, So.
Speaker 2 (17:03):
Yeah, I feel like that was my experience. I had
a molemet done maybe two years ago. Now, can you
just talk us through the process of how you make
it easy for people to get checks? Like do you
get text follow ups? How does that process work?
Speaker 3 (17:16):
So we're getting more and more ability to book online now,
which I find that really helpful. I'm terrible at making
phone calls. I'm pretty good if I can click and
book online. So you can do all of that now.
Then you'll get a text reminder about your appointment coming up,
and then you chin up on the day and you
come in your skin check. Now there's different types of
skin checks, obviously, but if you're having a full body check,
then you usually will undress down to your underwear and
(17:38):
you'll have a gown or a blanket to cover up
the skin that's not being checked. And basically what we'll
do is photograph each section of your body, which records
where the spots and moles are. And then with the dematoscope,
so the magnifying lens that looks into the skin, we'll
look at individual spots and moles, and we'll often photograph
those through that lens, and that records exactly how the
appearance of that looks at that time, can identify risk
(18:01):
features if you like off skin cancer, and you'll get
recommendations on the basis of that. But those photographs are
then stored and when you go for your next skin check,
we're comparing those sets of photographs. We're looking for new
moles and we're looking for changes in existing moles, and
that's one of the ways that we can pick skin
cancers up early.
Speaker 2 (18:19):
Laurna. Just finally, if you had one message to give
to people listening today, whether it's for them or their kids,
what would that be.
Speaker 3 (18:27):
Two things, so smart, slip, slop, slap, all of that
stuff's really important. It's important to teach our kids and
to model it for our kids. And two is, if
you're in that high risk group, go and get a
skin check done. Just get your first one done and
then you'll know whether you need to be doing regular
checking or not. So don't be shy about it. If
you've got a family member who's been affected by skin cancer,
(18:48):
you will know the heartbreak that that causes. And there
is you know, we just don't need to. We need
to be getting out there and preventing cancers from progressing,
treating them early.
Speaker 2 (18:58):
Well, thank you so much for joining me today and
for the refresh and the reminder I think for a
lot of people that think they know the risks but
perhaps aren't following through entirely how we should be.
Speaker 3 (19:09):
Thank you so much for having me, Tony.
Speaker 1 (19:11):
We need to talk with Coast FM's Tony Street. If
you enjoyed the podcast, click to share with family or friends.
To get in touch, email we need to talk at
cost online dot co dot nz
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