4 Dermatologists Share Tips for Preventing Skin Cancer Year-Round

May is Skin Cancer Awareness Month. And the American Academy of Dermatology (AAD) is using it as an opportunity to encourage people to practice safe sun.

While most people protect their skin in the summer, dermatologists want everybody to know their risk factors and take proactive measures year-round.

“Skin cancer is the most common cancer in the human body. There are more skin cancers in the USA in one year than all other cancers combined,” Jill Stewart Waibel, MD, a dermatologist with Baptist Health’s Miami Cancer Institute, tells Verywell. “Daily use of physical sun protection to sun-exposed areas of the body such as the face, neck, and hands is essential every day of the year.”

Why Skin Protection Matters Year-Round

The sun emits two types of ultraviolet rays: UVA and UVB. UVA rays primarily lead to premature skin aging while UVB rays mainly cause sunburns. Ultimately, both types of rays play a role in skin cancer development.

What's more, UV rays are reflected off both water and snow, making summer and winter activities particularly harmful to the skin. That's why protecting your skin against UV damage matters throughout the year.

“Dermatologists often advise that if you don't need a flashlight, you need sunscreen," Noëlle Sherber, MD, FAAD, a dermatologist in Washington, D.C., tells Verywell. "Ultraviolet rays are invisible and are present in every season, so sun protection isn't something that you should reserve for a summer beach day. On a cloudy day, up to 80% of UV exposure remains as compared to a sunny day. UVA light can also pass through windows, even when you are indoors or in your car.”

Tanning Beds Are Not a Safer Way to Get UV Exposure

Experts agree that tanning beds are as dangerous for your skin as time spent in the sun. “There is no safety in tanning beds," Waibel says. "Many small doses of UV light exposure such as those that an indoor tanner might receive are more carcinogenic than the sunburn a vacationer might experience."

Waibel adds that "there is very little regulation of indoor tanning salons, so there is great variability in operator safety.”

Dermatologists are seeing an alarming increase in new cases of skin cancer among younger people who frequently use tanning beds.

“Using tanning beds before age 35 can increase your chances of developing melanoma, the deadliest form of skin cancer by 59%, and the risk increases with each use,” Sherber says. “Even one session in a tanning bed can increase the risk of developing melanoma by 20%, squamous cell carcinoma by 67%, and basal cell carcinoma by 29%.”

Furthermore, a tan might look nice now, but you have to consider the long-term consequence of premature skin aging. “The end does not justify the means," Waibel says. "A tan will fade in a few weeks, but the effects of photoaging of the skin are everlasting."

Waibel adds that changes to the skin caused by long-term use of tanning beds can be quite dramatic. "It can cause molecular alterations believed essential in the development of skin cancer, similar to outdoor sun exposure,” she says.

Consider Self-Tanning Lotion Instead

“The sunless tan formulas have improved so much over the years," Sherber says. "So streaking and unnatural orange tones should be a thing of the past.”

Self-tanning creams are a healthier alternative to tanning beds and natural sun exposure. “Since no UV rays are involved in developing your tan, self-tanners provide a safe alternative to indoor or outdoor tanning," Sherber says. "The active ingredient, dihydroxyacetone (DHA), reacts with the skin's dead skin cell layer to give a tan tint that lasts for several days."

Sherber suggests exfoliating before you put on a self-tanner, washing your hands after you apply it, and make sure that the product has dried before you get dressed.

How to Protect Your Skin in the Sun

Naiara Braghiroli, MD, PhD, a dermatologist with Baptist Health’s Miami Cancer Institute, offers a few practical tips to protect your skin from daily sun damage.

• Avoid peak hours. Try to avoid going outdoors when the sun's rays are at their strongest—between 10 a.m. and 4 p.m. If this is not possible, seek shade during these hours.
• Wear protective clothing. Ultraviolet Protection Factor (UPF) clothing is one of the easiest ways to protect your skin from the sun. Complement your look with a hat (preferably with a wide brim) to help protect your scalp, face, and neck.

Sunscreen Basics

Experts say there are three key things to keep in mind when purchasing a daily sunscreen.

• Look for a broad-spectrum sunscreen, which protects against both UVA and UVB rays.
• Choose a product with a sun protection factor (SPF) of 30 or greater.
• Think about the activities you'll be taking part in while you're outside, such as swimming or boating. Water-resistant sunscreen will wear off less quickly than one that is not water-resistant.

“If you are spending time at the beach, pool, or lake, you are at double risk of exposure to UV rays as you not only face direct sunlight but also light reflecting off the water. As such, you are more predisposed for sunburn,” Braghiroli says. “If you are using a water-resistant sunscreen, reapply every 40 minutes. If using a very water-resistant sunscreen, reapply every 80 minutes.”

Types of Sunscreen

There are two types of sunscreens. The one that you choose will depend on your needs and preferences.

• Chemical sunscreens absorb UV rays before they can penetrate the skin. The most common active ingredients in chemical sunscreens are oxybenzone, avobenzone, octisalate, octocrylene, homosalate, and octinoxate. These products rub into the skin better than non-chemical sunscreens and do not leave a thick, white layer as some mineral sunscreens do.
• Mineral sunscreens deflect UV rays to protect the skin. These products are made of zinc oxide or titanium dioxide. Mineral-based sunscreens are more suitable than chemical ones for individuals with sensitive skin.

“Chemical sunscreens can be absorbed by the skin and found in the bloodstream, contributing to mood imbalances," Braghiroli says. "Chemical sunscreens are also being discouraged, even banned, in some areas for [their] negative impact on the environment as it has been linked to coral reef bleaching."

How to Use Sunscreen

There are a few components to proper sunscreen use:

• Apply sunscreen at least 15 minutes before you go outside.
• Cover every exposed surface of your skin with sunscreen. Don't forget areas like the tops of your feet and ears. Most adults will need to use about one ounce—or a full shot glass amount—of sunscreen.
• Use a lip balm with an SPF of 30 or more to protect your lips, which are also sensitive to the sun.
• Spray sunscreens are convenient but they don’t always provide complete protection. They can also irritate your eyes, mouth, nose, and lungs. For best results, spray the sunscreen onto your hands first, then rub it into your skin—especially around your face.

“The sun is present all year long and, in fact, is closer to the earth in the winter months,” Waibel says. “Sunscreens only attenuate sunlight and never completely eliminate the rays reaching the skin. Many patients believe the harmful effects of the UV light are completely blocked by sunscreens, leading to a false sense of security."

Start Safe Sun Practices Young

Over 80% of the damage that leads to skin cancer occurs before the age of 18, which is why sun safety habits need to start in childhood.

“One’s primary risk factor for skin cancer is the amount of sun exposure they have before the age of 18, so whatever sun exposure one receives during their childhood impacts their life-long risk,“ Denver, Colorado-based dermatologist Gregory Papadeas, DO, FAAD, tells Verywell. “If a child can graduate from high school without ever getting a sunburn, the risk of them ever developing a skin cancer is much lower.”

What If I Have Darker Skin?

“While people of color are less at risk for skin cancer caused by UV radiation, it’s important that they protect their skin nevertheless,” Braghiroli says.

Early skin cancer can be harder to spot on darker skin. Braghiroli advises regular skin exams and routine visits to a dermatologist to identify areas of concern. “Early detection is key in curing melanoma, so if you find an unusual spot, mole, or skin area, it’s critical to see your dermatologist right away.”

Braghiroli points out that "seventy-five percent of skin cancers diagnosed in people of color are in areas that are not exposed to the sun, such as the palms of the hands, nail beds, soles of the feet, inside the mouth and/or the genitalia area."

Given their location, these skin cancers are less likely to be diagnosed early and come with a higher mortality rate for people of color. "The estimated five-year melanoma survival rate for Black individuals is 67% versus 92% for whites," Braghiroli says.

But that doesn't mean sunscreen use doesn't matter for people with darker skin tones. Braghiroli says it's still essential.

“In the past, mineral sunscreens would appear as a white coating, which could create a chalky appearance on people of color. But sunscreen formulations have evolved and that the technology is far superior, with some mineral sunscreens even offering a tinted color to match various skin tones,” says Braghiroli. “Sunscreen use can also protect people of color against hyperpigmentation." 

Is Sun Exposure Important to Get Enough Vitamin D?

Sun exposure does play a role in the production of vitamin D, but dermatologists say that there are ways to get your vitamin D without damaging your skin.

“While the sun is a source of vitamin D, the amount of vitamin D a person creates from sun exposure is variable,” Sherber says. “Since sun exposure can lead to skin cancer, the American Academy of Dermatology recommends getting adequate vitamin D through dietary sources, including foods naturally rich in vitamin D, foods and beverages fortified with vitamin D, or vitamin D supplements.”

“The National Academy of Medicine recommends 600 IU as the Recommended Dietary Allowance for people 1-70 years of age, 400 IU for infants, and 800 IU for those over 70,” Sherber says. “While vitamin D is an essential vitamin, having an excess of vitamin D can cause problems such as increasing the risk of kidney stones and bone fractures, so having levels checked can be beneficial.”

When to See a Dermatologist

“No one is as well-trained as a dermatologist to evaluate your skin,” Papadeas says. He recommends that all individuals perform a monthly skin self-check, noting any lesions that are unusual or have changed in any way. Individuals with no additional risk factors for skin cancer should see a dermatologist once a year for a head-to-toe skin examination.

“Each individual with a first-degree relative diagnosed with melanoma has a 50% greater chance of developing melanoma in the future than those without a family history of the disease, so knowing your family history is very important,” Braghiroli says. “Additional risk factors to be mindful of are having a lot of moles, scars from previous trauma, and chronic/open wounds. Those who have HPV, an autoimmune disease, or who are immunosuppressed are also at greater risk.” If you have any of these additional risk factors, you may need to see a dermatologist more frequently.

If you have spots on your body that meet certain criteria, you should see a dermatologist. Keep an eye on any lesions and monitor the ABCDE characteristics.

• Asymmetry. Does one half of the area appear different from the other half?
• Border. Does it have a jagged border or irregular edges?
• Color. Is there any variation in color within the area of concern?
• Diameter. Greater than 6mm across, which is about the size of a pencil eraser.
• Evolving. Has the spot changed from what it used to look like, or is it notably different from the surrounding skin?