Ask The Expert: Dermatologist Nikki Ralph
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What is the main topic discussed in this episode?
The Pat Kenny Show on Newstalk. Now May is Melanoma Awareness Month and for this week's expert slot I'm joined by consultant dermatologist and photodermatology specialist Dr Nick V. Ralph from the Institute of Dermatologists who will take questions about melanoma and other matters related to the skin. Nicky, good morning and welcome. Morning Pat. Okay, Melanoma Awareness Month. People think this is Ireland, we don't need to worry about that. But we do.
We absolutely do, yeah.
Why is melanoma a concern in Ireland?
Skin cancer is the highest cancer that we have in Ireland and we're the ninth highest in the world for skin cancer rates. So we really have the fair skin, you know, the blue eyes, the red hair and we tend to freckle as opposed to tan. So our population is at highest risk of developing.
So people who live in sunny climes like Spain and Portugal and so on, generally they have sallow skin. So are they less prone to melanomas?
They still get it, of course, but certainly those with fairer skin. So we like to call it type 1 and type 2 skin. So that's, as I said, the red hair and the pale skin and the tendency to freckle and burn as opposed to naturally tan. There's a certain level of protection when your skin can tan, but essentially when you are tanned, it means you're damaged.
Do we know when the damage might be done to cause the cancer later on?
Yeah, so the majority of our damage is actually done in childhood. So up to about 20, our skin is actually susceptible to more damage. So it's really important that kids are protected. And thankfully nowadays, there's fantastic sunscreens, but there's also fantastic clothing. Like kids do not want to be chased around putting layers and layers of cream on them, but they just want to play in the water. They want to be outside. So if you can get suits and rash vests that are absolutely amazing for them, so they can play happily and you're not worried about them as much.
Now, what are people looking for if they're trying to spot whether they have a skin cancer issue?
So when it comes to melanoma, we've about 1200 cases a year in Ireland. It's the non-melanoma skin cancers that are actually more common. And we have between 11 and 12,000 of them. And they tend to be essentially like a pink spot that doesn't go away or a scaly plaque that just doesn't go away. So we can all get a spot and it comes and goes in a few weeks. So really, I like to say to people, if you've got something that's persisting for longer than four to six weeks and it's pink or scaly, you need to get it checked out. When it comes to melanoma, they tend to be, for the majority of cases, pigmented. So they're like a mole that's changing. And we use the alphabet to look out for changes. So the A, B, C, D and E. So A is for asymmetry.
So, you know, it should look nice and symmetrical with smooth borders, not jagged edges. I like to think of it like the map of Ireland if it's starting to kind of spread out at the edges. C is for colour. So if you're getting multiple colours or a change in colour. D is for diameter. So if you look at the top of an eraser on the top of a pencil, six millimetres and above, we'd certainly want you to get it checked out. And then E is for evolution. So if somebody sees something on their skin and it continues to change in the shape, the size, the colour, they absolutely need to go to their doctor.
Now, can you mistake it for something else? I mean, people might get what are called liver spots in age.
Yes, yeah, yeah. So yes, of course, seborrheic keratosis is the proper name for those kind of brown marks that people get. And the way I like to think of them is, and it was an old mentor who used to say to me, they're like barnacles on the bottom of a boat. They are almost stuck onto the surface of the skin. You feel like you can pick them off, but you actually can't. But you won't do any damage if you rub them with a towel. Of course, they could bleed, but it doesn't mean it's of any concern. They'll just heal again. But those ones that look a bit warty, they're a little bit dry.
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Chapters
5 chapters
1
What is the main topic discussed in this episode?
0:02–0:34
2
Why is melanoma a concern in Ireland?
0:34–4:54
3
How can childhood sun exposure affect skin cancer risk?
4:54–6:27
4
What should you look for to detect skin cancer early?
6:27–10:38
5
How do you differentiate between skin cancer and other skin conditions?
10:38–12:49