New sun safety guidelines a ‘timesaver for busy GPs’

GPs are being encouraged to tailor their sun safety advice to accommodate for a patient’s skin tone, as part of a new set of more specific guidelines.
 
The overhauled Balancing the Harms and Benefits of Sun Exposure position statement is based on new research published in the Australian and New Zealand Journal of Public Health.
 
Its major change is more detailed recommendations for specific skin types, with experts assigning patients into three groups based on skin cancer risk.
 
Led by researchers at Queensland’s QIMR Berghofer Medical Research Institute, the position statement considered growing research about the benefits of sun exposure in addition to vitamin D production.  
 
It suggests a knowledge gap remains among both consumers and clinicians, finding people are confused about what they should do to avoid vitamin D deficiency while still being sun safe.
 
Lead author Professor Rachel Neale said while the position statement has a more complex message than previous guidance, its overall priority remains the prevention of skin cancer.
 
‘We know there are some health benefits to going out in the sun, but we also know it is the main cause of skin cancer which has a terrible impact on so many lives,’ she said.
 
‘We’re really trying to get the balance right so we can reduce the risk of skin cancer but also enable people to get the benefits of sun exposure.’
 
The group with the lowest risk of skin cancer from sun exposure has deeply pigmented brown to black skin, with researchers saying routine sun protection is not needed unless those people are in the sun for extended periods.
 
However, this group is at highest risk of vitamin D deficiency.
 
In the second group, which is at highest risk of skin cancer, is those with very pale skin that burns easily.
 
It also includes those with less pale skin but additional risk factors, including family history of melanoma, personal history of skin cancer, those who are immunosuppressed, or have moles that are large or atypical.
 
The final group has an intermediate risk, with sun protection remaining very important, but they can spend some time outdoors to maintain their vitamin D and gain other benefits of sun exposure.
 
The position statement also includes a detailed breakdown for each state and territory on how many minutes a person should spend outside, depending on the time of year and average UV exposure.
 
Dr Jeremy Hudson, Chair of RACGP Specific Interests Dermatology, described the new set of guidelines as an impressive balance of advising on adequate sun protection and getting enough sun for your health.
 
‘The format of the advice also seems to be more user friendly. There is much better advice on sun exposure for different skin types in different areas of Australia,’ he told newsGP.
 
‘This should help both GPs and their patients understand how much sun is necessary to get a healthy amount of vitamin D, while still protecting from sun cancers.
 
‘However, it’s important to realise that all skin types may develop skin cancers and to screen appropriately.’
 
The research’s release comes as almost 20,000 Australians are diagnosed with melanoma each year, leading to more than 1300 deaths.
 
Australia continues to have the highest incidence of skin cancer in the world, and at least two-thirds of melanomas are attributable to Australia’s high ambient UV radiation.
 
Professor Neale’s advice for both patients and GPs is to err on the side of protecting their skin from the sun.
 
‘It is really important that everyone in Australia, apart from those with deeply pigmented skin, wears sunscreen daily. It should be part of your normal morning routine, just as routine as brushing your teeth,’ she said.
 
‘This needs to happen whenever the UV index is forecast to get to three or above, and for most of Australia that’s most of the year.
 
‘This provides a base level of protection, but people should also ensure that they reapply sunscreen and use hats, clothing, sunglasses, and shade when outdoors to reduce their risk of skin cancer.’
 
Dr Hudson hopes his GP colleagues will use the new advice to help keep patients safe.
 
‘Hopefully it will be a timesaver for busy GPs who can refer their patients to this resource for individualised advice,’ he said.
 
‘We have an incredibly important role when it comes to prevention, education, and detection.’
 
The updated position statement has been endorsed by the Cancer Council Australia and the Australasian College of Dermatologists.
 
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dermatology skin cancer skin checks