Prevention

When the UV index levels are 3 or above (during sun protection times), people should be encouraged to use a combination of sun protection measures to avoid relying on one form of sun protection and to minimise UV exposure. These measures include wearing long-sleeved clothing, a broad-brimmed hat and sunglasses, applying an SPF30 or higher broad-spectrum sunscreen, and seeking out shade. People should also be encouraged to avoid using solariums and to protect children from sunburn and longterm exposure to the sun.

Risk factors

• A personal history of melanoma or nonmelanoma skin cancer
• A family history of melanoma
• Increased numbers of naevi on a total body count (> 100 of more than 2 mm)
• Increased numbers of dysplastic naevi
• Solarium use
• A fair complexion (including fair skin with poor tanning ability, light or red-coloured hair and blue or green eyes)
• A history of blistering sunburn
• Multiple solar keratoses
• High levels of intermittent sun exposure (e.g. during outdoor recreation or sunny holidays)
• Immune suppression and/or transplant recipients
• Increasing age

Screening

Population screening is not appropriate for melanoma. However, high-risk patients should have regular total body cutaneous examinations.

Managing increased risk

• Education about skin self-examination and sun protection advice
• Total skin check every six to 12 months
• Use of surveillance photography
• Sequential dermoscopic imaging
• Referral to a dermatologist or cancer geneticist for people with a family history of cancer in two first-degree relatives

Checklist