Summer is officially here, and many of us are enjoying outdoor activities and lots of time in the sun at the beach or pool. While sun exposure is important for many reasons – for example, production of Vitamin D, your mood and healthy circadian rhythms – our time in the sun can also be associated with a significant health risk: Cancer.

South Africa has the 2nd highest incidence of skin cancer in the world after Australia, and in particular one of the highest incidences of melanoma worldwide, as far as Caucasians are concerned.

At least 20 000 South Africans are diagnosed annually with non-melanoma skin cancers, and a approximately 1 500 are diagnosed with melanoma.

It is important to take note of the fact that everyone, regardless of racial or ethnic group, is at risk of getting skin cancer. Although people with darker skins are less susceptible, because their skin contains more natural melanin, that protects against sun damage, everyone is at risk from the harsh African sun.

According to the World Health Organisation (WHO), the incidence of both non-melanoma and melanoma skin cancers has been increasing over the past decades, and WHO estimates that a 10 % decrease in ozone levels will result in an additional 300 000 non-melanoma and 4 500 melanoma skin cancer cases globally.

Types Skin Cancer

There are two main categories of skin cancer, namely, melanoma and non-melanoma.

Melanoma (NCR 2012), is less common than other skin cancers, but it is the most dangerous. It is of special importance to note that excessive ultraviolet (UV) radiation received as a child, increases the risk of melanoma later in life.

Non-melanoma skin cancers mainly comprise Basal Cell Carcinoma (NCR 2012) and Squamous Cell Carcinoma (NCR 2012). Of these, Basal Cell Carcinoma is the most common and the least dangerous.

Squamous Cell Carcinoma (SCC) tends to develop on skin that has been exposed to the sun for years. It is most frequently seen on sun-exposed areas of the body such as the head, neck and back of the hands. Although women frequently get SCC on their lower legs, it is possible to get SCC on any part of the body, including the inside of the mouth, lips and genitals. People who use tanning beds have a much higher risk of getting SCC – they also tend to get SCC earlier in life.

Other skin cancers include: Kaposi Sarcoma (NCR 2012), Merkel Cell Carcinoma (NCR 2011) and Sebaceous Gland Carcinoma

The following conditions can give rise to cancer or be mistaken as cancer:

  • Spitz Naevi (usually present in toddlers and children), can mistakenly be thought to be Malignant Melanoma because of the close resemblance…
  • Actinic Cheilitis and Actinic Keratosis – are pre-cancerous conditions that can lead to Squamous Cell Carcinoma
  • Bowen’s Disease ± is a pre-cancerous condition that can lead to Squamous Cell Carcinoma
  • Balanitis Xerotica Obliterans (BXO) – is a pre-cancerous condition that can lead to Squamous Cell Carcinoma
  • Gorlin-Goltz Syndrome is an inherited medical condition involving defects within multiple body systems such as the skin, nervous system, eyes, endocrine system, and bones. People with this syndrome are particularly prone to developing a common form of non-melanoma skin cancer.
  • Solar Elastosis ± is a pre-cursor to Squamous Cell Carcinoma
  • Xeroderma Pigmentosum (XP) ± an inherited condition characterized by an extreme sensitivity to ultraviolet (UV) rays from sunlight. Most people with XP develop multiple skin cancers during their lifetime.


  • The sun is only dangerous in summer or on a hot day
  • Sunscreen will protect me completely from the harmful effects of the sun’s rays
  • One or two cases of sunburn won’t result in skin cancer
  • People with darker skins are not at risk for getting skin cancer
  • Sunbeds are a safer alternative to obtain a tan

The Truth About Tanning

There is no such thing as a healthy tan – even a sunless tan…

In recent years there has been a considerable increase in the use of sunless and self-tanning products such as sprays, mousses, gels, pills, nasal sprays & injections called Melanotan 1 and 11.

Melanotan 11 has serious side effects and may induce melanoma. CANSA warns against this product.

Sunless tanning, also known as UV-free tanning, self-tanning, spray-tanning (when something is applied topically) or fake-tanning – refers to the application of chemicals to the skin or making use of chemicals that are taken by mouth or per injection, to produce an effect similar in appearance to a suntan. The browning effect usually occurs within a few hours. The effect is temporary – the colour fades in 7-10 days as the skin naturally sloughs off.

Sunless tanning products include:

  • Bronzing powder
  • Spray bronzers
  • Stick bronzers
  • Tanning wipes
  • Tanning tablets
  • Tanning capsules
  • Tanning injections
  • Tanning nasal spry
  • Sunless tanning lotion

None of these is safe!

Although some self-tanning products contain sunscreen, it offers minimal ultraviolet radiation protection. It does not provide protection from the ultraviolet rays of the sun and CANSA strongly discourages individuals to use any form of tanning product.

Topical sunless tanning products that contain Dihydroxyacetone (DHA), prevent the formation of Vitamin D in the skin when exposed to the sun.