Recommendations for Skin Examination
Regular examinations of the skin are recommended for prevention and early detection of skin cancer.  Total body skin examination (TBSE) combined with a photo-book and using digital photography to follow unusual moles in patients helps detect cancers early (Phelan & Heneghan, 2008).  A comprehensive skin examination includes not only a medical history and inspection of the skin (including hair, nails and mouth), but also information from the patient such as questions about how long noticeable artifacts have been present, have they changed, if it itches, if any products are used on the area (and if so, what products), and any changes in recent routines, medications, travel, and so on (Johannsen, 2005).

Populations at Risk for Skin Cancer
Populations at special risk for skin cancer include those patients who fit in any of the following groups (National Cancer Institute, 11 June 2010):

• Are exposed to natural or artificial (i.e., tanning beds) sunlight for extended periods of time;
• Are fair-complexioned, including having fair skin (freckles, burns easily, does not tan or tans poorly), having light colored eyes (blue, green, etc.), having blond or red hair;
• Have been treated with radiation in the past;
• Have actinic keratosis (scaly patches on skin that can become cancerous);
• Have a weakened immune system;
• Have a history of multiple blistering sunburns during childhood;
• Have several large or many small moles;
• Have a family history of unusual moles or a personal history of melanoma.

Recommendations for Sun Exposure
Guidelines for sun exposure are quite mixed. On the one hand, medical professionals believe that moderate sun exposures increases the vitamin D produced by the body, which in turn is an anti-cancer agent. On the other hand, exposure to UV radiation increases the risk of melanoma and nonmelanoma skin cancer. The effectiveness of sunscreen lotions against nonmelanoma skin cancer is uncertain, but at least one study shows that sunscreen may protect against actinic keratoses that may later become cancerous; it is not proven that sunscreen protects against melanoma, however (National Cancer Institute, 11 June 2010).

General guidelines are to use UV-protecting sunscreen; stay out of the sun for long periods of time, especially in the middle of the day when the sun is strongest; and use basic sun protection techniques (long sleeved shirts, long pants, hats, UV-protecting sunglasses). These apply to everyone, though children, those with fair complexions or other skin cancer risks, and the elderly should be especially vigilant (National Cancer Institute, 11 June 2010).

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