SKIN CANCER PREVENTION

By Gary M. White, MD


How to Reduce Your Risk of Skin Cancer

Sunscreen

Daily use of sunscreen reduces the risk of melanoma, squamous cell carcinoma and actinic keratoses. The evidence for prevention of basal cell carcinoma is less clear.

Aspirin

Taking aspirin regularly reduced the risk of melanoma in postmenopausal women in a large observational study from the Women's Health Initiative comprising nearly 60,000 women. Acetaminophen (e.g. Tylenol) and other pain killers (e.g. ibuprofen) did not protect. A meta-analysis Oncol Lett. 2015 Mar;9(3):1073-1080 of multiple studies concluded that a daily dose of 50-400 mg aspirin was significantly associated with a reduced risk of skin cancers.

Alcohol

One study found 20% increased risk of cutaneous melanoma with regular alcohol drinking [British J Dermatology 2014 May].

Nicotinamide

A study showed that taking 500 milligrams twice daily of nicotinamide (not nicotinic acid) reduced the subsequent risk of non-melanoma skin cancers by 23 per cent. When patients stopped taking the supplements, their risk of getting skin cancer rose again about six months later.

Coffee

A Danish study showed that increased coffee consumption was associated with a 30% relative risk reduction for diagnosis of a second BCC.

Tanning Booths

Going to as tanning booth 30 times approximately doubles your risk of melanoma.

Vitamin D

Lower vitamin D levels in patients with melanoma are associated with poorer outcomes [J Clin Oncol. 2016 May 20;34(15):1741-7]. If you do get melanoma, higher serum vitamin D levels correlate with better prognostic indicators [Australas J Dermatol. 2017 Mar 23]. Although not proven, it seems prudent to keep your vitamin D in the normal range to help prevent melanoma.

Avoid Hydrochlorothiazide

One study found an increased risk of SCC (IRR of 1.79) and MM (IRR of 1.43) among users of combined amiloride and hydrochlorothiazide therapy [Br J Cancer 2008;99:1522]. An increased risk of MM (IRR of 3.30) was found among users of indapamide. Both hydrochlorothiazide and indapamide are photosensitizing diuretics.

Other Drugs

Imuran (azathioprine) use has been found to predispose to the development of multiple BCC and SCC (e.g., 6 or more) [JAAD 2018;78,27–28.e1]

Treat yourself with 5-FU annually

A large study at the Veterans Hospitals showed that application of efudex 5% twice a day to the face and ears reduced the risk of SCC by 75% over the ensuing year!!

RegionalDerm

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