Article Topic: Skin Cancer

Skin Cancer Risk Often Comes From Everyday Sun Exposure, Not Just Severe Burns

Routine outdoor work, driving, hobbies and missed spots like the scalp and ears can add up over time — so make sun protection a daily habit, not just during vacation.

One of the most common themes I hear from patients with skin cancer is not a single dramatic sun exposure — it’s years of routine, unremarkable exposure that never felt risky at the time.

Occupational exposure plays a big role. People who work outdoors — construction workers, landscapers, electricians, delivery drivers, mail carriers, farmers — accumulate significant ultraviolet (UV) exposure over time. Even pilots and cabin crew have roughly double the risk of melanoma due to chronic UV exposure at altitude.

Hobbies matter too. Activities like golf and fishing often involve hours in direct sun with little shade, and patients rarely think of them as “high-risk.”

Other Contributors to Cancer Risk

Another important contributor to skin cancer is immunosuppression. Patients with conditions like rheumatoid arthritis or inflammatory bowel disease often are prescribed medications that dampen the immune system. Organ transplant recipients are at especially high risk — approximately 100 times more likely to develop squamous cell carcinoma.

That risk often catches people completely off guard.

I hear versions of this story all the time: “I had one bad sunburn there only once … .” And that’s exactly where we end up treating a skin cancer.

Another pattern I frequently see is skin cancer along the hair part in younger women. The scalp — especially the part line — is one area of the body that is exposed most directly to the sun, but it’s often missed when applying sunscreen.

Another area to keep in mind is the left side of the body in drivers. In the U.S., we commonly see more sun damage and skin cancers on the left hand and forearm from years of incidental exposure through the car window. It’s not something people ever think about in the moment, but it adds up significantly over time.

Keeping Kids Safe in the Sun

Parents and guardians also have an important role to play here. Children’s skin is especially vulnerable to UV damage, and the habits they learn early can help lower their skin cancer risk later in life. Modeling sun-safe behavior — applying sunscreen before school, sports and outdoor play; choosing hats, sunglasses and protective clothing; and seeking shade when possible — helps make protection feel normal, not optional. Just as important, teaching kids to reapply sunscreen and to think of sun safety as part of everyday life, not just beach or lake days, can help those habits last into adulthood.

Make It a Daily Habit

For ourselves and people of any age, it’s very important to make sun protection part of one’s routine. That means:

  • Applying sunscreen on ordinary days — not just vacations
  • Covering high-risk areas people forget (the scalp part, ears, hands, even eyelids)
  • Wearing sunglasses — not just for comfort, but to protect the delicate skin around the eyes, where skin cancer surgeries can be especially challenging

Just as important is getting familiar with your own skin — and remember that you have skin from the top of your head to the bottom of your feet. Many skin cancers are first noticed by patients or their partners. Look for the “ugly duckling” — a spot that stands out — or anything that’s changing, bleeding or not healing.

Another point I always emphasize is this: There’s no such thing as a “healthy tan.” A tan is a visible sign of DNA damage in the skin.

Finally, when it comes to sunscreen, the best one is the one you’ll actually use. I encourage people to try a few (with a Sun Protection Factor, or SPF, of 30 or higher) and find something that fits easily into their daily routine — because consistency is what really makes the difference over time.

Make an Appointment

To schedule an appointment with Dr. McEvoy or another WashU Medicine dermatologist at Siteman Cancer Center, call 800-600-3606 or fill out this form, and our Patient Care Coordination Center will contact you.

Other Resources

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WashU Medicine Dermatologist Featured in HuffPost Story on Skin Cancer Risk

A new HuffPost story spotlights WashU Medicine dermatologist Aubriana McEvoy, MD, MS, FAAD, of Siteman Cancer Center, and the everyday habits that can quietly add up to skin cancer risk over time. The article,  It’s Not Beach Days That Worry Skin Cancer Doctors — It’s These Everyday Activities, explores how routine sun exposure — not just major burns — can contribute to skin damage, and why prevention matters year-round.

In the story, McEvoy highlights the risks that often fly under the radar: outdoor jobs, time spent driving, popular hobbies like golf and fishing, and missed areas such as the scalp part, ears and hands. She also explains why immunosuppression can significantly increase the risk of skin cancer, and why it’s so important to make sun protection part of a daily routine.

Here, McEvoy shares even more about skin cancer risk from ordinary sun exposure, and she offers practical advice about sunscreen, skin checks and the often-overlooked places people forget to protect.

For Your Health: Staying cool and sun-safe this summer

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Food sizzling on the grill is one of the classic sounds of summer — right up there with kids splashing in sprinklers and the crack of a bat at the ballpark.

That sizzling can also be a good stand-in for how we might feel outside on a sweltering day.

With a little planning, though, we can make our time in the sun feel cooler and more comfortable — and much better for our skin.

“Any amount of tan, and certainly sunburn, represents damage to the DNA of our skin cells,” said Dr. Aubriana McEvoy, a dermatologist at WashU Medicine in St. Louis. “And the more sun people get over their lives, the more of a chance there is for damaged cells to turn into skin cancer, which can affect our quality of life and, in some cases, the length of our lives.”

Too much sun can also lead to wrinkles, coarse skin and discoloration, making our skin look older than it is, she added.

Some simple steps can go a long way toward lowering the risk of skin cancer while keeping our skin looking healthier as well. And everyone can benefit, from those with fair skin to those with darker skin.

Sunscreen is a great place to start. Choose one with Sun Protection Factor (SPF) 30 or higher and be sure to use a generous amount, about an ounce for an adult at the pool — reapplying every couple hours. There are a lot of sunscreen options these days, so try out a number of them to find one you and your family like.

“My favorite sunscreen is the one you will wear,” McEvoy said.

Clothes are another way to stay sun-safe. Long-sleeved shirts, pants and wide-brimmed hats do a great job covering skin and don’t need to be reapplied like sunscreen. And there are many inexpensive, lightweight options that are specifically made to protect from the sun and that have their own rating, called Ultraviolet Protection Factor (UPF). As with sunscreens, the higher the UPF number, the greater the protection.

The combination of clothes and shade from trees or sun shelters can be particularly important for kids. Sunscreen is not recommended for children under 6 months old. And older kids can be so active that it can be hard to keep them well-covered in sunscreen, McEvoy added.

Shade and lightweight, loose-fitting clothes can also help with staying cool and feeling good on a hot day summer day. And it’s hard to overstate the importance of drinking enough water. It can be easy to get behind on our hydration, especially on a fun-filled outing with family and friends. Try to keep a bottle close by filled with plain water or low-sugar sports drink mix. Make it as easy as possible for you and your family to stay hydrated.

For many of us, summer is the best time of year, in no small part because we get to spend so much time enjoying long days and warm weather outside. And that’s an important part of life, McEvoy feels. Also important, of course, is doing so safely and healthfully.

When asked for one of her favorite tricks for staying cool and sun-safe in summer heat, she replied:

“If I’m at the playground or park with my kids, I’ll wear a sun-protective shirt and just wet it down. That keeps me way cooler and protects me from the sun.”