How can I educate patients about the risk factors and prevention strategies for basal cell carcinoma?

To educate patients about the risk factors and prevention strategies for basal cell carcinoma (BCC), it is essential to communicate clearly about the main causes, high-risk groups, and practical protective measures. Risk factors include excessive and intermittent ultraviolet (UV) exposure, especially from sunlight and artificial sources like tanning beds, fair skin types that burn easily, a history of sunburns, older age, immunosuppression, and a personal or family history of skin cancer ¹,⁴ (Marghoob, 1997). Patients should be informed that BCC is the most common form of skin cancer and is primarily caused by cumulative UV damage to the skin (Blum and Volkenandt, 2002).

Prevention strategies focus on minimizing UV exposure and protecting the skin. Advise patients to avoid sunburn by seeking shade, especially between 11 am and 3 pm when UV radiation is strongest, and to wear protective clothing such as wide-brimmed hats and long sleeves during the months of March to October in the UK ¹,⁴. Sunscreen use is critical: recommend broad-spectrum sunscreens with at least SPF 15 and 4-star UVA protection, applied liberally 30 minutes before sun exposure and reapplied frequently, especially after swimming or sweating ¹,⁴. Patients should be cautioned that higher SPF (30 or above) may compensate for inadequate application but does not permit longer sun exposure without burning ¹.

Discourage the use of tanning booths, lamps, and sunbeds as these significantly increase the risk of BCC and other skin cancers ¹,⁴. Tailor advice to specific groups at higher risk, such as children (who should be kept out of direct sunlight and protected with clothing and sunscreen), outdoor workers, and those with many moles or a history of skin cancer ¹,⁴.

Encourage patients to perform regular self-examinations of their skin to detect new or changing lesions early, and to seek medical advice if they notice any suspicious changes such as asymmetry, irregular borders, uneven colour, diameter over 6 mm, or evolving lesions, as well as any that are itchy, painful, bleeding, crusty, or inflamed ¹,⁴.

Balance the message by explaining that some sun exposure is beneficial for vitamin D synthesis, but the time needed to produce sufficient vitamin D is typically less than the time it takes to burn, so short, safe exposure to uncovered areas like forearms and hands is advisable ¹,⁴.

Finally, use behaviour change principles to enhance patients’ confidence in adopting these protective behaviours and integrate education with existing public health resources and campaigns to reinforce the message ³,⁴.