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Skin Cancer: Basal and Squamous Cell

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Causes, Risk Factors, and Prevention TOPICS

Can basal and squamous cell skin cancers be prevented?

Not all basal and squamous cell skin cancers can be prevented, but there are things you can do that may reduce your risk of getting skin cancer.

Limit ultraviolet (UV) exposure

The most important way to lower your risk of basal and squamous cell skin cancers is to limit your exposure to UV radiation. Practice sun safety when you are outdoors. "Slip! Slop! Slap!… and Wrap" is a catch phrase that can help you remember the 4 key steps you can take to protect yourself from UV rays:

  • Slip on a shirt.
  • Slop on sunscreen.
  • Slap on a hat.
  • Wrap on sunglasses to protect the eyes and sensitive skin around them.

Protect your skin with clothing

Clothes provide different levels of UV protection, depending on many factors. Long-sleeved shirts, long pants, or long skirts are the most protective. Dark colors generally provide more protection than light colors. A tightly woven fabric protects better than loosely woven clothing. Dry fabric is generally more protective than wet fabric.

Be aware that covering up doesn't block out all UV rays. If you can see light through a fabric, UV rays can get through too.

Some companies in the United States now make clothing that is lightweight, comfortable, and protects against UV exposure even when wet. These sun-protective clothes may have a label listing the ultraviolet protection factor (UPF) value – the level of protection the garment provides from the sun's UV rays (on a scale from 15 to 50+). The higher the UPF, the higher the protection from UV rays.

Newer products, which are used in the washing machine like laundry detergents, can increase the UPF value of clothes you already own. They add a layer of UV protection to your clothes without changing the color or texture.

Wear a hat

A hat with at least a 2- to 3-inch brim all around is ideal because it protects areas often exposed to intense sun, such as the ears, eyes, forehead, nose, and scalp. A shade cap (which looks like a baseball cap with about 7 inches of fabric draping down the sides and back) also is good, and will provide more protection for the neck. These are often sold in sports and outdoor supply stores.

A baseball cap can protect the front and top of the head but not the neck or the ears, where skin cancers commonly develop. Straw hats are not as protective as ones made of tightly woven fabric.

Use sunscreen

Use sunscreens and lip balms on areas of skin exposed to the sun, especially when the sunlight is strong (for example, between the hours of 10 am and 4 pm). Many groups, including the American Academy of Dermatology, recommend using products with a sun protection factor (SPF) of 30 or more. Use sunscreen even on hazy days or days with light or broken cloud cover because the UV light still comes through.

Always follow directions when applying sunscreen. Ideally, a 1-ounce application (a palmful of sunscreen) is recommended to cover the arms, legs, neck, and face of the average adult. Protection is greatest when sunscreen is used thickly on all sun-exposed skin. To ensure continued protection, sunscreens should be reapplied. It is often recommended to do so every 2 hours. Many sunscreens wash off when you sweat or swim and then wipe off with a towel, so they must be reapplied for maximum effectiveness. And don't forget your lips; lip balm with sunscreen is also available.

Some people use sunscreen because they want to stay out in the sun for long periods of time without getting sunburned. Sunscreen should not be used to spend more time in the sun than you otherwise would, as you will still end up with damage to your skin.

Sunscreen can reduce your chance of actinic keratoses and squamous cell cancer. But there is no guarantee, and if you stay in the sun a long time, you are at risk of developing skin cancer even if you have applied sunscreen.

If you want a tan, one option is using a sunless tanning lotion. These can provide the look, without the danger. Sunless tanning lotions contain a substance called dihydroxyacetone (DHA). DHA works by interacting with proteins on the surface of the skin to produce color. You do not have to go out in the sun for these to work. The color tends to wear off after a few days. Most sunless tanning lotions provide very little protection from UV rays, so if you use one, you should still use sunscreen and wear protective clothing when going outside.

Wear sunglasses

Wrap-around sunglasses with at least 99% UV absorption provide the best protection for the eyes and the skin area around the eyes. Look for sunglasses labeled as blocking UVA and UVB light. Labels that say "UV absorption up to 400 nm" or "Meets ANSI UV Requirements" mean the glasses block at least 99% of UV rays. If there is no label, don't assume the sunglasses provide any protection.

Seek shade

Another way to limit exposure to UV light is to avoid being outdoors in direct sunlight too long. This is particularly important in the middle of the day between the hours of 10 am and 4 pm, when UV light is strongest. If you are unsure about the sun's intensity, use the shadow test: if your shadow is shorter than you are, the sun's rays are the strongest, and it is important to protect yourself..

When you are outdoors, protect your skin. Keep in mind that sunlight (and UV rays) can come through light clouds, can reflect off water, sand, concrete, and snow, and can reach below the water's surface.

The UV Index: The amount of UV light reaching the ground in any given place depends on a number of factors, including the time of day, time of year, elevation, and cloud cover. To help people better understand the intensity of UV light in their area on a given day, the National Weather Service and the US Environmental Protection Agency have developed the UV Index. It gives people an idea of how strong the UV light is in their area, on a scale from 1 to 11+. A higher number means a higher chance of sunburn, skin damage, and ultimately skin cancers of all kinds. Your local UV Index should be available daily in your local newspaper, on TV weather reports, and online (www.epa.gov/sunwise/uvindex.html).

Avoid tanning beds and sunlamps

Many people believe the UV rays of tanning beds are harmless. This is not true. Tanning lamps give out UVA and usually UVB rays as well, both of which can cause long-term skin damage and can contribute to skin cancer. Most skin doctors and health organizations recommend not using tanning beds and sun lamps.

Protect children from the sun

Children need special attention, since they tend to spend more time outdoors and can burn more easily. Parents and other caregivers should protect children from excess sun exposure by using the steps above. Older children need to be cautioned about sun exposure as they become more independent. It is important, particularly in parts of the world where it is sunnier, to cover your children as fully as is reasonable. You should develop the habit of using sunscreen on exposed skin for yourself and your children whenever you go outdoors and may be exposed to large amounts of sunlight.

Babies younger than 6 months should be kept out of direct sunlight and protected from the sun using hats and protective clothing. Sunscreen may be used on small areas of exposed skin only if adequate clothing and shade are not available.

A word about sun exposure and vitamin D

Doctors are learning that vitamin D has many health benefits. It may even help to lower the risk for some cancers. Vitamin D is made naturally by your skin when you are in the sun. How much vitamin D you make depends on many things, including how old you are, how dark your skin is, and how intensely the sun shines where you live.

At this time, doctors aren't sure what the optimal level of vitamin D is. A lot of research is being done in this area. Whenever possible, it is better to get vitamin D from your diet or vitamin supplements rather than from sun exposure, because dietary sources and vitamin supplements do not increase risk for skin cancer, and are typically more reliable ways to get the amount you need.

For more information on how to protect yourself and your family from UV exposure, see our document called Skin Cancer: Prevention and Early Detection.

Avoid harmful chemicals

Exposure to certain chemicals, such as arsenic, can increase a person's risk of skin cancer. People can be exposed to arsenic from well water in some areas, pesticides and herbicides, some medicines (such as arsenic trioxide) and herbal remedies (arsenic has been found in some traditional herbal remedies imported from China), and in certain occupations (such as mining and smelting).

Learn more about skin cancer prevention

Many organizations conduct skin cancer prevention activities in schools and recreational areas. Others develop brochures and public service announcements. For more information, refer to the “Additional resources” section of this document.


Last Medical Review: 05/05/2011
Last Revised: 01/20/2012

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