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Figure 1. Sid the seagull from the campaign Slip! Slop! Slap!

Have you ever noticed “SLIP!, SLOP!, SLAP!” written on beach boards in Australia and New Zealand? It was a jingle derived from Cancer Council Victoria in 1981 to raise awareness of skin cancers that were increasing in Australia. Even so, how often do you hear about skin cancers in Singapore? While the incidence of skin cancer among Singaporeans is 0.5 in 100,000, anyone can get it regardless of gender or race!

What is the main cause of skin cancer? The biggest factor  is an overexposure to ultraviolet (UV) rays of the sun. Other causes of skin cancer include tanning booths, and exposure to chemical carcinogens such as arsenic or coal tars. These factors cause alteration of our DNA which lead to abnormal cells that will grow and proliferate. Proliferated abnormal cells will lead to a mass of cancer cells that we will see on the skin as either “lumps” or “tags”.

There are 3 main types of skin cancer:

Squamous cell cancer - the most common skin cancer affecting the skin's outer layer. It is the easiest to treat if detected early.

Basal cell cancer – the second most common skin cancer that affects the second layer of skin cells but is likely to spread if not detected early.

Melanoma - the third most common skin cancer but most deadly, as it has a tendency to spread to the other parts of the body.

Figure 2. Types of skin cancer cells

You should look out for the signs of melanoma through the “ABCDE” checklist: 

Asymmetrical – a skin lesion with an asymmetrical shape

Border – irregular edges of a skin lesion

Color – an uneven color, or more than 1 shade of black, brown, and pink. Dark brown or black streaks on the toenails can also indicate melanoma

Diameter – typically more than 6mm in size

Evolving – changes in size, shape, and color over time might indicate that the skin lesion is worrisome. Other signs such as soreness/swollen, bleeding, itch, and crusty might further increase the suspicion

The good news is, most skin cancers can be prevented by the following:

Figure 3. Recommendation of sun protection measures by Cancer Council Victoria

  1. Slip on long-sleeved clothes to protect arms and legs from harmful UV rays.

  2. Slop on a broad-spectrum sunscreen with SPF 30 or higher. Apply sunscreen even when it is windy or cloudy.

  3. Slap hats/caps when outdoors to protect your face.

  4. Seek shelter if possible to avoid direct sunlight exposure.

  5. Slide on those shades to protect your eyes with a bonus of looking chic.

Most importantly, check your skin and moles regularly for any changes in color and size. If you have any concerns, our specialists at Melissa Teo Surgery and  The Surgical Oncology Clinic will be able to help and advise you. Do reach out at 6262 4301/ 6694 7107 or email us at

-Written by Thalia


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