By Dr Maxton Bergin
Skin cancer risk is not the same for everyone. In Australia, people may be at higher risk due to a combination of skin type, past UV exposure, mole pattern, family history, previous skin cancers, immune status, and age.
Having one or more risk factors does not mean you will develop melanoma, basal cell carcinoma or squamous cell carcinoma. Equally, people without obvious risk factors can still develop skin cancer. Risk factors change probability; they do not predict an individual outcome.¹˒²
The practical point is to understand what may increase your risk, protect your skin from further UV exposure and seek medical assessment for a new, changing, bleeding, painful, non-healing or otherwise concerning lesion.
Why is skin cancer risk especially relevant in Australia?
Australia has a high burden of melanoma and keratinocyte cancers, the group that includes BCC and SCC. High ambient ultraviolet radiation, outdoor work and recreation, and a population with varied skin types all contribute to this pattern.¹˒³
The Australian Institute of Health and Welfare estimated the lifetime risk of being diagnosed with melanoma at around 1 in 15 people in 2020. That is a population estimate, not an individual forecast; a person’s own risk can be lower or higher depending on their circumstances.³
Unprotected UV exposure is the most important modifiable lifestyle risk factor for melanoma and other skin cancers.¹˒⁴ However, risk is shaped by more than sun exposure alone. Genetics, skin phenotype, mole number, age, immune function and previous skin cancers all matter.
Who is at higher risk of skin cancer?
People may be at increased risk if they have fair or easily sunburned skin, many moles, atypical moles, a personal or family history of melanoma, significant UV exposure, previous BCC or SCC, immune suppression or substantial outdoor work exposure.¹˒²
Some people have several risk factors at once. For example, a person with fair skin, many moles, childhood sunburns and a first-degree relative with melanoma may need a different surveillance discussion from someone with one isolated risk factor.
Risk exists on a continuum. Your GP, dermatologist, skin cancer doctor or other qualified clinician can help interpret your overall profile and advise on the most appropriate plan.
Fair skin and skin phenotype
Fair skin, freckling, a tendency to burn rather than tan, light-coloured eyes and light or red hair can increase the risk of melanoma and keratinocyte cancers, especially when combined with UV exposure.¹˒⁴
Melanin is the pigment that gives skin, hair and eyes their colour. It offers some natural protection against UV radiation, but it does not provide complete protection. People with fair skin generally have less of the type of melanin that helps absorb UV radiation, which is one reason they may burn more easily and have a higher risk of UV-related skin cancer.¹
People with darker skin can also develop melanoma and other skin cancers. Darker skin should never be treated as a reason to ignore a suspicious lesion, especially one that is new, changing, bleeding, painful, non-healing or unlike the person’s usual skin markings.
Does having lots of moles increase melanoma risk?
Yes. Having numerous moles increases melanoma risk, although a high mole count does not mean that a person will develop melanoma.¹˒⁵
“Moles” are also called melanocytic naevi. People with many moles may find it harder to notice a new lesion or identify subtle change in an existing mole. This is one reason some higher-risk patients may benefit from professional surveillance and, in selected cases, total body photography or digital mole mapping.²˒⁶
A meta-analysis found that people with 101–120 common moles had a substantially higher melanoma risk than people with very few moles.⁵ That finding describes a group-level association; it is not a self-diagnostic threshold.
For detailed guidance on the role of total body photography, see Who Should Get Mole Mapping? High-Risk Groups. This article focuses on broad skin cancer risk rather than deciding who should have mole mapping.
What are atypical moles?
An atypical mole is a mole with features that differ from a typical mole. Clinicians may use the terms atypical or dysplastic naevus. “Naevus” simply means mole.
An atypical mole is not automatically cancerous. However, having multiple atypical moles is associated with increased melanoma risk, particularly alongside a personal or family history of melanoma.¹˒⁵
Patients should not try to decide for themselves whether a mole is atypical. It is more useful to focus on what you can notice: a mole that is new, changing or looks unlike your other moles. A clinician can decide whether dermoscopy, photography, monitoring or biopsy is appropriate.
Does previous melanoma increase future risk?
Yes. A person who has previously had melanoma has a higher risk of developing another primary melanoma, as well as needing follow-up appropriate to the original melanoma.¹˒⁷
This does not mean another melanoma is inevitable. It does mean clinician-directed surveillance is important. The appropriate schedule depends on the stage and features of the previous melanoma, personal risk factors, family history and advice from the treating team.
Follow the surveillance plan provided by your melanoma specialist or treating clinician. If you notice a new or changing lesion between scheduled visits, do not wait for the next routine review.
What if you have had BCC or SCC before?
A previous basal cell carcinoma or cutaneous squamous cell carcinoma indicates susceptibility to UV-related skin cancer. People with a history of BCC or SCC are more likely to develop additional keratinocyte cancers than people who have not previously had one.¹˒⁸
This is particularly relevant for people with extensive sun damage, multiple actinic keratoses, long-term outdoor exposure or reduced immune function. The level of follow-up should be individualised by the treating clinician based on the type, number, location and behaviour of previous lesions.
For information about rough, sun-damaged spots and their relationship to SCC, see Actinic Keratosis: Early Warning Signs of Sun Damage.
Does skin cancer run in families?
Sometimes. A first-degree relative—parent, sibling or child—with melanoma approximately doubles a person’s risk compared with someone without that family history.⁹
Risk may be greater when several relatives have melanoma, when a family member had melanoma at a younger age or when someone has had more than one melanoma.⁹˒¹⁰ Most families with melanoma do not have a single identifiable inherited syndrome; shared skin type and shared UV exposure can also contribute.
Rare familial melanoma syndromes do exist. If several close relatives have had melanoma, particularly at young ages or with multiple primary melanomas, discuss this pattern with your doctor. They can advise whether specialist assessment or genetic counselling may be appropriate.
How does sun exposure affect risk?
UV exposure damages skin cells over time and increases the risk of melanoma, BCC and SCC. In Australia, UV radiation is the dominant preventable cause of skin cancer.¹˒⁴
The pattern of exposure matters as well as the amount:
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Melanoma is associated with intermittent intense UV exposure, such as sunburns and high recreational exposure.
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BCC is linked to both intermittent and long-term sun exposure.
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SCC is strongly associated with cumulative, chronic UV exposure, including occupational exposure.¹˒⁴
This is not a reason to try to calculate a personal “safe amount” of sun exposure. It is a reminder that regular sun protection matters across the lifespan.
Does a history of sunburn increase melanoma risk?
Yes. Severe or repeated sunburn, especially earlier in life, is associated with an increased risk of melanoma.¹˒⁴
A past sunburn does not mean melanoma will develop, and there is no single number of sunburns that determines your future. But sunburn is a useful signal that the skin received excessive UV exposure, often alongside a tendency to burn rather than tan.
Preventing further sunburn remains worthwhile at every age. Use a combination of sun-protective clothing, a broad-brimmed hat, shade, sunglasses and broad-spectrum SPF 50+ sunscreen on exposed skin.
Are outdoor workers at higher risk?
Outdoor workers can be at higher risk of UV-related skin cancer because they may accumulate much more UV exposure than people who work mainly indoors.¹¹
In Australia, outdoor occupations can include construction, farming, landscaping, road and rail work, fishing, trades, lifeguarding, parks work and professional sport. Outdoor recreation can contribute as well.
Occupational UV exposure is particularly associated with SCC and BCC. Evidence for melanoma is more complex because melanoma is strongly linked to intermittent intense exposure patterns, although chronic exposure can be relevant for some melanoma sites, including the head and neck.¹˒¹¹
A person’s job title does not determine their risk on its own. Sun protection, working hours, location, shade, clothing, personal skin type and recreational UV exposure also matter.
How do age and sex affect skin cancer risk?
Skin cancer risk generally increases with age because UV damage accumulates over time. Most keratinocyte cancer treatments in Australia occur in older adults, and melanoma is also more common in older age groups.¹˒³
However, melanoma can occur in younger adults. It is the most commonly diagnosed cancer among Australians aged 15–29 years, even though the absolute risk in this age group is lower than in older people.¹
Melanoma patterns also differ by sex and age. Men have a higher overall melanoma burden at older ages, while younger women can have a relatively higher incidence than younger men.³ These patterns are useful for population planning but do not replace individual assessment.
Does immune suppression increase skin cancer risk?
Yes. People with reduced immune function can have a substantially increased risk of certain skin cancers, particularly SCC.¹˒²
Examples include organ-transplant recipients, people taking long-term immune-suppressing medicines and people with health conditions that affect immune function. The level of risk varies considerably according to the cause and degree of immune suppression.
If you are immune-suppressed, ask the clinician managing your care about an appropriate skin surveillance plan. Do not change medicines without medical advice.
Other less common risk factors
A small number of other factors can increase skin cancer risk. These include prior radiation therapy, previous exposure to arsenic and certain rare inherited conditions.¹˒⁴
These factors are not relevant to most people, so they should be considered in context rather than causing unnecessary worry. If you have had radiation therapy, substantial occupational or environmental chemical exposure, or a known inherited cancer predisposition, discuss it with your treating clinician.
Can people without obvious risk factors get skin cancer?
Yes. People without obvious high-risk characteristics can still develop melanoma, BCC or SCC.
A person may have no known family history, no large number of moles and no particularly fair skin, yet still develop a suspicious lesion. Risk factors affect likelihood; they do not create a guarantee or an exemption.
This is why everyone should remain generally aware of their skin. Arrange prompt assessment for a lesion that is new, changing, bleeding, painful, persistent, non-healing or simply different from the rest.
For a guide to warning signs that may be missed by the classic ABCDE checklist, see Early Signs of Melanoma: Beyond the ABCDEs. If a lesion does not hurt, that does not make it harmless; see Can Skin Cancer Be Painless?.
What does higher risk mean for skin checks?
Higher risk may mean a more structured surveillance plan, but there is no single skin-check interval that suits every person. The right approach depends on the complete risk profile, previous findings and advice from a qualified clinician.²
Higher-risk patients may benefit from:
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clinician-directed skin-check intervals;
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greater familiarity with their own skin;
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professional full-skin examination;
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total body photography or mole mapping in appropriate cases;
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digital dermoscopy of selected lesions; and
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a clear plan for what to do if a lesion changes between appointments.
For a detailed discussion of risk-based check frequency, see How Often Should You Have a Skin Check in Australia?. To understand the appointment process, see What Happens in a Full Body Skin Cancer Check?.
What is the role of mole mapping for higher-risk people?
Total body photography, sometimes called mole mapping, can be useful for selected higher-risk people because it creates a baseline record of visible skin. Future images can then be compared to identify new lesions or visible change over time.⁶˒¹²
It is particularly relevant when a person has many moles, an atypical mole pattern, previous melanoma or other reasons that make visual self-monitoring difficult. Mole mapping does not independently diagnose melanoma and does not determine the surveillance interval on its own.
For a dedicated assessment of who may benefit, read Who Should Get Mole Mapping? High-Risk Groups. For information regarding mole mapping in Melbourne, see Mole Mapping Melbourne.
How Skintel fits into risk-based skin surveillance
Skintel is a diagnostic skin imaging service. Our skin cancer checks include a full-body scan or body map, high-magnification assessment of selected lesions and review by accredited skin cancer doctors, followed by a report with recommendations for follow-up.¹³
Melanographers capture imaging during the assessment, while accredited skin cancer doctors review the findings and prepare the report.¹³
For selected lesions that remain diagnostically uncertain after clinical examination and dermoscopy, reflectance confocal microscopy may provide additional non-invasive diagnostic information. It is not a routine test for every patient or every lesion and does not replace a necessary surgical biopsy.
Skintel does not provide treatment for skin cancer. If biopsy, excision or other treatment is required, your treating or referring clinician coordinates the appropriate next step.
Unsure about your skin cancer risk?
If you are unsure about your individual risk factors or what level of surveillance may be appropriate, a comprehensive skin assessment can help document your skin and support a clinician-led follow-up plan.
To arrange an assessment, Book a skin check at Skintel.
Medical safety disclaimer
This article provides general information only. Risk factors describe probability and cannot predict whether an individual will develop skin cancer. People without obvious risk factors can still develop melanoma, BCC or SCC. If you notice a new, changing, bleeding, painful, non-healing or otherwise concerning lesion, arrange prompt assessment with a qualified medical practitioner rather than waiting for a scheduled routine check.
Frequently Asked Questions
Who is most at risk of skin cancer in Australia?
People at higher risk commonly include those with fair or easily sunburned skin, many or atypical moles, personal or family history of melanoma, previous BCC or SCC, substantial UV exposure, outdoor work and immune suppression.¹˒² Risk is cumulative: several factors together can matter more than one factor alone. However, no list can predict an individual outcome, and people without obvious risk factors can still develop skin cancer.
What is the biggest risk factor for melanoma?
UV exposure is the most important modifiable risk factor for melanoma, while fair sun-sensitive skin, many moles, atypical moles, family history and previous melanoma also contribute.¹˒⁴ There is not one “biggest” risk factor that applies equally to every person. Your overall risk comes from the combination of inherited traits, mole pattern, UV exposure and medical history.
Does having lots of moles increase melanoma risk?
Yes. A high mole count is associated with increased melanoma risk.¹˒⁵ It can also make it harder to recognise a new or changing mole. This does not mean that every mole is dangerous or that people with many moles will develop melanoma. It means regular awareness and clinician-directed surveillance may be helpful, with total body photography considered for selected people.
Does skin cancer run in families?
Sometimes. Having a first-degree relative with melanoma approximately doubles melanoma risk, and risk may increase further where several relatives are affected or melanomas occurred at younger ages.⁹˒¹⁰ Most melanoma is not caused by a single inherited syndrome, but family history is still important information to share with your doctor.
Are outdoor workers more likely to get skin cancer?
Yes. Outdoor workers may accumulate much more UV exposure than indoor workers, increasing the risk of UV-related skin cancers, particularly BCC and SCC.¹¹ Melanoma risk has a more complex relationship with exposure pattern, but outdoor workers should still use strong sun protection and discuss their individual risk where relevant. Work type is one factor among many, including skin type, recreational exposure and previous sun damage.
Can people with darker skin get melanoma?
Yes. People with darker skin can develop melanoma and other skin cancers. Although average risk may be lower for some UV-related skin cancers, it is not zero.¹˒² A new, changing, bleeding, painful or otherwise concerning lesion should be assessed regardless of skin colour. Do not use skin tone as a reason to dismiss a persistent or changing spot.
Does having one skin cancer increase the risk of another?
Yes. A history of melanoma increases the risk of another primary melanoma, and a history of BCC or SCC increases the risk of further keratinocyte cancers.¹˒⁷˒⁸ The appropriate follow-up plan depends on your diagnosis, treatment history, skin type, family history and other risk factors. Follow your treating clinician’s advice and seek earlier review if a new lesion develops.
Who should have regular skin checks?
People with higher-risk features may benefit from regular clinician-directed skin checks, but there is no universal schedule for everyone.² This can include people with previous melanoma or other skin cancers, numerous or atypical moles, strong family history, significant UV damage or immune suppression. Your clinician can advise whether professional surveillance, mole mapping or digital dermoscopy is appropriate for you.
Who should get mole mapping?
Mole mapping is most relevant for selected higher-risk patients, such as people with many moles, atypical mole patterns or previous melanoma, where baseline photography can help identify new or changing lesions.⁶˒¹² It is not required for everyone and does not replace clinical examination. Read Who Should Get Mole Mapping? High-Risk Groups for the dedicated guide.
Can someone with no risk factors still develop melanoma?
Yes. A person can develop melanoma without obvious risk factors. Risk factors change probability but cannot identify every person who will develop skin cancer.¹˒² This is why a new, changing or unusual lesion should be assessed even if you consider yourself low risk and even if you have recently had a normal skin check.
Conclusion
High-risk groups for skin cancer in Australia include people with fair or sun-sensitive skin, many or atypical moles, a personal or family history of melanoma, previous BCC or SCC, significant UV exposure, outdoor work and immune suppression.
These factors should guide awareness and clinician-led surveillance, not create fear or certainty. People without obvious risk factors can still develop skin cancer. The safest approach is to understand your personal risk, use consistent sun protection and seek prompt assessment when a lesion is new, changing or concerning.
References
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Cancer Council Australia. Skin cancer statistics and issues prevention policy: risk factors and epidemiology. Sydney: Cancer Council Australia; accessed 2026 Sep 8.
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Royal Australian College of General Practitioners. Skin checks in primary care. Aust J Gen Pract. 2019;48(9):585-590.
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Australian Institute of Health and Welfare. Cancer data in Australia: risk of melanoma of the skin by age and over time. Canberra: AIHW; 2024.
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Cancer Council Australia. Melanoma and other skin cancers: a guide for medical practitioners. Sydney: Cancer Council Australia; 2023.
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Gandini S, Sera F, Cattaruzza MS, Pasquini P, Abeni D, Boyle P, et al. Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer. 2005;41(1):28-44.
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Ji-Xu A, Dinnes J, Matin RN. Total body photography for the diagnosis of cutaneous melanoma in adults: a systematic review and meta-analysis. Br J Dermatol. 2021;185(2):302-312.
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Ferrone CR, Ben Porat L, Panageas KS, Berwick M, Halpern AC, Patel A, et al. Clinicopathological features of and risk factors for multiple primary melanomas. JAMA. 2005;294(13):1647-1654.
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Marcil I, Stern RS. Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: a critical review of the literature and meta-analysis. Arch Dermatol. 2000;136(12):1524-1530.
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Royal Australian College of General Practitioners. Familial melanoma. East Melbourne: RACGP; accessed 2026 Sep 8.
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Goldstein AM, Tucker MA. Genetic epidemiology of cutaneous melanoma: a global perspective. Arch Dermatol. 2001;137(11):1493-1496.
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Schmitt J, Seidler A, Diepgen TL, Bauer A. Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Br J Dermatol. 2011;164(2):291-307.
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Tzellos T, Kyrgidis A, Zouboulis CC. The value of total body photography for the early detection of melanoma: a systematic review. J Eur Acad Dermatol Venereol. 2021;35(2):230-237.
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