We talk a lot about sun damage and how to correct it, but that conversation is not complete without a discussion about skin cancer. May is Skin Cancer Awareness Month, which serves as an annual opportunity to shed light on the most common type of cancer in the United States. You (hopefully!) know to wear sunscreen year round and limit your exposure to ultraviolet (UV) rays as much as possible, and you may be keeping an eye on suspicious moles or visiting your dermatologist for skin cancer screenings. But there is still a lot to know about skin cancer that can be hard to keep track of even for those with a family history of it.
With education in mind, we’re breaking down some of the most important things you might not know about skin cancer. Read on to expand your sun safety knowledge and be sure to give us a ‘thumbs up’ at the end of the article if you learned something new.
1. There Are Multiple Types of Skin Cancer
Generally, skin cancers are usually discussed in two categories: melanoma and non-melanoma. Within those groups, there are three main types that present in different ways:
- Basal Cell Carcinoma (BCC): The most common form of skin cancer with about 3.6 million cases in the U.S. every year, BCC usually develops after years of sun exposure.
- Squamous Cell Carcinoma (SCC): Ranking as the second most common skin cancer with nearly two million cases diagnosed annually, SCC can grow deep into the skin and cause disfigurement.
- Melanoma: The most dangerous form of skin cancer due to its ability to spread, the Skin Cancer Foundation estimates there will be 197,700 cases diagnosed in 2022.
If you commit to regular skin checks with your dermatologist and practice safe sun, however, skin cancer is very treatable. From Mohs surgery to non-ablative laser therapy, there are more treatment options than ever.
2. Skin Cancer Is Common – But Preventable
One in five Americans will develop some sort of skin cancer during their lifetime, making it the most common form of cancer in the U.S. But even the sobering statistics don’t tell the whole story. According to the American Cancer Society, the actual number of non-melanoma basal cell and squamous cell (i.e. the two most common types of skin cancer) cases are difficult to estimate because they are not required to be reported to cancer registries. Invasive melanoma, meanwhile, only accounts for about one percent of skin cancer cases, but it is responsible for the majority of skin cancer deaths.
It is estimated that some 10,000 people are diagnosed with skin cancer every day, with more than one million Americans living with melanoma at any given time. If there is any good news to be had, it is this: Skin cancer is the most preventable form of cancer. Unlike cancers that have ambiguous origins or can’t be seen, we know exactly where skin cancer comes from: exposure to UV rays from the sun and artificial sources (read: tanning beds).
You can play an active role in skin cancer prevention and protection with healthy habits. They include:
- Monthly at-home skin checks (more on that below)
- Daily use of a broad spectrum sunscreen with a minimum of SPF 30
- Reapplication of said sunscreen every two hours or immediately after swimming
- Staying in the shade between 10 a.m. and 4 p.m.
- Wearing a wide-brim hat, polarized sunglasses, and UPF clothing
- Avoiding indoor tanning
3. No One Is Immune From Skin Cancer
There is a dangerous misconception that skin of color doesn’t burn or can’t develop skin cancer. It is true that people with lighter skin — types I through III on the Fitzpatrick scale — are at a higher risk of developing skin cancer than types IV, V, and VI. But people with darker skin have a higher risk of being diagnosed with skin cancer at a later stage. This means the cancer is often more aggressive and has a lower survival rate.
The most common form of skin cancer for BIPOCs is basal cell carcinoma, specifically on the palms of the hands and soles of the feet. Melanoma most often affects non-Hispanic whites, but people of color have higher rates of acral lentiginous melanoma (ALM), or melanoma of the palms, soles, and nail beds.
And then there is the age factor. While rare, pediatric melanoma should be on every parent’s radar. According to the National Cancer Institute, nearly 500 children are diagnosed with pediatric melanoma each year. This is why it is so important for everyone to apply sunscreen properly and to conduct skin checks regularly.
4. Skin Cancer Can Develop Anywhere
The skin is the body’s largest organ, and there is a lot of it. Skin cancer can develop anywhere, so you should be protecting and checking from the top of your head to the tips of your toes – though certain parts of the body are more overlooked than others. These include the fingers and toes (including under the nails) and the bottoms of the feet. The eyelids, scalp, and genital area are also easy to forget. Last but not least, don’t neglect your lips. Whether you realize it or not, they are part of your skin — a very sensitive one at that – and need protection. We’ve already rounded up the best lip balms with SPF to eliminate any excuse not to protect.
5. Skin Cancer Screenings Save Lives
All forms of skin cancer are treatable, but early detection is key. The five-year survival rate for melanoma is 99 percent, which is why committing to regular skin cancer screenings – both at-home and with your dermatologist – is vital. According to the American Academy of Dermatology (AAD), half of reported melanomas are self-detected. Just like you do a monthly self breast examination, skin checks should be a part of your routine, too.
As you know, skin cancer can develop anywhere on the body, so you have to be thorough in your exam. If you’re wondering how you are going to check your scalp or your back – we have an expert guide to conducting at-home skin cancer screenings. As it relates to melanoma specifically, the ‘ABCDE rule’ should be considered. The ABCDEs include:
- A – Asymmetry: Growth is asymmetrical
- B – Border: Rough or jagged edges
- C – Color: Various shades of brown, tan, black, red, white, or blue
- D – Diameter: Larger than six millimeters (think: a pencil eraser)
- E – Evolving: Changing, growing, bleeding, etc.
BCC and SCC do not necessarily follow the same pattern, but, generally speaking, you want to be mindful of spots that are growing asymmetrically, evolve in size or color, or suddenly start bleeding, itching, or burning. At the end of the day, self-exams are all about monitoring the skin for changes — whether it’s the evolution of an existing mark or the advent of a new one.
At-home skin checks are a must, but they do not replace a professional skin cancer screening with a dermatologist. It's usually recommended to start these checks annually around the time you turn 18, though, depending on you and your family's medical history, more frequent visits may be needed. Consulting with a board certified dermatologist is the best way to determine the ideal cadence.
6. Sun Damage Is Cumulative
Having five or more sunburns doubles your risk of developing melanoma, but skin cancer can form from repeated sun exposure over time regardless of if there’s a sunburn or not. We’re sorry to tell you that the sun damage we see in adulthood is the result of years of damage – often, the cumulative sun exposure we experienced before age 18. That chronic exposure to UV rays can lead to visible signs of aging (i.e. unwanted pigmentation, fine lines and wrinkles, crepiness, etc.), skin cancers, and potentially problematic pre-cancers.
Actinic keratoses (also known as solar keratoses) are the most common pre-cancers. According to the Skin Cancer Foundation, 58 million Americans have one or more AK and five to 10 percent of those spots become cancerous. They present as scaly patches on the skin – most commonly on the face, lips, ears, neck, scalp, and hands – and are the direct result of UV damage. If left untreated, they can turn into squamous cell carcinoma. Dermatologists can freeze off actinic keratoses with liquid nitrogen. Alternatively, topical chemotherapy or anti-inflammatory agents may be prescribed. In addition to sun protection, regular resurfacing treatments (think: chemical peels and lasers) may actually help treat pre-cancers by removing the top layer of the skin.
7. Sun Care & Skincare Are Critical Parts of Prevention
We’ve said it several times before, and we’ll say it again: The best way to prevent skin cancer is to protect yourself from harmful UV rays. One of the easiest ways to do that is to apply sunscreen every single day (rain or shine) and reapply regularly. While any sunscreen is better than no sunscreen, the AAD recommends using a broad spectrum sunscreen with a minimum sun protection factor (SPF) of 30. ‘Broad spectrum’ means the formula provides protection against both UVA and UVB rays. The former cause sun damage, while the latter are responsible for sunburns.
Whether you use a chemical or physical formula, the key is to apply the right amount and not miss a spot (we’ve got expert tips for both). Today’s sunscreens are infinitely easier to incorporate into your routine than ever before. If you are in the market for a new formula, we have a list of dermatologist-approved options, a crop that is lightweight to wear indoors, a group that’s great for guys, and a host that double as makeup.
When it comes to layering, apply sunscreen as the last step of your skincare routine but before any makeup. Speaking of skincare, what you put under your SPF can actually make it work harder. Research shows that pairing your SPF with antioxidants like vitamin C can better protect the skin from the sun and free radical damage. You can learn more in our deep dive into how skincare can treat sun damage.
And if the thought of a summer without a sun-kissed glow is too much to bear, consider a sunless alternative (no, we’re not talking about equally damaging tanning beds). Self-tanners are a cost-effective and safe way to glow – sans sun. Just remember that self tanner is not a substitute for sunscreen.
As long as the sun keeps burning, skin cancer is a risk. The best precaution is to avoid excessive sun exposure and to protect your skin with sunscreen or protective clothing. Early detection is key to a favorable prognosis, so get into the habit of conducting regular at-home skin checks and scheduling visits with your dermatologists. We may all be susceptible to skin cancer, but we have the knowledge and tools to prevent it.
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