For many, there’s nothing better than the summer season. Whether it's soaking up the delightful…
Melanoma is a less common type of skin cancer than basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), but it’s more dangerous. Why? Because it’s more likely to spread to deeper layers of skin and other body systems if you and your dermatologist do not find and treat it early. As summer sweeps in and we all spend more time in the sun, we’re going to take a look at how melanoma develops, risk factors, symptoms, and prevention strategies.
What is melanoma?
Melanoma is a skin cancer of the epidermis (the uppermost layer of the skin) that develops in the skin’s melanocytes. Melanocytes produce melanin, which is a pigment that gives skin its tan or brown color.
Your skin also produces melanin to protect itself from the sun’s damaging ultraviolet (UV) rays. Many people believe that a tan is good, but don’t be fooled. Yes, it can protect your skin from some further damage, but developing a tan is a sign that you’ve already caused trauma to the skin cells. Over time, UV damage can cause the cell’s DNA to mutate.
Mutated DNA can make your cells reproduce out of control. The process of rapid cell production is what we call cancer, and melanoma is when this process happens in the melanocytes. If you and your dermatologist do not find and treat melanoma soon enough, it can spread to deeper layers of the skin, called the dermis and subcutis. From there, the melanoma can continue to spread throughout the body.
Facts about melanoma
Did you know that:
- Having 5 or more sunburns doubles your risk for developing melanoma, but having just one blistering sunburn during childhood or adolescence more than doubles your chances of developing melanoma at some point in your life.
- Up to 86% of melanomas are caused by sun exposure.
- Only 20 – 30% of melanomas are found in existing moles! The other 70 – 80% grow on “normal-looking” skin.
- The annual cost of treating melanoma in the United States is about $3.3 billion.
- With early detection, the 5-year cure rate for melanoma is 98%.
- Compared to melanomas that are found and treated within 30 days, those treated more than 119 days after biopsy have a 41% chance of not surviving.
- The Skin Cancer Foundation is estimating that the number of cases of melanoma in the US will rise by 2% in 2020 (to just over 196,000 cases!), but the number of melanoma deaths is expected to decline by 5.3% in 2020.
Melanoma risk factors
A risk factor is something that raises your chances of developing skin cancer. While there are steps that you can take to reduce some risk factors, others (like family history) are, unfortunately, out of your control.
It’s important to note that having one or more risk factors does not guarantee that you will develop skin cancer of any type, just as having no risk factors does not mean that you can’t get skin cancer.
Some risk factors for melanoma are:
- A predisposition for developing moles – though they’re most often benign, people who have numerous moles face a higher risk of developing melanoma at some point in their life.
- Frequent or extended UV exposure, either outdoors or from a tanning bed – UV rays damage the DNA inside the cell, so the more UV damage you sustain in your life, the greater your skin cancer risk.
- Fair, light skin tones, especially if you freckle and burn easily.
- Red or blonde hair, and green or blue eyes.
- A family history of melanoma – especially close family, like a parent or sibling. However, this factor is complicated because families often have similar UV exposure habits, plus the same hair, skin, and eye colors.
- Personal history of skin cancer – people who have had melanoma once are at higher risk for developing it again. Also, people who have had BCC or SCC face an increased melanoma risk.
- Compromised or weak immune system from other illnesses or diseases – when your immune system is not in peak condition, it’s more difficult to fight cancers of all types.
- Advanced age – anyone can get melanoma, but it’s more common in older adults. However, if melanoma runs in your family, your risk for developing it younger increases. According to the American Cancer Society, melanoma is one of the most common cancers in people under 30, especially women.
- Under age 50, women face a higher risk, but over age 50, men have a higher risk.
Signs and symptoms of melanoma
Since melanoma occurs in the cells that make melanin, melanoma tumors are often brown or black, but they can also be tan, pink, or white. According to the American Cancer Society, men are most likely to develop melanoma on their chest and back, while women are more likely to develop it on their legs. Other common areas for both genders are the face and neck. It’s also possible for melanomas to develop in the eyes, mouth, and genitals, though these areas are less common.
It’s a myth that people with darker skin tones do not get melanoma. While it’s true that they are less likely to develop skin cancers of all types compared to people with fair skin, they can still develop melanoma in areas of their bodies with less melanin. Areas such as the palms of the hands and nail beds are common places to find melanoma in people of color.
Although 70 – 80% of melanoma cases do not begin with a mole, the other 20 – 30% do. If you notice a change in the size, shape, color, or texture of an existing or new mole, it could be a sign of melanoma and should be checked by a dermatologist right away. Also, a mole that looks different than other spots or moles on your body is called the “ugly duckling sign.”
Other symptoms are:
- A sore that won’t heal, or that does heal but then comes back
- Redness or swelling around a mole
- Change in sensation in or around a mole, such as itching, tenderness, or pain
- Changes to the surface of a mole or spot, such as scaling, oozing, or bleeding
You can also use ABCDE to look for melanoma warning signs:
A = Asymmetry: when one half of a mole or mark is different from the other half
B = Border: the edges of the mole or mark are scalloped, uneven, notched, or irregular
C = Color: the mole or mark is not a uniform color throughout; it can be different shades of the same color, or pink, red, or white in a spot that is otherwise brown or black
D = Diameter: if the mole or mark is 6 millimeters (about the size of a pencil eraser) or larger, it could be a melanoma, BUT it’s also possible for melanoma to be smaller than 6 mm
E = Evolving: the mole or mark is changing in size, shape, color, or texture
Not all melanomas show these warning signs, but if you do notice any of them, schedule an appointment with your dermatologist immediately.
Melanoma prevention strategies
An ounce of prevention is worth a pound of cure, so one of the best things that you can do this summer is take steps to lower as many risk factors as possible. Ways to avoid cancer-causing UV damage to the skin are to:
- NEVER use a tanning bed.
- Wear a broad-spectrum sunscreen every day, even if you’ll be inside because UV rays can still pass through windows.
- The American Academy of Dermatology recommends keeping infants under six months of age out of the sun entirely rather than applying sunscreen to their sensitive skin.
- Reapply sunscreen every 2 hours, or more often if you’re swimming or sweating in excess (refer to your bottle of sunscreen for more precise timing instructions).
- Don’t forget to apply sunscreen to the backs of your hands and use a lip balm with SPF.
- Avoid being outdoors between 10 a.m. and 4 p.m. when the sun’s rays are the strongest.
- If you are outdoors, wear protective clothing like long sleeves and pants with an ultraviolet protection factor (UPF) of 50 or more, a broad-brimmed hat that covers the face, neck and ears, and UV blocking eyewear, in addition to your sunscreen. Seek shade when possible.
- As an adult, perform a monthly skin cancer self-exam and see your dermatologist for yearly checks, especially if you have several risk factors.
If you notice a change, schedule an appointment
If you ever have a question about a spot on your skin or about how to protect yourself from UV damage, please schedule an appointment. We offer in-person or virtual appointments, so don’t put your skin health on the back burner.
Brentwood Dermatology is a leader in skin cancer detection and treatment. If you notice a spot that’s concerning, give us a call at (615) 377-3448 to schedule an appointment right away.