Both non-melanoma and melanoma skin cancers are primarily caused by sun exposure. The ultraviolet rays in sunlight can damage the DNA in skin cells, leading to skin damage and/or skin cancer. Understanding your individual risk can help reduce your chances of developing basal cell (BCC), squamous cell (SCC), and melanoma skin cancers.
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Key factors to determine what patients are most at risk for skin cancer
One feature that may increase a patient's risk for skin cancer is hair color. Patients with red/blonde hair, fair skin and freckles have a higher risk of developing melanoma. Researchers say that patients with genes for red hair have more mutations in their skin which make it more difficult for the skin to repair itself after sun exposure.
Lighter eye colors are associated with an increased risk of BCC and SCC. While eye color is not a significant contributor to your risk of developing melanoma, it is worthy to note that those with blue and green eyes are at a greater risk.
The Fitzpatrick Skin Type is a skin classification system that ranks skin types on a scale from one to six, with skin types I and II having the highest risk of developing skin cancer. Those with skin types V and VI have the lowest risk. People with darker skin have the lowest risk for skin cancer because those with more pigmentation have more natural protection from the sun, but still should be aware of the signs and symptoms of developing skin cancer. While rare, these patients are most likely to develop melanomas in areas where there is not been much sun exposure (i.e. palms, soles, nail beds, mouth, and groin)
Number of Moles
Another notable risk factor is the number of moles present on your body. Certain types and a large number of moles can be a risk factor for developing melanoma. Of the most common skin cancers, melanoma is the most dangerous form of skin cancer and can appear as moles that are changing, unusually dark, but can even be pink, asymmetrical, and/or enlarging. Seeing a dermatologist can help you identify moles that may be suspicious of skin cancer. At home skin mapping can also be a useful tool to detect new or changing moles.
History of Sunburn
The more often your skin gets burned in the sun, the higher your risk for skin cancer will be. Sunburns are the leading cause of the damage to your DNA that leads to many cases of BCC, SCC, and melanoma. Each time you get a sunburn your skin cells are damaged by the UV radiation from the sun. Over the years this repeated attack on your DNA can lead to skin cancer. By wearing a broad-spectrum sunscreen with an SPF of 30 or greater, you are reducing your risk of skin cancer by 40%. Wearing hats, sunglasses, protective clothing and avoiding midday sun exposure can also reduce your risk of skin cancers. While not as damaging, tanning, especially indoor tanning, also increases your risk of skin cancer.
History of Tanning Beds
When you use a tanning bed, the DNA in your skin cells are damaged which can lead to accelerated skin aging, increased risk of sunburns, as well as a multitude of other health issues. The exposure to ultraviolet rays from indoor tanning beds is associated with an increased risk of developing BCC, SCC, and melanoma. One indoor tanning bed exposure before age 35 increases your risk of developing melanoma by 75 percent. Both UVA and UVB radiation are emitted through indoor tanning devices. The World Health Organization has classified tanning beds as carcinogenic. Over time, the radiation from tanning beds will leave lasting damages on your skin that do not fade over time.
Genetics/ family history
Another significant risk factor worth mentioning is a family history of melanoma and non-melanoma skin cancer. Approximately five to ten percent of melanoma cases are hereditary. Gene mutations lead to an increased risk of developing skin cancer among the offspring of a person with malignant melanoma. Family history of melanoma as well as non-melanoma skin cancer should always be discussed with your dermatologist during your full body skin exam appointment.
Personal history of skin cancer
If you have had skin cancer in the past, you might be at a greater risk of developing the same or a different type of skin cancer again. Around 60 percent of people previously diagnosed with skin cancer will be diagnosed with another within a decade. It is important to get annual skin exams if you have a history of skin cancer and perhaps more frequently if you have other risk factors.
Additionally, early detection is key to identifying recurring or new skin cancers. Skin cancer detected early and treated quickly is typically of little concern. However, a personal history of skin cancer makes it that much more important to ensure sun protection, avoid tanning, and see a dermatology provider you trust.
Someone with a history of a melanoma, particularly if it occurs before age 30, has a 9-fold increased risk of getting another melanoma in their lifetime compared to someone who has never had a melanoma. The risks are most likely due to genetic susceptibility and sun exposure, and second melanomas are more likely to be detected earlier due to closer follow up visits with providers. Detecting melanomas when they are early is the best way to have the lowest chance of having serious consequences. People with melanoma are somewhat more likely to also have breast cancer, prostate cancer and non-Hodgkins lymphoma.
The bottom line is no matter your physical characteristics or skin cancer history, any and all people who are exposed to the sun face the risk of developing skin cancer. This means that even those who rarely burn can still get skin cancer. As mentioned above, there are certain features that people with fair/lighter pigmented skin should be aware of. This includes having red or fair hair color, an abundant number of moles or freckles throughout the body, or a history of extreme sunburns. If your skin type checks off any of the aforementioned boxes, you may be at a greater risk of developing skin cancer. Getting annual skin checks can reduce your risk of late detection of skin cancer. Anytime you notice a new spot of concern, be sure to reach out to your dermatology provider to ensure you can get the best information regarding your personal risk of developing skin cancer. You can also book an in-person skin spot check to get recommendations for a spot of concern in less than days.