Skin cancer can affect anyone, no matter the color of your skin or even your age. Although ultraviolet (UV) exposure from the sun and tanning beds is the most common cause, family history and other factors can also increase the likelihood of skin cancer.
For Melanoma Monday, Marc Hurlbert, PhD, the CEO of the Melanoma Research Alliance (MRA), debunks 10 of the most common skin cancer misconceptions and explains how to lower your risk and catch skin cancer early if it does arise.
Myth 1: There Is Only 1 Type of Skin Cancer
Of the several different types of skin cancer, some are more serious than others. The two most common are basal and squamous cell carcinomas, according to the Centers for Disease Control and Prevention (CDC).
“There are more than a million [cases] every year, so many that the government doesn’t even track them,” Dr. Hurlbert says.
These skin cancers originate in the basal and squamous layers of the skin. Melanoma, which is far less common, originates in the melanocytes, the skin cells that produce pigments. Melanoma is more serious and invasive than basal and squamous cell carcinomas, and accounts for about 100,000 skin cancer diagnoses annually in the United States, according to the American Cancer Society.
Myth 2: Melanoma Is Just a Mole That Needs to Be Removed
It’s true that all melanoma arises from melanocytes, including those found in moles, “But it’s so much more than a mole that needs to be removed — it can be deadly if it’s not dealt with early,” Hurlbert says.
When screening yourself for skin cancer, Hurlbert says to follow the “ABCDEs of melanoma.” Look for dark spots that are asymmetrical and have irregular borders. Melanoma spots evolve over time and sometimes have colors that vary within the spot. While most are bigger than a pencil eraser, some melanomas are caught when they’re smaller.
“We all know our own bodies better than even our doctors. We should all be aware of the marks on our own bodies,” Hurlbert says. “You get more of those as you age, but if they're changing, be screened by a doctor.”
Khloé Kardashian’s precancerous melanoma started out as a bump in her cheek, according to Insider. When what she assumed was a pimple didn’t go away for seven months, she decided to get it biopsied. "It was way more serious than I anticipated it to be," Kardashian said in the trailer for Season 3 of her family’s reality show The Kardashians.
Myth 3: Melanoma Appears Only on the Skin
These spots don’t just appear on the skin. Rare forms of melanoma can appear on the eyes (ocular melanoma), and in mucus membranes (mucosal melanoma), especially those in the nose, mouth, or lips.
Myth 4: Skin Cancer Isn’t Serious
Skin cancer, particularly melanoma, can be deadly if it isn’t caught early. “Melanoma has a propensity to spread to other parts of the body,” says Hurlbert. “Anyone diagnosed in the advanced stages, past stage 1, will need surgery and immunotherapy.”
Immunotherapies are now used to treat many different types of cancer, but an immunotherapy used to treat leukemia and melanoma was one of the first the U.S. Food and Drug Administration (FDA) approved. Rather than a toxic agent to kill fast-growing tumor cells, which is how chemotherapy works, immunotherapies teach a person’s immune system to attack cancer cells, just as it would a virus.
Some basal and squamous cell skin cancers may require radiation after surgery to kill remaining tumor cells, according to the American Cancer Society.
Myth 5: People With Darker Skin Don’t Get Skin Cancer
“People of any race or skin color can get skin cancer from UV, period,” says Hurlbert, adding that skin cancer may be missed more frequently in people who have darker skin.
According to the Dartmouth Geisel School of Medicine, Black patients are more than three times as likely to be diagnosed with melanoma at a late stage than white patients.
People with darker skin also get rare subtypes that are linked not just to UV damage. Communities of color have higher rates of a rare type of skin cancer called acral lentiginous melanoma, which appears on the palms of the hands, soles of the feet, and in the nail beds.
Myth 6: You’ll Develop Melanoma Only if You’ve Had Years of Sun Exposure and Burns
Just one blistering sunburn in childhood or adolescence more than doubles a person’s chances of developing melanoma later in life, according to the Skin Cancer Foundation.
“One sunburn is one sunburn too many, and can damage your skin cells and potentially increase your risk of melanoma,” says Hurlbert, adding that multiple severe sunburns and prolonged UV exposure over your lifetime is worse, since sun damage builds up over time. Still, just one sunburn causes lasting damage.
Myth 7: A Base Tan From a Tanning Bed Helps Prevent Sunburns and Therefore Skin Cancer
According to Hurlbert, no tan is healthy. “A tan is actually a sign that your skin is in distress. It’s the skin’s damage or stress response to UV exposure,” he says.
Even if you don’t burn, sun exposure causes cellular damage that raises your skin cancer risk, the Skin Cancer Foundation says. And a tan doesn’t protect you from sunburn. Studies have shown that a base tan has about the same UV protection as sunscreen with an SPF of 3 or less, according to the University of Central Florida.
Myth 8: Makeup Can Provide All the Skin Protection You Need
“It’s great that some makeups and foundations have SPF in them, but it’s not enough,” Hurlbert says. “You really want to put on SPF 30 or higher, and apply [your makeup], and then reapply that every couple of hours.”
Reapplication of sunscreen is key, and it usually isn’t part of someone’s makeup routine. And no matter how dark your skin is, everyone should wear sunscreen and avoid being outside during peak sun times year round, he says.
Myth 9: You Need to Bother With Sunscreen Only When You’ll Be Outside for Hours, Like When You Go to the Beach or the Pool
Sunscreen should be part of everyone’s morning routine, even if they’re going to be indoors for most of the day, Hurlbert says.
“You may be outside during your commute, and you can get sun exposure through windows while you’re inside, too,” he says.
When you're outside for an extended period of time, you need to reapply sunscreen every two hours, he says.
Myth 10: Only UV Exposure Causes Skin Cancer
While UV exposure is the primary cause of skin cancer, it’s not the only risk factor.
“Skin cancer can run in families. We haven’t yet identified the inherited genetics of melanoma, but there are hints of what genes may be involved,” Hurlbert says, adding that family history is more commonly a factor in teenagers and younger adults who develop skin cancer.
The rare skin cancer subtypes that affect the eyes, mucosa, and the bottoms of hands and feet are usually not caused by UV exposure, he says. A lot of moles and certain types of moles increase the risk of skin cancer, too, according to the CDC.