Skin cancer can affect anyone, no matter the color of your skin or even your age. Even celebrities like John Cena and Khloe Kardashian have shared their recent experiences with skin cancer.
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.
There are several different types of skin cancer, and some are more serious than others.
The two most common are basal and squamous cell carcinomas. These skin cancers originate in the basal and squamous layers of skin, respectively.
Although more than a million people in the U.S. may be diagnosed with these skin cancers each year, Dr. Hurlbert says, deaths from basal and squamous cell carcinomas are rare.
Melanoma, which is far less common, is more serious and invasive. It originates in the melanocytes, the skin cells that produce pigments, and accounts for about 105,000 skin cancer diagnoses annually in the U.S.
Myth 2: Melanoma Is Just a Mole That Needs to Be Removed
It’s true that melanoma can (but doesn’t always) start as a mole.
“But it’s so much more than a mole that needs to be removed,” Hurlbert says. “It can be deadly if it’s not dealt with early.”
In fact, melanoma accounts for the majority of skin cancer deaths, though these deaths have decreased in recent years because of an increase in treatment.
Perspectives
Holly Rowe
Melanoma Survivor
“I would set all these little goals for myself that I think helped get me through my cancer, because then I wasn't sitting around feeling sorry for myself and only obsessing about that... that living with a little bit of purpose and joy helped me.”
Transcript Available
Myth 3: Melanoma Appears Only on the Skin
Melanoma can occur anywhere we have melanocyte cells. 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.
As much as 80 percent of melanoma instances, however, appear on seemingly normal skin.
Hurlbert says to follow the “ABCDEs of melanoma” when screening yourself for skin cancer. Pay attention to spots that include:
Asymmetry
Borders that are irregular
Colors that vary
Diameter larger than a pencil eraser
Evolving shape, size, or color
“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.”
Myth 4: Skin Cancer Isn’t Serious
Skin cancer, particularly melanoma, can be deadly if it isn’t caught early.
Between 2,000 and 8,000 U.S. adults die each year because of basal and squamous cell skin cancers. There are about 8,400 deaths per year from melanoma alone.
“Melanoma has a propensity to spread to other parts of the body,” Hurlbert says.
Melanoma at any stage of progression typically requires surgery to remove cancerous cells. At stages 3 and 4 it has spread to other areas of the skin or lymph vessels.
Some basal and squamous cell skin cancers may require radiation after surgery to kill remaining tumor cells.
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,” Hurlbert says.
Research shows that Black people are more than three times as likely to be diagnosed with advanced-stage melanoma than white people.
People with darker skin also 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 can more than double your chance of developing melanoma later in life.
“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 during your lifetime is worse because sun damage is cumulative. Still, just one sunburn can cause lasting damage.
Myth 7: A Tan From a Tanning Bed Protects You From Sunburns and Skin Cancer
No tan is healthy, Hurlbert says.
“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 and tanning beds cause cellular damage that increases your risk of skin cancer.
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.
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 apply SPF 30 or higher and put on your makeup, then reapply 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.
Choose a sunscreen that protects against UVA and UVB rays, is SPF 30 or higher, and is water-resistant.
Myth 9: Sunscreen Is Only Needed When You’re Outside for Hours, Like at the Beach or the Pool
“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, accounting for as much as 90 percent of skin cancer cases, it’s not the only potential cause.
“Skin cancer can run in families,” Hurlbert says. “We haven’t yet identified the inherited genetics of melanoma, but there are hints of what genes may be involved.”
Hurlbert says that family history is more commonly a factor in teenagers and younger adults who develop skin cancer. Prevention tactics for people with a family history of skin cancer are the same as for everyone else.
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. Having a lot of moles or certain types of moles may increase your risk of skin cancer, too.
The Takeaway
Skin cancer affects 1 in 5 U.S. adults.
Melanoma is the deadliest form of skin cancer, but it’s not the most common.
Exposure to UV rays from the sun or from tanning beds is the most common cause of skin cancer.
Detection and early treatment are key to keeping skin cancer under control.
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Cymerman RM et al. De Novo vs Nevus-Associated Melanomas: Differences in Associations With Prognostic Indicators and Survival. Journal of the National Cancer Institute. October 2016.
Hu S et al. Comparison of Stage at Diagnosis of Melanoma Among Hispanic, Black, and White Patients in Miami-Dade County, Florida. Archives of Dermatology. June 2006.
Bradford PT. Skin Cancer in Skin of Color. Dermatology Nursing. July–August 2009.
An S et al. Indoor Tanning and the Risk of Overall and Early-Onset Melanoma and Non-Melanoma Skin Cancer: Systematic Review and Meta-Analysis. Cancers. November 25, 2021.
Daniel Landau, MD, is a distinguished board-certified hematologist-oncologist with a career that has spanned two eminent institutions: the Orlando Health Cancer Institute and the Medical University of South Carolina. With a specialized interest in genitourinary oncology and hematology, he has been at the forefront of managing both benign and malignant conditions.
Dr. Landau is a pioneering figure in integrating advanced technology into oncology, having served as a director of telemedicine services. Under his leadership, multiple innovative systems have been designed and piloted, all with a singular focus: enhancing the patient experience.
Beyond his clinical and technological endeavors, Landau is deeply committed to medical education. He has dedicated significant time and expertise to nurturing the skills of medical students, residents, and fellows, ensuring that the flame of knowledge and compassion burns bright in the next generation of oncologists.
Kaitlin Sullivan reports on health, science, and the environment from Colorado. She has a master's in health and science journalism from the City University of New York.
