Did you know that doctors diagnose skin cancer more often than all other kinds of cancer combined? The American Academy of Dermatology estimates that about one in five people living in the U.S. will develop skin cancer. But can you separate fact from fiction when it comes to this disease? Here, we break it down.
By Katherine Ladny Mitchell
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Skin Cancer, Defined
Fiction: I was born with freckles and moles, so they can’t be cancerous.
Fact: While most freckles and moles are completely normal, skin cancer can still develop anywhere.
Skin cancer is the unusual growth of skin tissue cells often found on, but not limited to, areas exposed to sunlight. People who have been exposed to ultraviolet (UV) light, radiation, and chemicals like arsenic, paraffin, or coal tar may have a higher risk of developing certain kinds of skin cancer. Other skin cancer risk factors include having severe skin inflammations, a weakened immune system, human papillomavirus (HPV) infection, a light skin tone, a smoking habit, a male gender, or an older age. However, having one or more risk factors does not automatically determine that you’ll get skin cancer, and there are ways to lower your risk.
More than Melanoma
Fiction: Melanoma is the only type of skin cancer.
Fact: There are many different types of skin cancer.
Basal cell carcinoma (BCC)
According to the American Academy of Dermatology, most people who get diagnosed with skin cancer have basal cell carcinoma. Basal cell carcinoma develops in the outer layer of the skin and often grows slowly on sun-exposed areas such as the head, neck, and arms. BCC often appears as a waxy scar, a pearl-shaped bump, a skin-toned or brownish lesion, a recurring sore, shiny, scaly pink or red bumps, or a hard white or yellow depressed growth.
Squamous cell carcinoma (SCC)
This kind of skin cancer develops within the skin’s surface cells and commonly appears on sun-exposed areas on the face, head, neck, or arms. “Sun exposure of any type can lead to skin cancer. Squamous cell carcinoma results from the cumulative effect of sun. It accumulates with time,” explains Dr. John Chung, a dermatologist with Skin Cancer & Cosmetic Dermatology Center. Squamous cell carcinoma can also form in the mouth, on the genitals, on the lips, on areas not exposed to sunlight on dark-skinned individuals, or on skin exposed to radiation, or certain chemicals, and bad burns. It can look like a hard, red bump, a scaly or crusty red patch, a recurring sore that bleeds or feels itchy, or scaly, thick skin on the lips.
Melanoma forms in skin cells that produce melanin and can appear anywhere on the skin regardless of sun exposure or skin tone. “You don’t have to be burned to get skin cancer. You could still get skin cancer having never being exposed to the sun, especially melanoma, because there is a genetic predisposition,” explains Dr. Chung. Melanoma often forms on men’s chests or faces, on women’s legs, and on the palms, soles, or under the nails of those with darker skin tones. It usually appears as a growing, scaly, oozing, or color-changing mole, a new, quickly-growing spot that resembles a mole, a dark streak underneath a nail, or a persistent bruise on the foot.
Rare Skin Cancers
There are other less common skin cancer types as well. Merkel cell carcinoma is an aggressive skin cancer. It can quickly spread and often appears as a dense patch of skin, a hard bump, or shiny bumps on or below the skin’s surface on the head, neck, and person’s core. Kaposi sarcoma typically affects people with weak immune systems, such as those with AIDS, or those who’ve taken medications to help their bodies accept organ transplants. Kaposi sarcoma causes reddish/purplish patches on the skin as it develops within the blood vessels. Sebaceous gland carcinoma is an aggressive cancer that forms in the skin’s oil glands and usually appears as firm, painless bumps on the eyelid.
Fiction: As long as I wear sunscreen, I’ll never get skin cancer.
Fact: Wearing sunscreen alone cannot guarantee a cancer-free life.
Sunscreens do not protect against all UV rays and cannot enable you to stay in the sun indefinitely. Seek shade between 10 a.m. and 4 p.m., when the sun’s rays are most intense. Avoid tanning beds. Protect your skin by wearing tightly-woven clothing, a brimmed hat, sunglasses, and a sunscreen with a sun protection factor (SPF) of 30 – even on cloudy days. Also, check your skin for any changes monthly and get a professional skin exam every year.
Fact: Certain chemicals in many commercial sunscreens may actually cause physical problems – including some forms of cancer.
According to the National Center for Biotechnology Information, chemicals called “parabens” are found in many brands of sunscreens and cosmetics. Parabens can penetrate skin, interfere with hormones, and may be linked to higher rates of breast cancer. The NCBI also found that retinyl palmitate, another common chemical in cosmetic products, can alter a cell’s composition and potentially lead to cancer when combined with UVA rays. Some recommend using micronized zinc oxide lotions instead as these sunscreens pose fewer health risks and will protect your skin without absorbing into your system. However, Dr. Chung explains that most of the controversy surrounding sunscreen is not totally backed up by studies. “It is of much greater benefit to use sunscreen than any harm than it can do,” he explains.
Fiction: Darker skin tones can’t get skin cancer
Fact: All skin tones are susceptible to skin cancer.
“It doesn’t matter what skin color you have – you can develop skin cancer. Everyone needs to protect their skin. I’ve seen all types of skin with cancer – black, Spanish, Middle Eastern, Caucasian, Asian. There is not one ethnic group that is immune to skin cancer,” says Dr. Chung. According to the Centers for Disease Control and Prevention, fair-skinned people have the highest rate of skin cancer, however, anyone can get skin cancer with or without any known risk factors. That’s why it’s important for all of us to make healthy preventative choices based on the facts.