FS037, February 2013




Skin Cancer Prevention

What is skin cancer?
Your skin is made of cells that are constantly changing. Normal healthy cells eventually grow old and are replaced by new healthy cells. Cancer develops when
new cells form that are not needed and old or damaged cells do not die like they are supposed to. Eventually a mass or build up of these abnormal cells forms a tumor. Some tumors that form are benign (noncancerous), others are malignant (cancerous).

The American College of Obstetricians and Gynecologists WOMEN’S HEALTH CARE PHYSICIANS Online Fact Sheet fo r Teens and Young Adults Tool Kit for Teen Care, second edition absorbed deep into the skin, which causes wrinkles and aging and plays a major role in the development of skin cancer. Ultraviolet B rays affect the top layer of the skin. These rays cause redness and sunburns and also contribute to the development of skin cancer. • If you have light skin that burns easily or freckles or you have a medical history of blistering sunburns (during childhood or as an adult), your risk is increased. New freckles can be a sign of sun damage and that you need sun protection. Although individuals with fair skin are at the highest risk, individuals of all different skin colors are at risk of developing skin cancer and need sun protection. Your risk also is increased if you try to get a tan or if someone in your family has had melanoma. • Damage done to skin cells when you are young often does not show up until you are much older because it takes a long time for the damaged skin to change into cancer. Sun exposure leads to other kinds of skin damage, including wrinkles, dark spots, red spots, and scaly patches called actinic keratoses. Actinic keratoses may eventually turn into cancer as well. What about tanning beds? • There is no such thing as a “safe” tan. Tanning damages skin no matter what type of light is used. • The lights used in artificial tanning beds produce UVA and UVB radiation that can cause cancer. The strength of these lights may be at the same levels as the sunlight or possibly stronger. • Individuals who use tanning beds are 74% more likely to develop melanoma, 2.5 times more likely to develop squamous cell cancer, and 1.5 times more likely to get basal cell cancer than those who do not use tanning beds. The bottom line is using tanning beds increases your risk of skin cancer. It also increases your chances of developing wrinkles and brown spots on your skin. Even if you use tanning beds only a few times for special events, you are still at risk of getting skin cancer. • The American Academy of Dermatology and the World Health Organization both recommend that no one younger than 18 years should use indoor tanning equipment. What is skin cancer? • Your skin is made of cells that are constantly changing. Normal healthy cells eventually grow old and are replaced by new healthy cells. Cancer develops when new cells form that are not needed and old or damaged cells do not die like they are supposed to. Eventually a mass or build up of these abnormal cells forms a tumor. Some tumors that form are benign (noncancerous), others are malignant (cancerous). • The three most common types of skin cancer are 1) melanoma, 2) basal cell cancer, and 3) squamous cell cancer. These are based on what type of cell is abnormal. Skin cancer can spread to nearby skin or even throughout the body. Melanoma is the most serious type of skin cancer and most likely to spread. • Melanomas can occur in all age groups, including teenagers and young adults. How common is skin cancer? • Skin cancer is the most common form of cancer in the United States. Currently, one in five individuals in the United States will develop skin cancer in their lifetime, and more than 2 million individuals in the United States develop nonmelanoma skin cancer every year. • Melanoma is the most common form of cancer for young adults aged 25–29 years, and is the second most common form of cancer for teenagers and young adults aged 15–29 years. What increases your chances for developing skin cancer? • The number one risk factor for skin cancer is contact with ultraviolet (UV) radiation. It is a carcinogen (cancercausing substance). Ultraviolet radiation is found in both sunlight and artificial light sources such as tanning beds. • Ultraviolet radiation is made up of ultraviolet A (UVA) and ultraviolet B (UVB) rays. Ultraviolet A rays are Skin Cancer Prevention Tool Kit for Teen Care, second edition • If a tanning bed store says that their tanning beds have a “controlled dose of UV radiation” remember that a controlled dose is still a dangerous dose. It is not safe for your skin. What can you do to protect yourself from skin cancer? • Avoid getting a sunburn. • Use sunscreen with a sun protection factor (SPF) 15 or higher. Use sunscreen daily from head to toe if possible and especially if you plan to be outside. • Avoid direct sun and stay in shady areas, especially between 10 am and 4 pm. • Avoid tanning beds. • Cover up with protective clothing, a broad-brimmed hat (that shades your face, ears, and neck), and UVblocking sunglasses. A cotton t-shirt has an ultraviolet protective factor of 5 so it is not enough to protect you from the sun. Some clothes are designed for skin protection and can have an ultraviolet protective factor of up to 50, which is good protection. • Start using sun protection when you are young. Approximately 25% of your lifetime sun exposure occurs in the first 18 years of your life. What kind of sunscreen should you use and how should you use it? • The U.S. Food and Drug Administration recommends using a sunscreen with an SPF of 15 or higher daily. The higher the SPF the better the sunscreen is at blocking UV rays. Using sunscreen properly is very important, otherwise it may not be effective no matter how high the SPF number. • Your sunscreen should protect you from both UVA and UVB rays. Sunscreens labeled “broad-spectrum” protect you from both UVA and UVB rays. • If you will be outside for more then 15–30 minutes, use a water-resistant, broad-spectrum sunscreen with an SPF of 30 or higher. • Apply 1 ounce (2 tablespoons) of sunscreen or more to your entire body. This is a lot more than most individuals typically put on. You need a lot of sunscreen for it to work properly. • The sun can damage your skin in as little as 15 minutes. You should put your sunscreen on 30 minutes before going outside because it takes time to absorb in your skin to protect you. • You should reapply sunscreen every 2 hours or immediately after swimming or excessive sweating. • Do not forget to apply sunscreen on cloudy or overcast days because UV rays are still present. You can get a sunburn on a cold or cloudy day. How should you monitor your skin? • The American Academy of Dermatology suggests doing an examination of your skin every year on your birthday. Do not forget to check hard to see places like the backs of your legs, back and upper arms, neck, scalp, and buttocks. You can ask someone to help or use a hand mirror to check private areas. • If you see a change in your skin, you should be examined by a health care provider. Most types of skin cancer are not painful. Skin cancer may appear as a lump or be flat. It can be the color of your skin or turn another color such as red or brown. Sometimes skin cancer bleeds or develops a crust. • “ABCDE” can help you check for signs of skin cancer, especially melanomas. If you have a mole or see a new mole with any of the following signs, ask your health care provider to examine these areas. A = Asymmetry One half is unlike the other half. B = Border An irregular, scalloped or poorly defined border. C = Color Is varied from one area to another; has shades of tan, brown or black, or is sometimes white, red, or blue. D = Diameter Melanomas are usually greater than 6 mm (the size of a pencil eraser) when diagnosed, but they can be smaller. Fig. 1. ABCDEs of melanoma. Reproduced with permission from the American Academy of Dermatology, Copyright © 2012. All rights reserved. E = Evolving A mole or skin lesion that looks different from the rest or is changing in size, shape or color. Tool Kit for Teen Care, second edition Should you be getting some sun for vitamin D? • Vitamin D is a nutrient that your body needs for strong bones and fighting off infections. Your body makes vitamin D when the sun’s UVB rays interact with a chemical present in your skin. However, the amount your body makes from exposure to the sun is very little. You can get vitamin D from the foods you eat. Vitamin D has been added to many foods labeled as “fortified,” such as milk, cereals, and other products, and is also found in egg yolks. Multiple vitamin supplements contain vitamin D as well. The Institute of Medicine recommends that children, adolescents, and adults (up to age 60 years) get 600 international units per day. Talk to your health care provider if you are not sure if you are getting the right amount of vitamin D from your diet. Prepared by the American College of Obstetricians and Gynecologists Committee on Adolescent Health Care. For more information, e-mail adolhlth@acog.org. Copyright February 2013, The American College of Obstetricians and Gynecologists, 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920 (FS037) For More Information The following resources are for information purposes only. Referral to these sources and web sites does not imply the endorsement of the American College of Obstetricians and Gynecologists. These resources are not meant to be comprehensive. The exclusion of a source or web site does not reflect the quality of that source or web site. Please note that web sites are subject to change without notice. American Academy of Dermatology Telephone: (866) 503-SKIN (7546) Web: www.aad.org Spot Skin Cancer: www.aad.org/spot-skin-cancer American Cancer Society Telephone: (800) 227-2345 Web: www.cancer.org Melanoma: www.cancer.org/cancer/skincancer-melanoma/ index Basal and Squamous Cell: www.cancer.org/cancer/skincancerbasalandsquamouscell/ index Centers for Disease Control and Prevention Telephone: (800) 232-4636 Web: www.cdc.gov/cancer/skin National Cancer Institute Telephone: (800) 4-CANCER (422-6237) Web: www.cancer.gov/cancertopics/types/skin Skin Cancer Foundation Telephone: (212) 725-5176 Web: www.skincancer.org