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What is Skin Cancer?
Skin cancer is the most common form of cancer in the United States. The two most common types of skin cancer—basal cell and squamous cell carcinomas—are highly curable, but can be disfiguring and costly.
Melanoma, the third most common skin cancer, is more dangerous and causes the most deaths. The majority of these three types of skin cancer are caused by exposure to ultraviolet (UV) light.
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Ultraviolet (UV) Light
Ultraviolet (UV) rays are an invisible kind of radiation that comes from the sun, tanning beds, and sunlamps. UV rays can penetrate and change skin cells.
The three types of UV rays are ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC)—
- UVA is the most common kind of sunlight at the earth's surface, and reaches beyond the top layer of human skin. Scientists believe that UVA rays can damage connective tissue and increase a person's risk of skin cancer.
- Most UVB rays are absorbed by the ozone layer, so they are less common at the earth's surface than UVA rays. UVB rays, which help produce vitamin D in the skin, don't reach as far into the skin as UVA rays, but they can still be damaging.
- UVC rays are very dangerous, but they are absorbed by the ozone layer and do not reach the ground.
In addition to sunburn, too much exposure to UV rays can change skin texture, cause the skin to age prematurely, and can lead to skin cancer. UV rays also have been linked to eye conditions such as cataracts.
UV Index
Check your UV Ind
The National Weather Service and the Environmental Protection Agency developed the UV Index
to forecast the risk of overexposure to UV rays. It lets you know how much caution you should take when working, playing, or exercising outdoors.
The UV Index predicts exposure levels on a 1–15 scale; higher levels indicate a higher risk of overexposure. Calculated on a next-day basis for dozens of cities across the United States, the UV Index takes into account clouds and other local conditions that affect the amount of UV rays reaching the ground.
What Are the Risk Factors?
Normal human skin showing the outermost epidermis, the dermis, and the hypodermis.
People with certain risk factors are more likely than others to develop skin cancer. Risk factors vary for different types of skin cancer, but some general risk factors are having—
- A lighter natural skin color.
- Family history of skin cancer.
- A personal history of skin cancer.
- Exposure to the sun through work and play.
- A history of sunburns, especially early in life.
- A history of indoor tanning.
- Skin that burns, freckles, reddens easily, or becomes painful in the sun.
- Blue or green eyes.
- Blond or red hair.
- Certain types and a large number of moles.
Tanning and Burning
Ultraviolet (UV) rays come from the sun or from indoor tanning (using a tanning bed, booth, or sunlamp to get tan). When UV rays reach the skin's inner layer, the skin makes more melanin. Melanin is the pigment that colors the skin. It moves toward the outer layers of the skin and becomes visible as a tan.
A tan does not indicate good health. A tan is a response to injury, because skin cells signal that they have been hurt by UV rays by producing more pigment.
People burn or tan depending on their skin type, the time of year, and how long they are exposed to UV rays. The six types of skin, based on how likely it is to tan or burn, are—
- I: Always burns, never tans, sensitive to UV exposure.
- II: Burns easily, tans minimally.
- III: Burns moderately, tans gradually to light brown.
- IV: Burns minimally, always tans well to moderately brown.
- V: Rarely burns, tans profusely to dark.
- VI: Never burns, deeply pigmented, least sensitive.
Although everyone's skin can be damaged by UV exposure, people with skin types I and II are at the highest risk.
What Are the Symptoms?
A change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that doesn't heal, or a change in a mole.
Not all skin cancers look the same.
A simple way to remember the signs of melanoma is to remember the A-B-C-D-Es of melanoma—
- “A” stands for asymmetrical. Does the mole or spot have an irregular shape with two parts that look very different?
- “B” stands for border. Is the border irregular or jagged?
- “C” is for color. Is the color uneven?
- “D” is for diameter. Is the mole or spot larger than the size of a pea?
- “E” is for evolving. Has the mole or spot changed during the past few weeks or months?
Talk to your doctor if you notice changes in your skin such as a new growth, a sore that doesn't heal, a change in an old growth, or any of the A-B-C-D-Es of melanoma.
What Screening Tests Are There?
The U.S. Preventive Services Task Force (USPSTF) has concluded there is not enough evidence to recommend for or against routine screening (total body examination by a doctor) to find skin cancers early. The USPSTF recommends
that doctors—
- Be aware that fair-skinned men and women aged 65 and older, and people with atypical moles or more than 50 moles, are at greater risk for melanoma.
- Look for skin abnormalities when performing physical examinations for other reasons.
Is Indoor Tanning Safe?
Using a tanning bed, booth, or sunlamp to get tan is called "indoor tanning." Indoor tanning has been linked with skin cancers including melanoma (the deadliest type of skin cancer), squamous cell carcinoma, and cancers of the eye (ocular melanoma).
Dangers of Indoor Tanning
Indoor tanning exposes users to both UV-A and UV-B rays, which damage the skin and can lead to cancer. Using a tanning bed is particularly dangerous for younger users; people who begin tanning younger than age 35 have a 59% higher risk of melanoma. Using tanning beds also increases the risk of wrinkles and eye damage, and changes skin texture.
Myths About Indoor Tanning
“Tanning indoors is safer than tanning in the sun.”
Indoor tanning and tanning outside are both dangerous. Although tanning beds operate on a timer, the exposure to ultraviolet (UV) rays can vary based on the age and type of light bulbs. You can still get a burn from tanning indoors, and even a tan indicates damage to your skin. Tanning beds cause about 1,800 injuries requiring visits to the emergency room every year.
“I can use a tanning bed to get a base tan, which will protect me from getting a sunburn.”
A tan is a response to injury: skin cells respond to damage from UV rays by producing more pigment. The best way to protect your skin from the sun is by using these tips for skin cancer prevention.
“Indoor tanning is a safe way to get vitamin D, which prevents many health problems.”
Vitamin D is important for bone health, but studies showing links between vitamin D and other health conditions are inconsistent. Although it is important to get enough vitamin D, the safest way is through diet or supplements. Tanning harms your skin, and the amount of time spent tanning to get enough vitamin D varies from person to person.
Statistics
According to the 2011 Youth Risk Behavior Surveillance System, the following proportions of youth report indoor tanning—
- 13% of all high school students.
- 21% of high school girls.
- 32% of girls in the 12th grade.
- 29% of white high school girls.
According to the 2010 National Health Interview Survey, indoor tanners tended to be young, non-Hispanic white women.
- 32% of non-Hispanic white women aged 18–21 years reported indoor tanning. Those who reported indoor tanning device use reported an average of 28 sessions in the past year.
- Among non-Hispanic white adults who used an indoor tanning device in the past year, 58% of women and 40% of men used one 10 times or more in the past year.
- Non-Hispanic white women between the ages of 18 and 21 years residing in the Midwest (44%) and non-Hispanic white women between the ages of 22 and 25 old in the South (36%) were most likely to use indoor tanning devices.
Healthy People 2020 Goals for Indoor Tanning
Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. Healthy People 2020 has 20 cancer objectives, including—
- Reduce the proportion of adolescents in grades 9 through 12 who report using artificial sources of ultraviolet light for tanning to 14.0%.
- Reduce the proportion of adults aged 18 years and older who report using artificial sources of ultraviolet light for tanning to 13.7%.
Indoor Tanning Policies
Indoor tanning is restricted in some areas, especially for minors.
United States
International
- Brazil and one state in Australia (New South Wales) have banned the use of tanning beds.
- The United Kingdom, Germany, Scotland, France, several Australian states, and several Canadian provinces have banned indoor tanning for people younger than age 18.
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