Melanoma: Separating Myths from Facts

Every year as warmer weather approaches, doctors share advice and reminders around the importance of sun healthy behaviors, with emphasis on sunscreen usage. Sunscreen is a vital tool in the prevention of melanoma and other skin cancers. However, with so much medical information now available online, and through social media influencers, it can be confusing to determine what is based in fact, and what is more of a myth. When it comes to melanoma, the most serious form of skin cancer, it is important to have accurate information about who is at risk and what can be done to remain cancer free. Here we explore 5 common myths related to melanoma. 

Myth #1: Only people with light skin can get melanoma.
Fact: Melanoma can affect anyone, regardless of skin tone.

While it is true that people with certain traits -- fair skin, light hair, and blue eyes – may have a higher risk for melanoma, the disease does not discriminate. In fact, anyone, of any race and/or ethnicity, can develop this form of skin cancer. While rates of melanoma are lower in individuals with darker skin, there is still a risk. And unfortunately, when individuals with darker skin are diagnosed with melanoma, it is often at a later stage because of the common belief that having dark skin is protective against skin cancer. Everyone should pay attention to growths and moles that newly appear, change quickly, or grow over time.

Myth #2: Melanoma only happens in skin exposed to the sun.  
Fact: Melanoma can develop anywhere on the body.

It is true that UV radiation from the sun is a significant risk factor for melanoma, but cancerous growths can appear on virtually any part of the body (even the eyes). It is helpful to have a loved one check for moles on hard to see places like the shoulder blades or backs of the legs, but it is also important to look in places that are rarely exposed to sunlight. Think the bottom of the feet, in-between toes, under nails, and the scalp. This is why during skin checks dermatologists are interested in seeing every area of the body (and should ask you to take your socks off!).

Myth #3: Tanning beds are not as dangerous as a sunburn.
Fact: Tanning bed usage is associated with a higher risk of developing melanoma.

In 2009, the World Health Organization classified ultraviolet radiation–emitting tanning devices as Class I carcinogens. This decision was based on factual evidence linking indoor tanning to an increased risk of skin cancer. Despite the passing of legislation that is meant to restrict use by young people and provide education around the risks, tanning beds are still marketed for ‘health benefits’ such as helping with seasonal depression or vitamin deficiencies. However, even what seems like limited usage can elevate the risk of melanoma.

Myth #4: A mole that has always been present is low risk for melanoma regardless of appearance.
Fact: Any changes in moles or new skin growths warrant a check-up by a doctor. 

It is impossible for someone to recall the detail of every mole on their body. This is why the “ABCDE” rule can be helpful to use at home. Moles that meet any of the below should be looked at by a physician:

A: Asymmetry, when two sides of a mole don’t seem to match each other. 
B: Border: Moles with an irregular or poorly defined edge should be checked. Think of “coloring outside the lines” when looking at the border of a mole.
C: Color: Moles that seem to have a variety of colors (brown, black, tan, red) instead of one solid color may be higher risk.
D: Diameter: A mole that is or becomes larger than the size of a pencil top eraser should be evaluated. 
E: Evolving: Any mole that just “looks different” over time should be monitored. Some doctors now encourage using cell phone cameras to document moles to more easily identify changes over time.

Myth #5: Sunscreen is only needed on hot, bright days.
Fact: Sunscreen should be used every day when skin is exposed to outdoor elements.

UV rays can penetrate clouds and cause skin damage, even on darker days. Dermatologists recommend using a broad-spectrum sunscreen with an SPF of 30 or higher, applying it generously. When swimming or sweating, sunscreen should be re-applied. An additional benefit of regular sunscreen usage is that is also helps prevent skin damage that is associated with wrinkles and age spots.

Individuals of all skin types – but especially those with a blood-relative that has had melanoma – should practice sun safety, schedule annual skin checks, and talk to a healthcare provider about any skin changes that are concerning. With melanoma and other forms of skin cancer, the best defense is a good offense.