May is Melanoma Awareness Month and we would like to talk about what melanoma is, how to detect it, and ways to protect yourself from it.  

* Experiencing five or more blistering sunburns between ages 15 and 20 increases one’s melanoma risk by 80 percent. *

 What is melanoma?

There are two major categories of skin cancers. The first category is melanoma, and the second category is called non-melanoma skin cancers. The two most common non-melanoma skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Basal cell carcinoma is the most common type of skin cancer. BCC and SCC are caused by chronic sun or UV radiation exposure over a patient’s lifetime.  

 Melanoma is the most serious form of skin cancer due to its ability to spread to lymph nodes and other areas of the body. When this occurs, it is called metastasis. Melanoma can be easily treated if caught early. Unfortunately, if melanoma has spread even a few millimeters into the layers of the skin it becomes more difficult to treat and may result in death. We now have treatment for metastatic melanoma. 

 Melanoma can arise in what is called an existing mole, meaning a mole a person has had for many years, or it can develop as a completely new growth. 

* Women younger than 30 are six times more likely to develop melanoma if they tan indoors. *

 Risks of developing melanoma 

There are a few important risks that increase a person’s chances of developing melanoma. These include genetic factors and exposure to UV radiation, either due to sun exposure or tanning indoors. We also know that having certain natural personal characteristics increases this risk as well. Check out the list below to determine if you have any of the qualities that increase your risk of developing melanoma. 

  1.  Blue or green eyes 
  2. Blonde or red hair
  3. Lighter skin color or skin that freckles, burns easily in the sun or turns red when exposed to the sun
  4. Over 50 moles, multiple large moles, multiple patterns of moles or having multi-colored moles. These unusual moles are called atypical moles.
  5. A personal history of a non-melanoma skin cancer or a previous melanoma
  6. A family history of melanoma (this risk is significantly increased if this includes a first-degree relative such as mom, dad, brother, sister, or children)
  7. History of multiple blistering sunburns
  8. Any indoor tanning bed use
  9. A history of other cancers including breast or thyroid cancer
  10. Immunosuppression (those who have a disease that causes a depressed immune system, those who take immunosuppressant medication or organ transplant history) 

* Using tanning beds before age 20 can increase your chances of developing melanoma by 47%, and the risk increases with each use. * 

 Do you know the ABCDEs of melanoma? 

The ABCDEs of melanoma is a useful tool to help you detect if a new or existing mole may have features of melanoma. Each letter represents a concerning quality of a mole that helps you determine if a mole is normal or maybe melanoma. If a mole has any one of the features listed below it should promptly be evaluated by your dermatology provider.  

       A: stands for ASYMMETRY 

If a line is drawn across the middle of a mole each half should look the same on both sides of the line. Notice in the picture below one half of this mole looks dark and raised compared to the other half which is lighter in color and flat.  

       B: stands for BORDER 

The border of a mole should be smooth and defined. Irregular, blurred or ill-defined borders are concerning. Notice in the picture below that we cannot draw a smooth circle around this mole. Its edges are irregular and, in some areas, difficult to find. 

       C: stands for COLOR 

Groupings of multiple colors within one mole such as tan, brown, red, black, blue or white is abnormal. Notice how the mole below has many different colors within it. These colors are grouped together in what we call focal areas. In the picture below on the left we see a blue hue, the right side of the mole has black groupings, the lower right appears as white, and there is red, tan and brown in various areas of this mole.

       D: stands for DIAMETER 

Moles larger than the size of a pencil eraser or greater than 6 mm could be concerning. Although a mole that is large may be concerning for melanoma, remember that not all melanomas are large. A melanoma may be diagnosed when it is much smaller than 6 mm and the earlier this is detected the easier it is to treat. 

       E: stands for EVOLVING 

Any mole that is changing color, size or shape, or looks different from your other moles should be checked. Look at your moles and notice your pattern. Just as you have a natural eye color, hair color or skin tone, your body has a natural mole pattern that is specific to you. If you notice that one of your moles is different from all the others, we call this the “ugly duckling sign”. Also, if you notice a mole changing in any way, even if it seems subtle, it should be evaluated promptly.   

 

How can I protect myself from melanoma? 

As listed above there are some risk factors for melanoma that cannot be changed such as genetic risk factors, hair, skin or eye color, or immunosuppression. However, protecting yourself from harmful UV radiation is something we can control.  

  1.  Wear a broad-spectrum sunscreen (SPF 30-50) daily and re-apply at least every 2 hours, every 1 hour if in or near the water.  
  2. Wear sun protective clothing. Choose a wide brimmed hat, long sleeve UPF protective clothing, sunglasses, and pants when you go out.
  3. Avoid the sun between 10:00 am and 2:00 pm when the UV rays are the strongest. Many local weather reports also include the UV index rating which can help you plan your day. 
  4. Choose self-tanner lotions, sprays or products rather than tanning beds. There is no such thing as a “protective tan”. There is no benefit to using a tanning bed in the spring or prior to a vacation to obtain a base tan “so I won’t burn”. Any amount of tanning bed exposure significantly increases the risk of developing melanoma.  

 

What should I do if I have any of the risk factors listed above and I think I am at risk for developing a melanoma? 

Schedule a visit with us at Central Minnesota Dermatology for your skin check. This is a quick and easy office visit where your specially trained dermatology provider will look at your skin and talk with you about your individual risk of developing skin cancer. It can be difficult to detect an abnormal mole. Your dermatology provider uses specialized magnifying handheld devices to look at each one of your moles closely. We are excited to meet you! 

 

For more information visit: 

The American Academy of Dermatology Association website at : https://www.aad.org/media/stats-melanoma 

The Mayo Clinic website at: https://www.mayoclinic.org/diseases-conditions/melanoma/in-depth/melanoma/art-20546856 

 

References 

James, W. D., Elston, D. M., Treat, J. R., & Rosenbach, M. A. (2019). Andrews’ Diseases of the  Skin (13th ed.). Elsevier – OHCE.