Skin cancer myths and facts

7 Skin Cancer Myths vs. Facts That You Should Know

Skin cancer is the most common form of cancer in the US, and it’s also one of the most preventable. On average, about 10,000 people are diagnosed with skin cancer each day, and 1 in 5 people will be diagnosed with skin cancer by the age of 70. Skin cancer is typically caused from too much UV exposure from the sun or tanning beds throughout a person’s lifetime. In this blog post, Dr. Akin discusses seven skin cancer myths and facts, so you can get the truth behind how you can protect yourself. Check out the interview on our YouTube channel.

1. Myth – Dark-Skinned People Don’t Get Skin Cancer

This is a myth. We see a fair number of people who have darker complexions that develop skin cancer; however, the most common skin type in which we see skin cancer is with patients who have light-colored skin, eyes, and hair, such as blonde hair and blue eyes. Although people with blonde hair and blue eyes are at higher risk for skin cancer, we still see those with darker complexions, such as African Americans, Hispanics, and those with Asian descent develop skin cancer. The makeup of skin cancer in these populations is a little bit different. For example, melanoma-type skin cancer in people with darker pigmentation is commonly found on the palms of the hands and soles of the feet, and it tends to be much more further advanced, as opposed to melanoma-type skin cancer that is diagnosed in patients with lighter skin. I believe part of the issue is awareness and screening: 1. Knowing that skin cancer CAN develop on skin with darker pigmentation, and 2. Knowing to go see a dermatologist to get it checked out if you have something on your skin that’s abnormal. In addition, we see pigmented basal cell skin cancers pretty commonly as well in patients with darker skin.

2. Myth – Only Sun Exposure Cause Of Skin Cancer

That’s a myth, to some extent. With the development of skin cancer, you have a change or an alteration in the genetic makeup of the skin cells. Once that change or alteration is present, then other things can cause skin cancer to develop. Over the years, I’ve seen patients who have said, “Oh, I walked into a tree branch, and I developed a sore on my forehead that wouldn’t go away.” Or we find skin cancers in areas that don’t commonly get sun exposure, such as the genitalia area, or areas that are typically not uncovered. So, there’s more than just sun exposure, but it’s thought that there’s an initial inciting event that causes a change in the DNA structure of the cells, and it’s thought that the “likely initial event” is sun exposure. 

3. Fact – When it Comes to Sunscreen, the Higher the SPF, the better

This is a fact. The American Academy of Dermatology previously recommended an SPF of 30 on sunscreen, but they recently changed that to an SPF of 45. With an SPF of 30, it was thought for a long time that that blocks about 93-94% of ultraviolet rays, which is true if you put it on appropriately. However, most people don’t put on enough sunscreen, or per the recommendations, so as a result, it is recommended that patients utilize a higher-SPF sunscreen. There are some sunscreens even up to 100 SPF, but the American Academy of Dermatology recommends a minimum SPF of 45. But, at this point, I think it’s safe to say that the higher the SPF, the better.

4. Myth – Only Older People Get Skin Cancer

This is a myth. While the vast majority of the patient population that develops non-melanoma-type skin cancers are over the age of 60, the youngest person that I’ve done Mohs surgery on for a basal cell skin cancer was 17 years old. It’s not uncommon that we see skin cancers in younger populations. In fact, ever since the ‘80s and ‘90s, skin cancer diagnoses in younger populations became much more common. Since the fad with tanning beds increased, we started to see skin cancers in a much younger population than we had previously. In general, skin cancer affects older patients much more commonly than younger patients, but the tragedy with melanoma-type skin cancer is that melanoma can fatally affect young, healthy adults as well, so it’s important to be aware of it.

5. Myth – People Who Tan Easily and Rarely Burn Will Not Get Skin Cancer

This is a myth. What you should know is that although the skin’s pigment, or melanin, is a protective factor, that skin cancer can still develop in patients with darker skin. There’s different types of melanin, but patients who have red hair and fair-complected skin tend to have “pheomelanin,” whereas “melanin,” is the other type of pigment found in hair and skin. Pheomelanin is not as protective as melanin. Melanin takes in light and scatters the light, so not as much damage occurs at the cellular level. Patients with pigmented skin can and do develop skin cancer, although it’s probably at a lower rate than fair-skin individuals. It’s important for everyone to wear their sunscreen, not just fair-skin individuals.

6. Myth – Skin Cancer is Not Deadly

This is a myth. Non-melanoma skin cancers tend to not be deadly, as long as they’re treated appropriately from the beginning. The risk of basal cell skin cancer metastasizing and going other places is very rare and almost unheard of. Squamous cell carcinoma metastasis can occur, but that typically happens in less than 5% of the patient population. My experience is that ulcerated skin cancers are much more likely to metastasize than others, but melanoma-type skin cancer can and does commonly lead to adverse consequences, and even death in the young patient population. The two most aggressive forms of skin cancer, excluding very rare skin cancers, are probably Merkel cell carcinoma and melanoma-type skin cancer. It’s extremely important for skin cancer to be diagnosed early and treated appropriately, as it leads to fewer problems.

7. Myth – Skin Cancer is Only Limited to the Skin

Non-melanoma skin cancer is limited to the skin; however, melanoma-type skin cancer can affect any place in the body that has “melanocytes.” Melanocytes are, of course, found in the skin, but you also have melanocytes in other places, such as the pigment of the retina in the back of the eye (there is such a thing as “ocular melanoma” or “uveal melanoma”). Patients who aren’t screened on a routine basis usually show up with ocular melanoma, with loss of eyesight in one of their eyes. It is important for anybody who has a first-degree relative with a history of melanoma to get an eye exam once a year, where they look in the back of the eye and make sure that there are no pigment changes, or anything of that nature. In addition, melanoma can occur on any mucosal surface. For example, females can develop melanoma vaginally, and melanoma can also occur inside the mouth or rectally. 

For more information regarding skin cancer removal and treatment options at Midland Dermatology, visit our Skin Cancer Treatments page or check out our Facebook or Instagram page for helpful skincare tips and education. At Midland Dermatology, we offer Mohs surgery and Xoft Brachytherapy to treat skin cancer. Mohs surgery is considered one of the best options for skin cancer removal, as it only removes thin layers of cancer-infected skin until cancer-free skin remains, while Xoft is a painless, non-surgical option to treat non-melanoma-type skin cancer. 

Russell Akin, MD, RPh. FACMS, FAAD, is a board-certified dermatologist and fellowship-trained Mohs surgeon who specializes in skin cancer treatments and other dermatological procedures with patients ages 12 and up at Midland Dermatology. If you’d like to schedule an appointment with Dr. Akin, or any of the providers at Midland Dermatology, please call 432-689-2512.

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