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Healthy Skin is In! Keep Melanoma Out! | Knowledge Is Power

May is Melanoma Awareness Month. Be Melanoma Smart!

This article is about melanoma awareness which is appropriate as the month of May is melanoma awareness month. It describes melanoma, its prevalence, risk factors, signs to look for, prevention methods. A section about myths and facts about melanoma is also included as well as a call-to-action for healthcare providers.

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  • Maggie Aime
    Maggie Aime, BSN, RN
    Specializes in Freelance Writer, Utilization Review RN Consultant. Has 9 years experience.
May is Melanoma Awareness Month. Be Melanoma Smart!

The month of May is known for Spring flowers and the start of Summer vacation, but did you know that it is also Melanoma Awareness Month?  While it is not a common type of skin cancer, melanoma is the leading cause of skin-cancer-related deaths.  The American Cancer Society expects about 99,780 new melanoma cases and approximately 7,650 deaths from melanoma in 2022 alone.  Early detection and prevention are the best means to improve prognosis, increase survival, and limit further incidences of melanoma.

What is Melanoma?

Melanoma develops when the pigment-producing cells on the skin, also known as melanocytes, degenerate and grow uncontrollably.  This growth is usually triggered by unprotected exposure and burning from ultraviolet (UV) radiation coming from the sun and is also found in tanning beds.  Other names for melanoma are “malignant melanoma” or “cutaneous (related to the skin) melanoma”.  However, melanoma is not only found on the skin; it can develop in extracutaneous (outside the skin) sites such as the eyes, nails, mouth, genitals, or elsewhere inside the body, although those are rare.

How Prevalent is Melanoma?

While melanoma is more likely to develop in men than women, the rates of melanoma in people under age 50 tend to be higher in women.  According to the American Cancer Society, melanoma is 20 times more common in those with fair skin than those with a darker complexion, and the risk of developing melanoma increases with age.  In the United States, the incidences of melanoma have increased significantly over the past decades, reported at a six-fold rise over the past 40 years!  These numbers illustrate that melanoma is a rising cancer threat, and awareness and educating the public are of utmost importance.

What are the Risk Factors for Melanoma?

According to Mayo Clinic, the following factors increase one’s risk of developing melanoma:

  • Exposure to UV light/History of sunburn.  Excessive and unprotected exposure to the sun with severe sunburn as well as exposure to UV light from tanning beds is a major risk for melanoma.
  • Fair skin.  People with a light skin complexion – have less pigment to protect against UV rays – as well as people with blue or green eyes, light or red hair, those with freckles and tend to burn easily when in the sun, are predisposed to developing melanoma.
  • Moles.  People with many moles as well as those with large moles are at increased risk for melanoma.
  • Genes.  Those with a family history of melanoma have been found to be at increased risk of developing melanoma.
  • Immunosuppression.  People who have a weakened immune system, such as those undergoing treatment for cancer or for autoimmune disease, those with human immunodeficiency virus (HIV), and those who have undergone organ transplant, are more likely to develop melanoma.

What to Look for?  Easy as ABCDE

Early detection of melanoma is key to increase the chances of survival.  The American Academy of Dermatology Association says that checking a mole for melanoma is as easy as knowing your ABCDE:

  • A – Asymmetry (if you visually split the mole in half, do the two halves match?)
  • B – Border (are the borders of the mole uneven, irregular, ragged?)
  • C – Color (are there varying colors or different shades within the mole?)
  • D – Diameter (is the mole greater than the size of a pencil eraser, about 6 millimeters or 1/4 inch?)
  • E – Evolution (does the mole look different than other moles on the body or than it did before?)

It is, however, always recommended to see a healthcare provider if unsure as some melanoma may not have all the ABCDE characteristics.  The rule of thumb is to seek medical care if any new or unusual skin changes are seen.

Another way to check for melanoma is called the Ugly Duckling method which means comparing moles on the body to see if any one of them stands out like an “ugly duckling”.   Is it bigger, darker, smaller, raised, lighter than the other moles?

Can Melanoma be Prevented?

While melanoma, or any cancer, is not 100% preventable, certain steps can be taken to reduce the risk of developing melanoma:

  • Stay in the shade.  Avoid the sun during peak times, usually between 10 a.m. and 4 p.m. when the sun’s rays are more powerful.
  • Cover up.  Protect skin with clothing, and wear a wide-brimmed hat and sunglasses that block UVA and UVB rays.
  • Lather up (with sunscreen that is!).  Two tablespoons of sunscreen with an SPF of at least 30, generously applied to the entire body 15 minutes before going outside, is recommended for extended outdoor activities.  Remember to reapply every two hours or more often after being in the water or sweating.
  • Say “No” to tanning beds.  They emit UV rays which increase the risk of skin cancer.
  • Do skin checks.  Every month, perform a skin self-exam, from head to toe, to check for new or changing moles.  If in doubt, get it checked out!

Myths and Facts About Melanoma

Myth:  People with dark complexion don’t get melanoma.

Fact:  Although more prevalent in those with fair skin, anyone is at risk of developing melanoma.  There is no discrimination by race, gender, or age when it comes to melanoma.

Myth:  If the mole does not have all the ABCD characteristics, then it’s not melanoma.

Fact:  Just like with almost everything, there are exceptions.  Not all melanocytic moles or lesions will have all the ABCD characteristics.  If unsure, get examined by a healthcare professional.

Myth:  Melanoma only affects middle-aged and older people.

Fact:  The American Cancer Society reports that melanoma is one of the most common cancers in young adults (ages 20 to 39), and even more so in younger women.

Myth:  Sunscreen and other sun protection are not needed on cloudy days.

Fact:  UV rays can still affect the skin even on cloudy days.  Sun protection before going outdoors is essential!

Myth:  Melanoma is not a big deal! It’s only skin cancer.

Fact:  Melanoma is a very serious type of skin cancer that can metastasize (spread to other organs) rapidly; but if caught early, it can be easily treated with a good prognosis.

What Can We Do?

  • Educate! Educate! Early diagnosis of melanoma can save lives.  As nurses and healthcare providers, we have a duty to become familiar with the signs and risk factors of melanoma and share that knowledge with the public. 
  • Teach about the importance of monthly skin self-exam and the avoidance of unprotected sun exposure and tanning beds.
  • Encourage the appropriate use of skin protection and sunscreen.
  • It’s never too early or too late to start early detection and prevent melanoma!

Resources

Melanoma - Symptoms and causes - Mayo Clinic

Melanoma Warning Signs and Images - The Skin Cancer Foundation

Early detection of cutaneous melanoma improves prognosis

Can Melanoma Be Prevented?

What Is Melanoma Skin Cancer?

What to Look for: ABCDEs of Melanoma

How to Do a Skin Self-Exam

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Maggie Aime

About Maggie Aime, BSN, RN (Platinum)

Maggie Aime, BSN, RN has a combined 25 years as an oncology medical coder and oncology nurse.

3 Articles   12 Posts

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Julie

Julie

2 Articles; 135 Posts

Specializes in Sm Bus Mgmt, Operations, Planning, HR, Coaching. Has 41 years experience.

Thank you! Thank you! Thank you for this article.  EVERYONE needs to know this.  I wish my mother was aware years ago.  Her death at 58 yrs old, was devastating to my father, her 6 children (including a 13 yr old), and her many grandchildren.  Totally avoidable if caught soon enough.  I have since been checked regularly, with mole removal and my mother's death has likely saved my life.  

Maggie Aime

Maggie Aime, BSN, RN

3 Articles; 12 Posts

Specializes in Freelance Writer, Utilization Review RN Consultant. Has 9 years experience.

@Julie Thank you for your feedback. I'm very sorry to hear about your mother and what you and your family must have gone through.  As an oncology nurse, I can get careless with sun protection.  It is absolutely important to bring the awareness! Thank you. 

Emergent

Emergent, RN

2 Articles; 4,062 Posts

Specializes in ER. Has 30 years experience.

The best way to protect the skin is with sun hats and clothing. Sunscreen contains potentially dangerous chemicals that are absorbed directly into the bloodstream through the skin.

Very fair people did not evolve to live in the southern areas of the world and need to protect their skin. I am fortunate that, in spite of my predominantly English, Scotch, Welsh heritage, that I have almost olive skin and brown eyes. 

I'm convinced that there are beneficial rays from the sun that are important and that sunscreen is full of chemicals that can work on other parts of the body in negative ways. It's full of endocrine disruptors and other chemical unknowns that most likely will have bad effects overtime. From what I have researched, these chemicals have not been investigated closely enough.

 

Maggie Aime

Maggie Aime, BSN, RN

3 Articles; 12 Posts

Specializes in Freelance Writer, Utilization Review RN Consultant. Has 9 years experience.

@Emergent Thank you for your comment and feedback.

No Stars In My Eyes

No Stars In My Eyes

3,653 Posts

Specializes in Med nurse in med-surg., float, HH, and PDN. Has 43 years experience.

Grew up spending every Summer Sunday at the beach ... from about 10 AM until 5 or 6 PM. Never used tanning lotion or sunscreen back in those days. Now I have a back and trunk like my mom's, loaded with a variety of moles, etc. I know I will have to go have a total body check, and I'm sure I will have quite a crop to be removed/tested. I know it's important and much-needed in my case, but here I sit on the sofa talking about it instead of making an appt w/ a dermatologist...................I know, I know, better safe than sorry, and get a move on and call for that appointment! 

macawake

macawake, MSN

2,141 Posts

Has 15 years experience.

OP, thank you for shining a light on this vitally important topic.

 

I spend a lot of time outdoors; walking, running and hiking. I always apply sunscreen. I have since my early twenties, before that it was basically only when going to the beach. 

I wish everyone would use sunscreen (as well as protective clothing, sunglasses, hats and seeking shade when appropriate). I love the outdoors and I love the sun but its rays can cause a lot of harm. 

I understand why many people might not apply sunscreen every day. It can be hard to find one that suits your skin type, they can be a bit messy and sometimes not cosmetically appealing and they are not cheap. But they do protect against skin cancer and that’s worth a lot. 

While protecting against burning your skin and possibly getting skin cancer is the primary goal, using sunscreen on a daily basis comes with an added bonus. It protects against skin aging. In my n=5 anecdote, I and two of my siblings use sunscreen daily and two don’t. I’m close to fifty and my face doesn’t have any wrinkles at all and hardly any of what’s commonly referred to as ”fine lines” either. The only lines are two really faint - barely there - crow’s feet at the corner of each eye. That’s it. The other two that also use sunscreen look the same (one older, one younger), but the two who seldom use sunscreen and despite never getting burned (”only” tanned) have a lot of sun damage. Hyperpigmentation and wrinkles galore. So while this whole wrinkle business is all rather superficial… it still is (at least to me) a welcome additional benefit. Women spend a fortune on ”anti-age” skincare products when they could be using sunscreen instead and also get that vital protection against skin cancer.

Is anyone surprised when I tell you that the two siblings who slather themselves in sunscreen are both in the medical field? One is a radiation oncologist and one is a medical physicist. We all have tremendous respect for UV radiation. 
 

 

Julie, I’m very sorry to hear about your loss. Thank you for sharing. It might have a positive effect and remind readers to protect themselves. 
 

No Stars in My Eyes, you can probably guess what I’m about to say. Please make an appointment with a dermatologist. Just to be on the safe side. Take care! 
 

Emergent, after reviewing the available evidence I personally feel safe using sunscreen with organic UV-filters (a.k.a. chemical filters) but if you have concerns, perhaps you could use sunscreen with inorganic (physical) filters like zinc oxide and titanium dioxide instead?

A wide-brimmed hat is great but sunscreen still has a role to play. UV radiation reflects off surfaces, sand, water and snow and hits us from all directions, not just from above.

 

While not super recent, I think this is an interesting article about sunscreen and vitamin D.

https://onlinelibrary.wiley.com/doi/full/10.1111/phpp.12096

Julita

Julita, BSN, RN

3 Articles; 8 Posts

Specializes in OR,PAR,PainMgmt,GenSurg,Cosmetic,Imaging,Endoscopy. Has 23 years experience.

Thank you Maggie for this timely information. No excuse to step out in the sun this Summer without putting applying the knowledge you have just shared.All the best with your writing.

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