The short answer to the question “Am I at risk for malignant melanoma?” is “Yes!”. Melanoma doesn’t discriminate. It can strike anyone of any age with any skin type. The Melanoma Research Foundation estimates that this year alone 137,000 will be diagnosed with melanoma.
Many seem under the impression melanoma only develops in older people who have spent enough time in the sun to get that leathery look, or to people who frequent tanning beds. While those people do have an increased risk, I rarely laid out in the sun, usually wore sunblock, and never used a tanning bed, and I still got melanoma at the age of 20.
I did have other risk factors: pale skin, blue eyes, occasional sunburns (some of which peeled), and a family history of melanoma. The last one may have been the biggest risk factor, but it was also the reason I even knew what to look for, and knowing what to look for is one of the main reasons I am alive today. You can learn more about melanoma, my experience, and the sunscreens I’m using this year here.
Although anyone can get melanoma, there are many risk factors* that can increase your risk of developing melanoma:
Exposure to UV rays: These can come from sunlight but also from tanning beds and sun lamps. Those who are out in sunlight during the midday are also at increased risk.
Fair skin, especially that burns easily, and/or light hair color (blonde, red), blue eyes, or freckles: Due to having less pigment to begin with, someone with fair skin has less protection against UV radiation.
Having many moles or large or irregular moles: Having more than 50 ordinary moles, or having any large or irregular moles increases the risk of melanoma. If you have many moles, you may want to photograph them or have them photographed by someone you trust or a dermatologist to keep track if there are changes. You can also ask a significant other or trusted friend or family member to help in checking hard-to-see spots.
History of sunburns, especially ones that peeled or blistered: Even one blistering sunburn can increase your risk of melanoma.
Living close to the equator or at a higher elevation: These locations place you in more direct and higher contact with the sun’s radiation.
A family history of melanoma: About 10% of people with melanoma have a family history, and your chance of developing it is 2-3 times greater if you have a first-line relative (parent, brother, sister or child) with melanoma. The person in my family with it prior to me was not a first-line relative, but it was still good to know the family history existed.
Personal history of melanoma or other skin cancers: 5% of people with melanoma may develop another one and those with other skin cancers are also at increased risk.
Weakened immune system or certain genetic conditions: If you have a weakened immune system such as from an organ translate or HIV, you are more susceptible to developing melanoma. Those with certain genetic conditions (xeroderma pigmentosum, retinoblastoma, Li-Fraumeni syndrome, Werner syndrome, and hereditary breast and ovarian cancer syndrome) are also at increased risk.
Male gender especially after age 45; Female gender before age 45: Males overall have a higher rate of melanoma than women and have a higher risk of developing melanoma than women after the age of 45. However, before the age of 45, women have a higher risk of developing melanoma than men.
Whether you identify with the above risk factors or not, it’s a good idea to be sunsmart. Avoid sun exposure between 10am and at least 2pm ideally 4pm. Wear high SPF sunblock if you will be out. You should also be aware of the signs of melanoma so that you can monitor any moles you have. Any changes in a mole can signal melanoma, but changes meeting ABCDE and P (see below) warrant special concern.
You should regularly check your skin for new moles and any changes to existing moles. The Melanoma Research Foundation provides a Self-Screening Guide, which you can pin to Pinterest or download as a PDF. Make sure to use a hand mirror to check hard-to-see places. Though they didn’t turn out to be anything, I have had moles removed from areas that I wouldn’t have been able to check without a mirror. If you have a significant other or trusted friend or family member, you can also ask for their help in checking hard-to-see moles.
If you see new moles, existing moles with any of the symptoms above, or any changes to your moles, get to a dermatologist as soon as possible. Even if you don’t see these changes, it’s a good idea to have regular skin screenings. In the U.S. the American Academy of Dermatology offers free screenings. You can use this map to find a location offering skin screenings in your area.
Are you going to self-screen and/or get a skin screening this summer?