Skin cancer

Following the reaction to Jeff Salmond’s article in the January issue of SportsTurf, where he details his brush with mortality due to an undetected heart issue, we are beginning this “Personal Rootzone” series to call attention to personal health issues. Thanks to the American Academy of Dermatology for their assistance.

According to the American Academy of Dermatology, skin cancer is the most common cancer in the US; current estimates are that one in five Americans will develop skin cancer in their lifetime. Nonmelanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma, affects more than 3 million Americans a year. Women’s incidence rates are increasing for both types of NMSC, as are those for people younger than 40.

The number of these cancers has been increasing for many years. This is probably from a combination of better skin cancer detection, people getting more sun exposure, and people living longer.

Caucasians and men older than 50 have a higher risk of developing melanoma than the general population, but skin cancer can affect anyone, regardless of skin color.

The 5-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 99%. Still, nearly 20 Americans die from melanoma every day.

According to one estimate, about 5.4 million basal and squamous cell skin cancers are diagnosed each year, and about 80% of these are basal cell cancers. Squamous cell cancers occur less often.

An estimated 2,000 people in the US die each year from these cancers. Most people who die from these cancers are elderly and may not have seen a doctor until the cancer had already grown quite large. Other people more likely to die of these cancers are those whose immune system is suppressed.

Risk factors

Exposure to natural and artificial ultraviolet light is a risk factor for all types of skin cancer.  The majority of melanoma cases are attributable to UV exposure.                                  

Increasing intermittent sun exposure in childhood and during one’s lifetime is associated with an increased risk of squamous cell carcinoma, basal cell carcinoma and melanoma. Even one blistering sunburn during childhood or adolescence can nearly double a person’s chance of developing melanoma. Experiencing five or more blistering sunburns between ages 15 and 20 increases one’s melanoma risk by 80% and nonmelanoma skin cancer risk by 68%.

Exposure to tanning beds increases the risk of melanoma, especially in women 45 and younger.                          

Risk factors for all types of skin cancer include skin that burns easily; blond or red hair; a history of excessive sun exposure, including sunburns; tanning bed use; a weakened immune system; and a history of skin cancer.

People with more than 50 moles, atypical moles or large moles are at an increased risk of developing melanoma, as are sun-sensitive individuals (e.g., those who sunburn easily, or have natural blond or red hair) and those with a personal or family history of melanoma.

Men and women with a history of nonmelanoma skin cancer are at a higher risk of developing melanoma than people without a nonmelanoma skin cancer history.                                              

Women with a history of nonmelanoma skin cancer are at a higher risk of developing leukemia, breast, kidney and lung cancers, and men with a history of nonmelanoma skin cancer are at a higher risk of developing prostate cancer.

Types of skin cancer

Actinic Keratoses (AK) are dry, scaly patches or spots and are precancerous growths. People who get AKs usually have fair skin. Most people see their first AKs after 40 years of age because AKs tend to develop after years of sun exposure.

AKs usually form on the skin that gets lots of sun exposure, such as the head, neck, hands, and forearms. Because an AK can progress to a type of skin cancer called squamous cell carcinoma (SCC), treatment is important.

Basal cell carcinoma (BCC) is the most common type of skin cancer. BCCs frequently develop in people who have fair skin, yet they can occur in people with darker skin.

BCCs look like a flesh-colored, pearl-like bump or a pinkish patch of skin. BCCs are common on the head, neck, and arms, yet can form anywhere on the body, including the chest, abdomen, and legs.

Early diagnosis and treatment for BCC is important. BCC can invade the surrounding tissue and grow into the nerves and bones, causing damage and disfigurement.

Squamous cell carcinoma (SCC) is the second most common type of skin cancer.

People who have light skin are most likely to develop SCC, yet they can develop in darker-skinned people. SCC often looks like a red firm bump, scaly patch, or a sore that heals and then re-opens. SCC tend to form on skin that gets frequent sun exposure, such as the rim of the ear, face, neck, arms, chest, and back. SCC can grow deep in the skin and cause damage and disfigurement. Early diagnosis and treatment can prevent this and stop SCC from spreading to other areas of the body.

Melanoma is the deadliest form of skin cancer. It frequently develops in a mole or suddenly appears as a new dark spot on the skin. Early diagnosis and treatment are crucial.


Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 am and 2 pm. If your shadow is shorter than you are, seek shade.

Wear protective clothing, such as a lightweight long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, when possible.

Generously apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Broad-spectrum sunscreen provides protection from both UVA and UVB rays. Reapply sunscreen every 2 hours, or after sweating.

Use extra caution near water, snow and sand, as they reflect the damaging rays of the sun, which can increase your chance of sunburn.

Avoid tanning beds. Ultraviolet light from tanning beds can cause skin cancer and premature skin aging.

Consider using a self-tanning product if you want to look tan, but continue to use sunscreen with it.

Perform regular skin self-exams to detect skin cancer early, when it’s most treatable, and see a board-certified dermatologist if you notice new or suspicious spots on your skin, or anything changing, itching or bleeding.

Image courtesy of American Academy of Dermatology

How to apply sunscreen

Sunscreen is safe and can protect your skin against skin cancer and premature aging. However, it is not as effective unless it’s applied correctly.

Choose a sunscreen that has an SPF of 30 or higher, is water resistant, and provides broad-spectrum coverage, which means it protects you from UVA and UVB rays.

Apply sunscreen generously before going outdoors. It takes approximately 15 minutes for your skin to absorb the sunscreen and protect you. If you wait until you are in the sun to apply sunscreen, your skin is unprotected and can burn.

Apply enough sunscreen to cover all exposed skin. Most adults need about 1 ounce (think shot glass) to fully cover their body. Rub the sunscreen thoroughly into your skin.

Remember your neck, face, ears, tops of your feet and legs. If you have thinning hair, either apply sunscreen to your scalp or wear a wide-brimmed hat. To protect your lips, apply a lip balm with a SPF of at least 15.

To remain protected when outdoors, reapply sunscreen every two hours, or immediately after swimming or sweating. People who get sunburned usually didn’t use enough sunscreen, didn’t reapply it after being in the sun, or used an expired product. Your skin is exposed to the sun’s harmful UV rays every time you go outside, even on cloudy days and in the winter.

People who get sunburned usually didn’t use enough sunscreen, didn’t reapply it after being in the sun, or used an expired product. Your skin is exposed to the sun’s harmful UV rays every time you go outside, even on cloudy days and in the winter. So whether you are on vacation or taking a brisk fall walk in your neighborhood, remember to use sunscreen.