Childhood Melanoma Cases on the Rise
If you only apply sunscreen to your children on sultry summer days, it might be time to reconsider. Outdoor winter sports such as skiing and snowboarding are prime time for children to get sun exposure. In fact, the snow and ice can reflect up to 80% of the sun’s ultraviolet rays putting children without sunscreen protection at an increased risk for melanoma, a type of skin cancer, according to David E. Bank, M.D., a board-certified dermatologist practicing in Mount Kisco and a spokesperson for the Skin Cancer Foundation (SCF). “Essentially, you are getting hit twice with the sun’s direct rays and then the reflection from the snow,” explains Bank. We spoke with him recently to learn about the latest research on melanomas in young children and teens and how to prevent and treat it.
Melanoma is one of the most dangerous forms of skin cancer affecting more than 190,000 people in 2019, according to SCF. Once thought of as a disease only for older adults, the disease can actually strike at any age although it is most commonly found in older adults.
Research from the SCF shows that one-third of all new melanoma cases are diagnosed on the head and neck. A new study from St. Louis University found that the incidence of melanoma in these parts of the body in children, teens, and young adults has increased 51.1% from 1995 to 2014. “Melanomas found on the head and neck have a worse prognosis than other parts of the body,” says Bank. “They can spread more easily because the head and neck have more blood vessels and lymph nodes than other parts of the body.
Look out for ‘lone ranger’ moles
Moles, spots or growths can vary greatly in appearance appearing black, dark pink or even red and purple. “What you are really looking for is the spot, mole or growth that looks different from others that appear on the child’s body or what Bank refers to as “the lone ranger.”
“The simplest rule of thumb is if the spot, mole or growth differs from others then that is enough of a reason to go see a dermatologist for a skin check,” explains Bank. He believes that annual skin checks are a good habit to start in childhood plus “they are relatively quick, painless, non-invasive, and potentially life-saving.”
Risk factors for melanoma
Are there specific risk factors associated with melanoma? Yes, says Banks, one in every 10 patients with melanomas has a first degree relative with it, so there is a genetic link. In addition, having fair skin and a large number of moles also increases the risk.
The effects of the sun’s harmful rays are cumulative so daily sunscreen application is best. Bank suggests mineral sunscreens with zinc oxide and titanium dioxide especially for babies 6 months and up due to their sensitive skin. These sunscreens offer protection and are inert so they don’t cause any chemical reaction in the skin. “For parents who are concerned about the long-term effects of chemicals on the skin, this takes the issue off the table,” he says. The SCF suggests that parents look for a sunscreen labeled “broad spectrum” meaning that it protects against UVA and UVB rays. UVA rays are associated with aging and UVB rays are responsible for sunburns. If your child is spending most of their day indoors, a broad-spectrum SPF 15 or higher is fine. If they are outside a lot, apply sunscreen 30 minutes prior to outdoor exposure so that it has time to attach to the skin. Choose a water-resistant one with an SPF of 30 or higher and reapply every two hours or more frequently if the child is swimming or sweating.
A hat with a wide brim is best, and for all the kids insisting on wearing a baseball cap for prevention, bear in mind that it only keeps the sun off the skin that is shaded by the cap’s visor. Baseball hats do not offer protection of the child’s profile. Protective clothing, UV-blocking sunglasses and seeking shade as much as possible are also important.
The SCF suggests that parents try tubes of sunscreen with colorful packaging for kids who make a fuss about having it applied. Also keep in mind that although spray sunscreens may seem easy to use, it is possible to miss a spot so be sure to look for an even sheen on the child’s skin after application and rub it in thoroughly.
Treatment of melanoma
Bank has been treating patients for more than 30 years. In the 90s, he started seeing a spike of patients in their late teens and early 20s with melanomas. The common link for these patients was frequent visits to tanning salons, which Bank strongly advises against.
Unfortunately, surgical removal of melanomas is the necessary treatment and additional treatments may be needed based on the stage of the tumor such as immunotherapy for the more advanced stages of melanoma.
So before you head to the slopes or spend time in the warm Florida sun during winter break, be sure to apply sunscreen, wear protective clothing, and take frequent breaks indoors.