10 Melanoma Risk Factors You Should Know
What’s a risk factor? It’s something that increases your chance of developing an illness without necessarily directly causing it. And when it comes to melanoma, there's a pretty wide range of them (hello, sunburns and fair skin). But here's the thing: While you can have risk factors and never develop this form of skin cancer, it’s still best to reduce them whenever possible—and pay close attention to your skin, says Faye Yin, M.D., an oncologist at Jersey City Medical Center-RWJBarnabas Health in Jersey City, NJ. Here are the big ones linked to melanoma.
This one plays a big role in melanoma, especially in childhood. “Research shows that early sun exposure can damage the DNA in skin cells,” Dr. Yin says. Teaching children early about sun safety is vital—a study in Cancer Epidemiology, Biomarkers & Prevention showed that five or more blistering sunburns between ages 15 and 20 increased risk of melanoma by 80%. She recommends following the American Cancer Society’s slogan: “Slip! Slop! Slap! and Wrap.” “Slip on a shirt, slop on some sunscreen, slap on a hat, and wrap on some sunglasses,” she explains.
While we might equate a tan with being healthy, they’re actually our skin showing proof it’s been injured by ultraviolet (UV) light, according to the Centers for Disease Control and Prevention. And it’s not just natural sunlight that’s a problem. It’s best to avoid artificial light from tanning beds, tanning parlors, and sun lamps, says Dr. Yin. These can all increase your risk of not just melanoma, but the other two skin cancer types that are more common but less serious: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
If you have lots of moles (dysplastic nevi) or unusual moles (atypical moles), you’re at higher risk of melanoma, says Arturo Loaiza-Bonilla, M.D., an oncologist and medical director of clinical research at Cancer Treatment Centers of America in Philadelphia. Moles are small brown spots caused when pigment cells cluster in one spot. Most people have 10 to 40 moles—50 or more is considered a large number. “Most are benign, but those with excessive moles should consult a dermatologist, especially if they observe any changes. Often, a mole will be removed as a precautionary measure,” Dr. Yin explains.
Fair Skin, Freckling, and Light Hair
They might say that blondes have more fun—not so in this case. Those with natural blonde or red hair, light eye color (blue and green), and freckles have an increased risk of melanoma, Dr. Loaiza-Bonilla says. The risk is also high if your skin has a tendency to burn instead of tan when exposed to UV rays (which, again, indicates skin injury, increasing skin cancer risk).
“Approximately 10% of melanomas are familial. Among subjects from melanoma families, defined as ‘kindreds’ in which melanoma occurred in two or more blood relatives, the likelihood of developing melanoma is even greater among those family members who have dysplastic nevi,” says Dr. Loaiza-Bonilla. Mutations in specific genes (like CDKN2A, CDK4, P53, and MITF) have also been associated with an increased risk. Other inherited conditions, such as xeroderma pigmentosum, retinoblastoma, and certain hereditary breast and ovarian cancer syndromes, are also risk factors.
Personal History of Melanoma or Other Skin Cancers
If you’ve had melanoma before, you’re at an approximately nine-fold increased risk of developing another melanoma than those who’ve never had it. And you’re at risk for melanoma, too, if you’ve had the other skin cancer types, basal cell carcinoma or squamous cell carcinoma. This is why it’s so important to watch for any recurrence of cancer, so talk to your doctor about the next steps for follow-up care if this is you.
Weakened Immune System
A weakened and/or suppressed immune system is an additional risk factor for skin cancer, including melanoma. You can have this either from certain medical treatments (chemotherapy or immunosuppressive therapy are typical ones) or if you have a medical condition that comprises the immune system, like HIV or lymphoma. There are two main reasons for this, Dr. Yin explains: “First, because the body has less ability to detect and destroy cancer cells. And secondly, because the body is more susceptible to infections that may lead to cancer.”
Being Male Over Age 50
In the U.S., after the age of 50, men are more likely to get melanoma, but before the age of 50, women are, according to the American Cancer Society. “We believe that this discrepancy relates to the fact that men are likely to spend more time in the sun over the course of their lifetimes. I also think that women are more likely to wear sunscreen than men, so this may play a role,” Dr. Yin explains. Other potential reasons: Differing skin thickness and estrogen levels.
Being of a Certain Age
Melanoma is most frequently diagnosed in 65- to 74-year-olds, Dr. Loaiza-Bonilla says. The average age at diagnosis is 65 years old, while the median (the midpoint) age is 50—meaning that about half of people with melanoma will be diagnosed before the age of 50, and about half after. One key thing to know? Melanoma is the third common cancer type in people ages 20-39, after thyroid cancer and testicular germ cell tumors in those 20-29, and breast cancer (female) and thyroid cancer in those 30-39. Thankfully, rates have been dropping in these age groups, according to the American Cancer Society.
Belonging to a Certain Race or Ethnicity
Melanoma is far more common in white people than Black people—by more than 20 times in Caucasians. To break it down even more: The lifetime risk of melanoma by race is about 1 in 38 for whites, 1 in 1,000 for Blacks, and 1 in 167 for Hispanics. Your individual risk is based on many things, however, including all your risk factors (some of which haven't even become apparent yet), so that’s something to keep in mind.
Is Smoking a Risk Factor for Melanoma?
You might be wondering: What about that other typical cancer risk factor, smoking? “Based on recent studies among men, current and former smokers did not have a higher risk of melanoma compared to ‘never smokers,’” Dr. Loaiza-Bonilla says. A study published in 2019 in Cancer Research did find that melanoma patients who’d smoked were 40% less likely to survive this cancer than those who hadn’t… tough to hear, we know. Dr. Yin says she encourages her patients to not smoke for their overall health, even though researchers haven’t (yet) found a link between the two.
What Can You Do About Melanoma Risk Factors?
Some risk factors you can change—and others you simply can’t, Dr. Yin says. Like… “you can’t change your skin color or family history, and you can’t avoid getting older,” she says. What can you do? Limit your (and your children’s) sun exposure when it’s most intense, between 10:00 a.m. to 4:00 p.m. Wear sun-protective clothing and use a sunscreen with an SPF of 15 or higher, year-round. Examine your skin monthly and take photos of any changes, then show it to your dermatologist. See your derm for regular (typically, yearly) exams.