You’re probably aware that protecting your skin from overexposure to the sun is key for both avoiding sunburns and skin cancer. Perhaps you even dutifully lather up with sunscreen or wear sun-protective clothing whenever you know you’ll be outdoors for a fair amount of time. These are great habits, but even if you haven’t had a sunburn in 30 years, your risk of skin cancer could still be elevated, depending on your sun-safety habits as a child.
Decades ago, wearing daily sunscreen was far less common, as was the attention given to sun safety. As a result, when you were a child you may have spent countless hours in the summer sun, paying the price for your fun in the form of a nasty sunburn. Childhood sunburns are, in fact, one of the major risk factors for skin cancer as an adult.
Five or more sunburns as a child increases skin cancer risk by up to 80 percent
A childhood spent outdoors in the sun likely played a major role in Karl Berens’ skin cancer diagnosis. Berens is Vice President of General Services for Cancer Treatment Centers of America® (CTCA), Tulsa. He noticed a red spot on his nose that wouldn’t heal for about a year. When he finally had it checked out, he was diagnosed with invasive squamous cell carcinoma (SCC), which accounts for about 2 out of 10 skin cancer diagnoses — and are most often found on sun-exposed areas of the body.
“I spent a lot of time in the sun growing up, living on a farm in Kansas,” Berens said in a recent interview for an affiliate of NBC News. “So that’s probably been the main issue — the damage that was done when I was a child … We didn’t wear hats or caps as children growing up and certainly didn’t use sunscreen in the late ‘50s, early ‘60s. I don’t think it ever dawned on anybody back then.”
Skin cancer is the most common type of cancer in the U.S., affecting millions of Americans every year. Among the many risk factors, like having fair skin or red hair (as Berens does), is sun exposure in childhood. One study found that women who had at least five severe sunburns (bad enough to blister) between the ages of 15 and 20 had a:
- 68 percent increased risk for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)
- 80 percent increased risk for melanoma
Exposure to higher amounts of sunlight in adulthood was also linked to a more than two-fold increased risk for BCC and SCC in later life. In addition to SCC, Berens has had additional skin cancer diagnoses, including a non-invasive SCC behind his ear and pre-cancerous areas known as actinic keratosis on his forehead and ears.
In addition to his childhood spent outdoors on the farm, where he helped with everything from cattle to planting crops and working fields, Berens has enjoyed a variety of outdoor activities as an adult, including motorcycle touring, snow skiing and water skiing — so he’s no stranger to the sun. Now, however, he’s sure to take precautions, like wearing a hat and sunscreen, when he spends time outside.
What Are the Different Types of Skin Cancer?
Skin cancer is divided into two broad categories: non-melanoma skin cancers, which include BCC and SCC, and melanoma. The cell types refer to the three types of cells in the top layer of your skin. BCC affects basal cells, in the lower part of the epidermis (the top layer of your skin), while SCC affects the flat cells in the outer part of the epidermis. BCC and SCC make up the vast majority of skin cancers and are highly treatable. Melanoma, although less common, is more serious as it’s more likely to spread to other parts of your body.
It begins in the melanocyte cells, which protect the deeper layers of your skin from sun damage and make the melanin pigment that turns your skin tan or brown color. Melanoma accounts for only about 1 percent of skin cancers but also the majority of skin cancer deaths.
Common signs and symptoms of different skin cancers
The different types of skin cancer have different signs and symptoms, noted below. If you notice any suspicious spots on your skin, have them checked by your doctor right away (and it’s a good idea to have a yearly skin check as a precaution).
- A flat scar-like area that feels firm and is a pale or yellow color
- Raised red patches, possibly itchy
- Small pearly bumps that may be red, translucent or have blue, brown or black coloring
- Pink growths with raised edges and a dip in the center
- Sores that won’t heal or recur often
- Rough or scaly red patches that may crust or bleed
- Raised growths or lumps that may have a dip in the center
- Sores that won’t heal or recur often
- Wart-like growths
- A new or unusual spot on the skin that is changing in size, shape or color
- The spot will typically appear different than other spots on your skin
- The spot may be asymmetric, have an irregular border or contain different colors ranging from brown and black to pink, red, white or blue
- The spot may be larger than 1/4 inch across
- The spot may be itchy, tender or painful
Beyond BCC, SCC and melanoma, there are other much less common types of skin cancer that together make up less than 1 percent of all skin cancers. This includes merkel cell carcinoma, Kaposi sarcoma, skin lymphoma, tumors in the hair follicles or skin glands and other types of sarcomas.
To spot potential skin cancer early, conduct regular skin checks for yourself, asking a friend or family member to check areas you can’t see, such as your back and scalp. Be sure to check your nails, ears, palms and soles of your feet, too. If you spot anything that looks unusual, is new or has changed in appearance, texture or color, see your doctor right away.
As Berens notes, “SCC usually begins as a dome-shaped bump or a red, scaly patch of skin. It can be rough and crusty, and can bleed easily when scraped. Large growths may itch or hurt. It may also pop through scars or chronic skin sores. It’s best to check for any changes and report them to your doctor.”
Protecting Your Skin From Sun Damage
Dr. Rola Eid, Medical Director of Plastic and Reconstructive Surgery and plastic surgeon at CTCA® Tulsa, who treated Berens’ cancer, notes that “the number one way to maintain a more youthful complexion is seeking shade.”
“Enjoy the sun,” she says, “but limit direct exposure” especially between the hours of 10 a.m. and 4 p.m., when damaging ultraviolet light is typically at its strongest.” She recommends wearing a wide-brimmed hat, long sleeves, long pants and UV-blocking sunglasses to protect your skin and eyes from sun damage.
“SPF-30 sunscreen can limit the skin-damaging effects of sun exposure, too,” Dr. Eid says, highlighting the importance of applying the product liberally and often (every two hours, or more if you’re swimming or sweating). “And use sunscreen at other times of the year, not just in the summer,” she says. “The skin can burn when exposed to the sun, no matter the season.”
It’s important to start these sun-safety habits early on because, as mentioned, burns in childhood can lead to skin cancer in later life. In fact, Dr. Eid says 25 percent of your exposure to sun over the course of your lifetime occurs between the ages of 1 and 18. “Previous generations of parents weren’t aware of these increased skin cancer risks, but parents today who protect their children from sun damage can know they’re doing right in helping prevent skin cancer.”