Skin Cancer in Children
Reviewed by: HU Medical Review Board | Last reviewed: May 2017. | Last updated: November 2020
Your child’s soft, delicate skin is especially vulnerable to damage from the sun’s ultraviolet (UV) rays. Skin cancer is very rare in children and young adults. However, childhood sun exposure can be a risk factor for later skin cancer. The early years are an important time for making sun protective behaviors a habit.
Why are young children especially sensitive to the sun?
Babies and young children have lower levels of melanin.1Melanin is the protective pigment that gives skin a tan or brown color when it is exposed to sun. The topmost layer of skin is called the stratum corneum.1 This layer is made of flat, dead cells, and it is the skin’s first line of defense against UV rays.2 In children, the stratum corneum is very thin.
Children exposed to intense sun intermittently are more likely to develop melanoma or basal cell carcinoma as adults.1 However, sun exposure is not just a concern when spending a day at the pool. Studies have shown that even “incidental” sun exposure can cause skin changes in children.1 Incidental sun exposure includes playing outside on a cloudy day or riding in the car. For this reason, experts recommend taking precautions to protect the skin any day you will be outside.
How can I protect my child from skin cancer?
Major organizations such as the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA), and the American Academy of Dermatology (AAD) recommend taking multiple steps to protect skin from the sun.3-5 Precautions include:
- Seeking shade between 10 am and 2 pm.
- Wearing long sleeves, long pants, wide-brimmed hats, and sunglasses.
- For children older than 6 months, using a broad spectrum sunscreen with sun protection factor (SPF) 15 or higher.
For babies less than 6 months old, the best strategy is to avoid the sun.1 It is fairly easy to dress a young infant in light-weight protective clothing and a wide-brimmed hat. Because she is not moving on her own yet, you can keep her in the shade.
Sunscreen is recommended for older infants, children, and adults.3-5 The AAD states that “preventing skin cancer and sunburn outweighs any unproven claims of toxicity or human health hazard from ingredients in sunscreens.”6
Sun protection is important for parents, too. Not only will you be protecting your own skin from UV rays, but you set an example for your children.
What about sun protection for tweens and teens?
Sun protection is just as important for tween and teens, but many kids this age feel pressure to tan. As a result, teens become less likely to protect their skin from the sun. Some even start tanning indoors.
Sunscreen use drops dramatically between ages 9 and 15.1 More than half of high school students report having had a sunburn in the previous year, including more than 3/4 white female high school students.7
Indoor tanning is a strong skin cancer risk factor in young women. One study showed that among women younger than 30 with melanoma, 97% had started indoor tanning before age 25.8 Any indoor tanning increases your skin cancer risk – and the more you tan, the higher your risk.8 Thirteen states prohibit people under 18 from using indoor tanning beds.9 Nevertheless, 15% of white female high school students report tanning indoors in the previous year.7
The risk of adulthood skin cancer might not persuade teens to cover up, but fear of wrinkles might. Studies have shown that focusing on the unattractive effects of tanning—wrinkles, fine lines, and brown spots—reduced indoor tanning by 35%.10
Do children and young adults develop skin cancer?
Melanoma is very rare in children. Among children of all races and genders, there is about 1 case per 100,000 people younger than 20.11 Between 1% and 4% of melanomas occur in children.1 Melanoma accounts for 3% of pediatric cancer.1
In one of the largest studies of pediatric melanoma, most common type was superficial spreading melanoma.12 (This type of melanoma is also the most common type in adults.) In the study of pediatric melanoma, the tumor was most likely to develop on the head and neck. The 5-year survival rate was 94% in children with cancer-free lymph nodes. In nearly 30% of cases, the cancer had spread to nearby lymph nodes by the time it was diagnosed. In these children, the 5-year survival was 78%. This study showed that melanoma can grow back (recur) more than 5 years after diagnosis. Ask your child’s dermatologist how often to follow up.
Genetics may play an important role in melanoma at a young age. The strongest risk factor in kids is having many moles.13 Having a giant congenital mole (a mole present at birth) is a risk factor for melanoma.14 Kids with red hair, blue eyes, freckles, and skin that does not tan are at higher risk of melanoma.13 Children with the medical condition xeroderma pigmentosum are prone to melanoma at a young age.13,14