Myth #1: A tan is healthy.
Fact: Tanned skin is damaged skin.1 There is no such thing as a healthy or safe tan.
In our culture, we associate a tan with health and beauty. We’ve learned to think of a year-round tan as a sign of “the good life.” This perception is reinforced in the popular media and fashion magazines. The tanning industry even claims that a base tan is “nature’s sunscreen.”2
The fact is that ultraviolet radiation (UV) is the cause of 90% of melanomas.1 UV radiation from the sun or tanning beds is the most important risk factor for skin cancer. The US Department of Health and Human Services has labeled UV radiation a carcinogen (cancer-causing substance).3 This is because UV radiation can damage the DNA in cells. DNA changes, called genetic mutations, may lead to uncontrolled cell growth.
The so-called “protective base tan” provides a sun protection factor (SPF) less than 31 For comparison, experts recommend using a sunscreen with SPF 15 to 30. SPF 3 provides inadequate protection—and a false sense of security. Having achieved a base tan, you may be likely to stay outside longer. You may take fewer precautions against the sun. You may actually end up at greater risk of a sunburn.
Myth #2: We need sun to get enough vitamin D.
Fact: You can meet your need for vitamin D through food and dietary supplements without risking UV overexposure.1
We all need vitamin D. The recommended amount for children, teens, and adults is 600 International Units (IU) per day.4 Adults age 71 and older need 800 IU per day.4 Vitamin D is important for bone health, and it may have a role in other health conditions.
Your skin makes vitamin D when it is exposed to sunlight. But it is hard to know how much sun exposure is required. The amount of exposure depends on the time of year, location, your skin type, and how much skin is exposed, among other factors.1 No single recommendation would meet the needs of everyone. A general recommendation may lead to UV overexposure for some people. For other people, a general recommendation might lead to inadequate vitamin D production.
Food sources of vitamin D include fatty fish, fortified milk, ready-to-eat cereals, fortified orange juice and yogurt, beef liver, cheese, and egg yolks.4 Check the labels of the food you buy. Vitamin D supplements are recommended for breastfed infants. Supplements can be used to meet the vitamin D needs of adults as well.
Myth #3: Skin cancer survivors have to be hermits.
Fact: It is important to be careful in the sun after skin cancer, but with some precautions, skin cancer survivors can enjoy time outside.
Time outside improves your mood. Outdoor recreation is a fun way to be physically active. It is not possible or desirable to avoid the sun entirely.1 However, it is important for skin cancer survivors to avoid unprotected sun exposure. People who have had one skin cancer are at risk of recurrence or new cancer. For example, after one melanoma, your chance of a second melanoma is 9 times higher than average.5
Recommendations for protecting your skin from outside UV radiation are:
- Use a broad spectrum sunscreen with an SPF 15 or higher. Apply sunscreen every day, even when it is cool or cloudy. There are many sunscreen products available. Find one that you like and will use consistently.
- Seek shade between 10 am and 2 pm. (Some organizations recommend staying out of the sun until 4 pm.) UV exposure is greatest in the middle of the day. It is especially intense on water, sand, and snow.
- Wear protective clothing. This includes long sleeves, long pants, a wide-brimmed hat, and sunglasses. Some clothes have a UPF or UV Protective Factor that indicates how well the fabric protects against the sun.
Myth #4: Skin cancer only affects people with fair skin.
Fact: People of all skin tones are at risk of developing skin cancer.
Indeed, skin cancer is more common in white persons than it is in people with dark skin tones. Per 100,000 people, there are 26 cases of skin cancer in non-Hispanic white persons, compared with 1 case per 100,000 black persons or 5 cases per 100,000 Hispanic persons.6 Nevertheless, UV damages skin of any color.7 Non-UV risk factors may play a role in skin cancer among people with darker skin tones.
In people with dark skin tones, skin cancer may have an atypical appearance. For example, basal cell carcinoma is often pink or translucent in fair skinned individuals. In people with dark skin tones, BCC can be pigmented (dark). The skin cancer may appear in less typical locations, such as the finger nails or bottom of the foot. Because skin cancer may be harder to recognize, it may take longer to diagnose.
Myth #5: If you have all your hair, you can’t have cancer.
Fact: There are many ways to treat cancer, and not all of them cause hair loss.
Hair loss is a well known side effect of chemotherapy. Because chemotherapy is used to treat many types of cancer, people may assume that hair loss is unavoidable if you have cancer.
Surgery is the preferred way to treat most types of skin cancer. Non-melanoma skin cancer and early-stage melanoma can usually be treated by surgery alone.8,9 Other local treatments may be used for some non-melanoma skin cancers and pre-cancers. (Local treatment is treatment of the tumor only.) Some of these may cause hair loss at the treated area, but do not cause general hair loss. Radiation therapy also may cause hair loss in the treated area.
Hair loss is a side effect of some medications for widespread or advanced skin cancer. Examples include:
- SMO inhibitors, Odomzo® (sonidegib) and Erivedge® (vismodegib)
- BRAF inhibitors, Tafinlar® (dabrafenib) and Zelboraf® (vemurafenib)
Myth #6: Having melanoma makes you an expert on other people’s moles.
Fact: It can be hard to identify skin cancer, even for medical professionals. A skin biopsy is the only way to know with certainty if a suspicious mole is cancerous.
If you have had melanoma, you’ve probably been asked by friends or family: “Is this mole cancerous?” As a melanoma survivor, you are probably familiar with the ABCDE memory aid to help you identify suspicious lesions:
- Asymmetry
- Border irregularity
- Color variation/unevenness
- Diameter of 6 mm or more
- Evolution or changes in the mole
However, it is impossible to diagnose cancer by sight—even for doctors. If your loved one is concerned about a suspicious lesion, she should make an appointment with her dermatologist.