Dispelling the myths of skin cancer

According to Martine Dunnwald, Pharm.D., Ph.D., one of the biggest misconceptions is that a suntan, rather than sunburn, cannot lead to skin cancer. "Tanning beds increase the risk of skin cancer, and every college student and tanning bed customer should know it," said Dunnwald, who is an assistant professor of dermatology at the University of Iowa College of Medicine. Confusion abounds when it comes to skin cancer and many myths and misconceptions have evolved over the years.

In an effort to set the record straight, the American Academy of Dermatology (AAD) issued a press release in May as part of its Melanoma/Skin Cancer Detection and Prevention Month. "Despite our ongoing public education efforts on the causes and symptoms of melanoma, a number of misconceptions exist," explained the president of the AAD, Diane R. Baker, M.D., FAAD. "These myths could cause some people to think they are not at risk for melanoma because of their skin type or to dismiss warning signs because they are not typical symptoms of the disease."

The first common misconception is that all melanomas follow the ABCD rule, standing for Asymmetry (one-half of the mole is different from the other), Border irregularity (borders are ragged or notched), Color (different colors exist within the same lesion), and Diameter (most are greater than 6 mm in diameter). Baker specifically noted the nodular melanoma does not follow these criteria and could therefore be missed, and, in fact, results from two studies published in 2003 and 2004 in the Journal of the American Academy of Dermatology (JAAD) and Journal of the American Medical Association, respectively, supported the argument that not all melanomas follow the ABCD rule.

Moles that have hairs are not cancerous is another half-truth. While the majority of moles with hairs are benign, a new study in the March 2007 issue of JAAD highlighted cases in which there was hair in a pigmented mole that turned out to be invasive melanoma. One possible explanation for this myth is that when melanomas were being diagnosed long ago, when this myth originated, the melanomas were much larger than they are today and had destroyed the surrounding hair follicles. "Today, dermatologists are diagnosing melanomas much earlier, when the lesions are thinner and before the hair follicle is wiped out," Baker explained.

Although Caucasians are 10 times more likely to be diagnosed with melanoma than other races, African-Americans are more likely to develop skin cancer in non-sun-exposed areas of the body, such as the nails, soles of the feet, mouth, nasal passages, genitals, and palms of the hands. This leads to the third and final myth that people of color don't get skin cancer. "The common belief that melanoma and other skin cancers don't affect people of color goes hand-in-hand with the myth that skin cancers develop only in sun-exposed areas," explained Baker. One study showed that only 33% of African-American patients got skin cancer in sun-exposed areas compared with 90% in Caucasians. And, in a study published in the January 2004 issue of JAAD, only 12.7% of Caucasians were diagnosed with melanoma that had already metastasized (Stage III or IV), compared with 32.1% of African-Americans.