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Skin Cancer Surging Among Young People

Ah, summertime and youth — it’s a fun fusion, with the beach or other outdoor activities beckoning.

But these sunny scenes have a dark side for a growing number of young adults. Baptist Health dermatologist Alysa Herman, M.D., [1] calls it “the changing demographic of skin cancer.” Dr. Herman, who is affiliated with Baptist Hospital, Doctors Hospital and South Miami Hospital, has noticed a troubling trend in her two decades as a skin cancer surgeon: younger and younger patients.

‘Chronic, Cumulative Exposure’
She now frequently sees people in their 20s and 30s with non-melanoma skin cancer, including squamous cell and basal cell, which are caused by “chronic, cumulative exposure” to the sun’s ultraviolet rays. She even has treated a 17-year-old for skin cancer.

“When I started training 20 years ago, I never saw somebody my own age, ever,” said Dr. Herman, who is a member of the Baptist Health Quality Network [2]. “Not only do I see my own age now but a growing group of patients much younger without any other underlying condition. It’s incredible how the age has dropped so dramatically.”

What Dr. Herman has experienced is borne out by research in recent years. According to a report in May from the National Cancer Registry of Ireland [3], the incidence of basal cell and squamous cell skin cancer increased 72 percent for females under age 35 between 1994 and 2011—the largest increase of any age group. The rise in skin cancer among young people was attributed to “repeated sunburn during leisure activities,” as well as the use of tanning beds.

A 2014 report in Dermatologic Surgery [4] noted “a higher and increasing incidence of skin cancer in younger women as compared with men.” A 2012 Mayo Clinic study [5] also found a “dramatic rise in skin cancer in young adults.”

Studies also have reported an increased incidence in melanoma, a less common but often deadly form of skin cancer, among younger people. While melanoma’s most significant risk factor may be genetic, intense sun exposure that causes sunburn and the use of tanning beds also contribute to its development, Dr. Herman said.

“Since the 1960s there has been a 200-fold increase in melanoma,” Dr. Herman said. “Just one indoor tanning session raises the risk by 20 percent.”

Prevention Takes Daily Vigilance
The good news is that skin cancer is largely preventable by avoiding or blocking the sun’s harmful rays. And anyone can do that if they are willing, though it takes daily vigilance. Wear 30 SPF or higher sunscreen every day, Dr. Herman said, and make sure to cover the entire face, hands and neck — the spots that are exposed as you drive a car.

Even though glass blocks UVB rays, and front windshields are treated to block most of UVA rays, you still get fully zapped by the sun’s UVA rays through the back windshield and side windows. (In fact, more people in the United States get skin cancer on the left side of their face and body, a fact that a 2010 study published in the Journal of the American Academy of Dermatology [6] attributed to cumulative time in the driver’s seat.)

The tough news for young people is the often intrinsic “disconnect” between youth and the longer term effects of their choices and behavior.

Getting Young People to Change Behaviors
“It’s shocking to me when I see young people who are tanned or burned,” Dr. Herman said. “Skin cancer was once a disease of older people. It’s really hard to get young people to change their behavior. They say, ‘Oh, my grandfather had one of those.’ We get wise with age.”

Dr. Herman understands that young people go out in the sun without the proper protection or frequent a tanning salon because they want to get tanned — “not because they want to get damaged.” So she likes to offer young patients an alternative way to get that desired look.

Parents of teens and young adults, take note. Today’s tanning sprays and airbrushes offer a nice, realistic — and safe — bronze glow.

“This is what you tell your 20-year-old,” Dr. Herman said. “You can still get the color you want, but you don’t have to damage your skin at the same time.”