Tanning beds and melanoma. Here’s what to know

Melanoma is one of the most common cancers in young women under the age of 30, and the incidence of cases has increased by about 50 percent since 1980, according to Elizabeth Tocci, MD, a dermatologist with Cape Cod Dermatology.

“The increase in melanoma is partially connected with the use of tanning beds,” she said. The increase is due to many factors, mostly increased awareness of and screening for melanoma, and also UV exposure, including tanning bed use.

However, the good news is that early detection and treatment are keeping mortality rates from also increasing, she added.

Melanoma is a type of skin cancer caused by sun exposure and tanning beds. It occurs when the melanocytes, which are cells that produce the pigment in your skin, reproduce out of control, Dr. Tocci said. Sunlight and tanning beds emit ultraviolet radiation: UVA (long wave) that primarily causes aging and wrinkling, and UVB (short wave) that causes sunburns.

UVA rays penetrate the skin (dermis) more deeply, whereas UVB usually remains in the top layer of the skin (epidermis).

A recent study published in Science Advances showed that tanning beds have a higher risk of causing melanoma and are more damaging to the skin than exposure from sunlight.

There are two reasons for this, Dr. Tocci said.

• Sunlight is about 95 percent UVA and 5 percent UVB. Tanning beds have a much higher percentage of UVA and very little UVB. The UVA waves are primarily responsible for abnormal growth by damaging cells’ DNA. They also damage collagen, elastin, cause premature aging and are more likely to cause skin cancers.
• When using tanning beds, you are usually naked and the concentration of UVA rays is higher, which puts you at an increased risk of getting melanoma, especially in areas of the skin where you normally wouldn’t get it.

Warning Signs of Melanoma

One of the ways to become aware of the warning signs of melanoma is to think of your ABCs, said Dr. Tocci.

• A: Asymmetry: If you look at one half of the mole or spot, it will be different on one side.
• B: Border: The borders are irregular.
• C: Colors: The colors can be brown, black, blue, pink or tan. Typically, there are two to three colors in a melanoma and some melanomas are pink without any color because they don’t contain melanin.
• D: Diameter: The spot is greater than six millimeters, which is about the size of a pencil eraser.
• E: Evolution: The mole or spot changes in appearance over time.

Treatment Can Vary

Treatment depends on the type of melanoma you have, said Dr. Tocci. One type of melanoma is in situ (stage 0) and not aggressive. It is in the top layer of the skin (epidermis) and is removed with an excision.

“We always do a biopsy when we diagnose a melanoma, and this tells us how deep the melanoma is,” she said. “If it is deeper in the skin (dermis), then we will biopsy the lymph nodes to see how far it has spread.”

With stage II, the cancer cells are in the top and deeper into the skin. With stage III, cancer cells are deep in the skin and have spread to lymph nodes. In stage IV, the tumor has spread to other parts of the body.

“Treatment has come a long way in the past 10 years,” said Dr. Tocci. “It used to include chemotherapy but now more commonly consists of targeted immunotherapy, depending on the genetic makeup of the tumor, and we can manage it much better.”

Melanoma can be deadly if not caught early, she said. “If you find something new on your skin, don’t hesitate to get it checked.”