Skin Cancer in Children

Individuals of any age can develop skin cancer even through the risk of developing cancer increases as people age. Research shows that the average age of diagnosis of skin cancer, particularly melanoma, is approximately 60 years, with the lowest rate, approximately 0.7%, occurring in people under the age of 20.1

The good news for parents is that skin cancer is relatively rare in children, although it can and does occur. Often children that are born with congenital moles, especially large moles or birthmarks along with atypical moles are much more likely to develop skin cancer than children that develop normal moles after birth. In addition any moles on children that swell, change in shape or size or that bleed or scab need to be examined by a dermatologist or oncologist immediately to provide the earliest possible diagnosis and treatment.2

Risk Factors

Children have the same risk factors for developing skin cancers, including melanoma, as adults. This includes both genetic and environmental factors. Parents that have large numbers of moles, atypical moles or a history of melanoma or skin cancer in their family need to be particularly attentive to any moles or skin irregularities in their children.

A condition known as FAMMM or familial atypical multiple mole-melanoma is found within families. Typically members of these families have light skin, light or red hair and a significant number of moles and freckles. This condition is most common in white people but can also occur in difficult ethnic groups. It is least common in those families that are from African and Asian ethnic backgrounds.3skin cancer in children Skin Cancer in Children

Children that are using immunosuppressant drugs due to a transplant or those that are receiving radiation treatments due to another cancer diagnosis are at greater risk for developing skin cancers than children of any age that are not on these drug therapies. Parents need to speak to their doctors, dermatologists and oncologists to understand the early signs of skin cancers because of these very specific types of medical treatments and drug therapies.

Sun exposure can contribute very early in life to the chances of a child developing basal or squamous cell carcinoma or melanoma. The more unprotected skin is exposed to sun and is damaged by the UV radiation the greater the chance of skin cancer later in life. In addition deep or significant burns, which are typically on the back, arms, face and legs are also major factors in cellular damage to the skin.

Parents should actively work to educate children about the importance of avoiding direct exposure to sunlight. Wearing a high SPF sunscreen, ideally over 30 SPF is a good start in preventing this damage. For very fair skinned children wearing long sleeves and long pants and avoiding long periods of outdoor time at the hottest part of the day can also be important education for parents to consider.

The Appearance of Moles

Parents often become concerned when a child starts to develop moles on his or her body. However, moles that are normal in shape, size, number and color are not problematic and are not an indicator of skin cancer. Moles that are atypical are of concern and should be carefully monitored.

As with adult skin the indicators of an atypical mole in a child include the ABCDs. This is the asymmetry of the mole, the borders, the color and the diameter. The mole should be circular or oval in shape and not asymmetrical. The borders should be clear and defined, not blurred or jagged in shape. In addition the color should be uniform throughout the mole and the diameter should be less than 5 millimeters, about the size of a pencil eraser.

It is not uncommon for children to develop moles as they grow and this process can continue until the child reaches adulthood at about the age of 20. Approximately one percent, so a very small number, of children are born with moles.4  These moles should be normal in the ABCD factors and, if any changes in the mole are noted, a dermatologist should be consulted.

There are some children that are born with excessively large moles, which are known as giant congenital nevus. These are often larger than 8 inches in diameter and may increase a child’s risk of developing melanoma by as much as 10%. These moles may become very thick and have a large number of hairs protruding from the surface of the skin. It is essential to carefully monitor these moles and ensure that the child has regular appointments with a dermatologist to detect the earliest signs of melanoma.5

Treatment of Childhood Skin Cancers

Childhood skin cancers including melanomas and nonmelanoma cancers are treated with the same methods used in adults. Small atypical moles or areas of the skin that are diagnosed with basal or squamous cell carcinomas can often be treated in a doctor’s office without the need for hospitalization or invasive surgical procedures. Early diagnosis is the key in ensuring that the cancer is contained and removed from the body before it spreads or moves into deeper layers of the skin.

Small mole areas or cancerous portions of skin can also be removed using a cryosurgery technique that includes the use of liquid nitrogen. This is also a simple procedure that is typically completed in a dermatologist’s office. More complex surgical procedures including Mohs surgery or laser therapy can be indicated if the skin cancer is deeper, larger or is reoccurring.6

References

1 SEER Stat Fact Sheets: Melanoma of the Skin. (2011). Retrieved from National Cancer Institute: seer.cancer.gov/statfacts/html/melan.html

2 Skin Cancer Disease Information. (n.d.). Retrieved from Children’s Hopsital Boston: www.childrenshospital.org/az/Site1603/mainpageS1603P1.html

3 Moles: Who gets and types. (n.d.). Retrieved from American Academy of Dermatology: www.aad.org/skin-conditions/dermatology-a-to-z/moles/who-gets-types

4 Moles in Children: What Parents Should Know. (n.d.). Retrieved from SkinCancerNet: www.skincarephysicians.com/skincancernet/moles_children.html

5 Giant Congenital Nevus. (n.d.). PubMed Health.Retrieved from PubMed Health: www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002424/

6 Skin Cancer: Treatments And Drugs. (n.d.). Retrieved from Mayo Clinic: www.mayoclinic.com/health/skin-cancer/DS00190/DSECTION=treatments-and-drugs