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Many Americans aren’t aware of how sun exposure can raise their risk of skin cancer. Javi Indy/Getty Images
  • Skin cancer is the most common cancer affecting Americans today.
  • A new survey by the American Academy of Dermatology (AAD) found that about a third of Americans failed a basic quiz on skin cancer and sun exposure.
  • Thirty-one percent of Americans are unaware that tanning can cause skin cancer.
  • Wearing sunscreen, protective clothing, and performing regular skin self-exams can all help lower your risk of skin cancer.

Skin cancer is the most common cancer in the United States, affecting 1 in 5 Americans by age 70, according to the Skin Cancer Foundation.

However, a survey by the American Academy of Dermatology (AAD) found that about a third of Americans failed a basic quiz on skin cancer and sun exposure.

Here’s what Americans got wrong:

  • 53 percent are unaware that shade will protect them from the sun’s harmful UV rays
  • 47 percent either incorrectly believe or are unsure that having a base tan will prevent sunburns
  • 35 percent either incorrectly believe or are unsure that as long as you don’t burn, tanning is safe
  • 31 percent are unaware that tanning causes skin cancer

Dr. Seemal R. Desai, member of the AAD board of directors, said he was surprised to learn how many Americans failed the quiz.

“Our work as board certified dermatologists is to educate our patients about skin cancer prevention and sun safety. During times like this, when social distancing regulations due to the pandemic are compelling people to be outdoors more, this becomes very timely,” Desai told Healthline.

To help inform the public about reducing the risk of skin cancer, the AAD launched the #PracticeSafeSun campaign.

“Everyone is at risk of skin cancer, regardless of age, gender, or race. Tanning, whether it be indoors or outdoors, can be extremely detrimental to patients and lead to skin cancer as well as premature wrinkles, age spots, and more,” Desai said.

He added that using tanning beds before the age of 35 can increase your chances of developing melanoma by close to 60 percent. The risk continues to increase with each use of a tanning bed.

When outdoors, Desai recommends seeking shade whenever appropriate. He points out that the sun’s rays are the strongest between the hours of approximately 10 a.m. and 2 p.m.

Since shade isn’t always possible, the following steps can help ensure you enjoy the sun safely.

Although a JAMA report found that consumers consider SPF rating to be the most important criterion for selecting a sunscreen, the AAD survey discovered that most Americans misunderstand what SPF means in the following ways:

  • 85 percent either incorrectly believe or are unsure that an SPF 30 sunscreen offers twice as much protection as an SPF 15 sunscreen
  • 55 percent either incorrectly believe or are unsure that high-SPF sunscreens can be applied less frequently than low-SPF sunscreens

Desai recommended applying a broad spectrum, water resistant sunscreen with an SPF of 30 or higher to all skin that’s not covered by clothing, and reapplying every 2 hours or after swimming or sweating.

Dr. Adam Friedman, professor of dermatology at George Washington School of Medicine and Health Sciences, agreed and pointed out that finding the right sunscreen isn’t always easy.

“I think the toughest part is finding one that ‘plays nice’ with one’s skin as we are all unique with respect to the biological makeup and activity of our skin, because the best sunscreen is the one you will use and reapply and reapply…,” he told Healthline.

Friedman suggested experimenting between products that contain the minerals zinc oxide or titanium dioxide, or organic minerals such as oxybenzone, avobenzone, ecamsule, and octocrylene.

“Or even the vehicle itself (cream vs. lotion vs. spray),” he said.

Wearing sun-protective clothing, particularly lightweight, long-sleeved shirts and pants, a wide-brimmed hat, and sunglasses with UV protection, can help keep you safe in the sun.

“In fact, clothing is now available that contains an ultraviolet protection factor (UPF) label, which offers more effective sun protection. I often recommend this for my patients, and they have found types of clothing in very nice styles to suit many different tastes,” Desai said.

While shopping for clothing that’s been tested for UV protective properties, Friedman said to keep in mind that the thicker and higher woven clothing is, the more it can physically block the harmful effects of the sun.

“In general, we recommend covering exposed areas when possible — and summer heat can make that difficult,” he said.

Because skin cancer is highly treatable when detected early, the AAD encourages everyone to perform regular skin self-exams.

Look out for the following ABCDEs, which are the warning signs of melanoma:

  • A is for Asymmetry. One half of the spot is unlike the other half.
  • B is for Border. The spot has an irregular, scalloped, or poorly defined border.
  • C is for Color. The spot has varying colors from one area to the next, such as shades of tan, brown, or black or areas of white, red, or blue.
  • D is for Diameter. While melanomas are usually greater than 6 millimeters — or about the size of a pencil eraser — when diagnosed, they can be smaller.
  • E is for Evolving. The spot looks different from the rest or is changing in size, shape, or color.

Desai suggested using a handheld mirror and standing in front of a large, full-body mirror to scan yourself.

“Don’t be afraid to touch your own skin and look for lesions that you may feel,” he said.

Desai also suggested referring to the AAD’s Body Mole Map. It describes the different types of skin cancers, including melanoma, basal cell carcinoma, and squamous cell carcinoma.

Friedman advised performing a self-exam every other month, and asking someone you live with to look at areas you can’t readily see.

“I also encourage patients to take skin screening selfies (same lighting, same distance from skin) at the self-screens to allow for a photo timeline. [This is] a way to track any changes over time, and these can be helpful when one comes to see the dermatologist,” Friedman said.

If you notice a spot on your skin that’s different from others or that changes, itches, or bleeds, it’s time to make an appointment with a board certified dermatologist.

“Early detection is key to limiting the negative and harmful consequences of skin cancer, so when in doubt, get it checked out,” Friedman said.

If you notice a growth or spot that’s changed over time — maybe it got bigger versus smaller, lighter versus darker, went from symmetrical to asymmetrical — call your doctor.

“[Also a spot that has] new onset pain/itch, easily bleeds — good to have it examined by a board certified dermatologist,” Friedman added.