Melanoma in children

Melanoma is the most serious type of skin cancer, but it’s one you might normally associate with adults. But it can occur in children as well.

Pediatric melanoma represents only about 1 percent of new melanoma cases diagnosed in the United States each year. However, though still rare, malignant melanoma is the most common skin cancer in children and teens. It increased by about 2 percent annually from the 1970s through 2009, primarily in teens.

Melanoma is almost always a skin cancer. Less common is a melanoma that forms in the body’s digestive system and mucous glands.

Melanoma starts as melanocytes. These are cells that produce melanin, the substance that gives skin its color. Melanoma can often be seen as an isolated mole on the skin in its early stages. But from there, the cancer can spread to other parts of the body, including your organs.

Pediatric melanoma usually first appears as a suspicious mole. Features of a possible melanoma include a:

  • change in shape, color, or size of a mole
  • mole that is painful or appears as a sore that doesn’t heal
  • mole that itches or bleeds
  • lump that looks shiny or crusty
  • dark spot under a fingernail or toenail not caused by trauma to the nail

Remember that most moles are not melanomas.

Fair-skinned, light-haired children are at a higher risk for pediatric melanoma. Exposure to ultraviolet (UV) radiation from the sun and a history of sunburns makes you more susceptible to melanoma formation.

A family history of melanoma also increases a child’s likelihood of developing skin cancer. In children who have already been treated for melanoma, the chances of additional skin cancers forming is higher than in kids with no skin cancer history.

The use of tanning beds may also explain the growing risk of pediatric melanoma, especially among adolescents.

In general, the risk factors for skin cancer in children over the age of 10 are the same as those for adults, though for younger children the risk factors are less clear.

Skin cancer in children and adults is categorized by stages 0 through 4. The more advanced a cancer is, the higher its stage. Treatment options depend on the stage and location of the cancer.

Stage 0 or 1 melanoma can usually be treated successfully with wide excision, an operation that removes the mole and the healthy skin just around its margins.

At stage 0, a melanoma may instead be treatable with imiquimod cream (Zyclara), a prescription ointment that helps cancerous and noncancerous skin growths disappear.

Stage 2 melanoma requires wide excision, and may also involve a lymph node biopsy. A stage 2 melanoma may have invaded the lymph system, so a biopsy may be appropriate. Talk with your child’s doctor about whether a biopsy makes sense at this stage.

Stage 3 melanoma requires surgery to remove the tumor and surgery on the lymph nodes to which the cancer spread. Radiation therapy may also be necessary.

Stage 4 melanoma can be very difficult to treat. This stage means the cancer has spread to distant lymph nodes and possibly other parts of the body. Surgery, chemotherapy, and immunotherapy may all be involved.

Skin cancer in children is on the rise. There’s been an increase in awareness of the dangers of too much UV exposure and the importance of skin cancer screenings. Teach your child how to check for suspicious moles, sores, and growths, and schedule annual visits with your pediatrician.

If your child is at higher risk for melanoma or you or your pediatrician notice any suspicious lesions, have your child see a dermatologist. This will help you catch pediatric melanoma or any other type of skin cancer in children at its earliest, most treatable stage.

Treating early-stage melanoma is usually successful. Surgery may leave little or no scar if the melanoma is diagnosed when it’s still small.

The most important preventive step you can take to protect your kids is to reduce their direct exposure to UV rays. This means wearing a sunscreen of at least SPF 15. Doing so can reduce the risk of pediatric melanoma by 50 percent.

Letting kids play outside early in the mornings or late in the afternoons also reduces exposure to the sun when it’s at its strongest. Dark clothes offer the best protection, but any shirt, hat, or other clothing is better than no protection.

Children and adolescents should not use tanning beds.

Do skin checks on your child regularly, especially on the face, neck, and legs. Children who spend a lot of time outside without a shirt may develop skin cancer on their trunk. Have a dermatologist examine any concerning lesions.