Skin Cancer in Children

What is skin cancer in children?

Skin cancer is a type of cancer that starts in the cells of the skin. It can spread to and damage nearby tissue. Over time, it can spread to other parts of the body. Skin cancer is very rare in children.

What causes skin cancer in a child?

Exposure to sunlight is a major risk factor for skin cancer. Skin cancer is more common in people with light skin, light-colored eyes, and blond or red hair. Other risk factors include:

• Family history of skin cancer

• Time spent in the sun

• Exposure to tanning beds or lamps

• History of sunburns

• Having many freckles

• Having many moles

• Having atypical moles (dysplastic nevi). These large, oddly shaped moles run in families.

• Radiation therapy to treat cancer in the past

• Taking a medicine that suppresses the immune system

• Having moles present at birth (congenital melanocytic nevi)

• Certain rare, inherited conditions such as basal cell nevus syndrome (Gorlin syndrome) or xeroderma pigmentosum (XP)

• HPV infection

• Actinic keratoses or Bowen disease. These are rough or scaly red or brown patches on the skin.

What are the symptoms of skin cancer in a child?

Basal cell carcinoma

Basal cell carcinomas most often start in skin that's exposed to the sun, such as the head, face, neck, arms, and hands. Symptoms can include:

• A small, raised bump that is shiny or pearly, and may have small blood vessels or brown, blue, or black areas

• Firm, flat yellow or pale areas that look a lot like a scar

• A small, flat spot that is scaly, irregularly shaped, and pale, pink, or red

• A spot that bleeds easily, then heals and appears to go away, then bleeds again in a few weeks

• Patches of raised, red skin that might itch

• A pink growth with raised edges, a lower area in the center, and blood vessels spreading out from it

Squamous cell carcinoma

Squamous cell carcinoma tends to start in skin exposed to the sun, such as the head, face, neck, ears, lips, and hands. They can also appear on other parts of the body, like skin in the genital area. Symptoms can include:

• A rough or scaly bump that may bleed or crust over

• Wart-like growths

• A raised growth that's lower in the center

• Open sores that don't heal or heal and then come back

Melanoma

Sometimes moles are present at birth. But most appear during childhood or in young adults. Symptoms of melanoma include a change in a mole, or a new mole that has ABCDE traits such as:

• Asymmetry. One half of the mole does not match the other half.

• Border. The edges of the mole are ragged, notched, or blurred.

• Color. The mole has different colors in it. It may be tan, brown, black, red, or other colors. Or it may have areas that appear to have lost color.

• Diameter. The mole is bigger than 6 millimeters across, about the size of a pencil eraser. But some melanomas can be smaller.

• Evolving. A mole changes in size, shape, or color.

Other symptoms of melanoma can include a mole that:

• Itches or hurts

• Oozes, bleeds, or becomes crusty

• Turns red or swells

• Looks different from your child's other moles

How is skin cancer diagnosed in a child?

The healthcare provider will examine your child's skin. Tell the healthcare provider:

• When you first noticed the skin problem

• If it oozes fluid or bleeds, or gets crusty

• If it’s changed in size, color, or shape

• If your child has pain or itching

Tell the healthcare provider if your child has had skin cancer in the past, and if other family members have had skin cancer.

Your child's healthcare provider will likely take a small piece of tissue (biopsy) from a mole or other skin mark that may look like cancer. The tissue is sent to a lab. A doctor called a pathologist looks at the tissue under a microscope. They may do other tests to see if cancer cells are in the sample. The biopsy results will likely be ready in a few days or a week. Your child's healthcare provider will tell you the results. They will talk with you about other tests that may be needed if cancer is found.

How is skin cancer treated in a child?

Types of treatment for basal cell and squamous cell cancers include the below.

What are possible complications of skin cancer in a child?

Possible complications depend on the type and stage of skin cancer. Melanoma is more likely to cause complications. And the more advanced the cancer, the more likely there will be complications.

Complications may result from treatment, such as:

• Loss of large areas of skin and underlying tissue

• Scarring

• Problems with the area healing

• Infection in the area

• Damage to nerves

• Return of the skin cancer after treatment

Melanoma may spread to organs throughout the body and cause death.

What can I do to prevent skin cancer in my child?

The American Academy of Dermatology (AAD) and the Skin Cancer Foundation advise you to:

• Limit how much direct sun your child gets between the hours of 10 a.m. and 4 p.m.

• Use broad-spectrum sunscreen with an SPF 30 or higher that protects against both UVA and UVB rays. Put it on the skin of children older than 6 months of age who are exposed to the sun.

• Reapply sunscreen every 2 hours, even on cloudy days. Reapply every hour after swimming or sweating.

• Use extra caution near water, snow, and sand. They reflect the damaging rays of the sun. This can increase the chance of sunburn.

• Make sure your child wears clothing that covers the body and shades the face. Hats should provide shade for both the face, ears, and back of the neck. Wearing sunglasses will reduce the amount of rays reaching the eye and protect the lids of the eyes, as well as the lens. Clothing with UV protection factor (UPF) gives additional protection.

• Don’t let your child use or be around sunlamps or tanning beds.

The American Academy of Pediatrics approves of the use of sunscreen on babies younger than 6 months old if adequate clothing and shade are not available. You should still try to keep your baby out of the sun. Dress the baby in lightweight clothing that covers most surface areas of skin. But you also may use a small amount of sunscreen on the baby’s face and back of the hands.

How can I help my child live with skin cancer?

If your child has skin cancer, you can help them during treatment in these ways:

• Your child may have trouble eating. A dietitian or nutritionist may be able to help.

• Your child may be very tired. They'll need to learn to balance rest and activity.

• Get emotional support for your child. Counselors and support groups can help.

• Keep all follow-up appointments.

• Keep your child out of the sun.

After treatment, check your child's skin every month or as often as advised.

When should I call my child's healthcare provider?

Call your child's healthcare provider if you see any unusual changes in your child's skin.

Key points about skin cancer in children

• Skin cancer is rare in children.

• Skin cancer is more common in people with light skin, light-colored eyes, and blond or red hair.

• Follow the ABCDE rule to tell the difference between a normal mole and melanoma.

• Biopsy is used to diagnose skin cancer.

• Skin cancer can be treated with surgery, medicine, and radiation.

• Staying out of the sun is the best way to prevent skin cancer.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed, how your child should take the medicine, and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is advised and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know what symptoms to report to your child's healthcare provider.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.