Skin cancer checks for kids: When to take them

If you have a family history of skin cancer, it's likely that your child needs to be checked as well. Read more about what experts say about skin cancer in children, tips for keeping an eye out for unusual skin markings and more.

With sun comes a lot of fun, but also comes the risk of skin cancer. But those risks can be minimized by taking simple steps to protect your children.

Mind your A,B,C,Ds and Es

So where should you start? According to oncologist Dr. Jessica Roberson, rates are on the rise for melanoma and research suggests the rise may be partly due to sun exposure during early childhood. "But the good news is," says Roberson, "Parents can substantially lower their child's risk by protecting them from the sun, paying attention to moles on the skin and teaching sun safety at an early age." Roberson suggests following the ABCDE rule. If you answer "Yes" to any of the following questions, you should consult with a dermatologist.

• Asymmetry - If you were to cut the mole down the middle, would the left and the right sides look different?
• Border - Are the edges blurry and undefined?
• Color - Does the mole look darker or lighter than usual?
• Diameter - Is the mole larger than the eraser on a pencil top?
• Elevation - Does it have a raised surface?

When looking for irregular moles, be sure to check your child's entire body — not just the obvious spots. "Don't forget to check the scalp and the feet and toes where moles aren't as obvious," urges Dr. Heather Woolery-Lloyd, a Miami-based board certified dermatologist.

In addition to a new mole that looks different or stands out from all the other moles on the skin, you're also looking for moles that bleed and/or don't heal. "Signs and symptoms of skin cancer are spots that bleed easily without trauma and spots that don't want to heal," says Dr. Jean Urquhart, a board certified dermatologist and dermatopathologist at Mountain Dermatology Specialists in Colorado.

How early do you start checking?

When you've just had a baby, the last thing you want to think about is anything bad happening to your child, especially cancer. But that's when your skin cancer checks should begin. "From birth on," says Dr. Judith Hellman, associate clinical professor of dermatology and board certified dermatologist at Mt. Sinai Hospital in New York. "Some children are born with congenital moles and some of those can pose a risk of skin cancer. It's good to have a dermatologist examine any growths as early as one finds them."

So how likely is it that you could discover skin cancer in your baby or very young child? "Skin cancer is very rare in prepubertal children. The most common skin cancers such as basal cell carcinoma and squamous cell carcinoma are very rarely found in children because they are a result of chronic sun damage that is accumulated over many years. If a child does have a basal cell carcinoma or squamous cell carcinoma, it may be an indication of a genetic disorder that can make children more prone to skin cancer," says Dr. Urquhart.

Dr. Urquhart adds, "Melanoma is also very rare in prepubertal children. Risks for melanoma are linked to family history, history of multiple sunburns as a child, history of precancerous moles, fair skin and greater than 50 moles."

How can you help prevent your child from getting skin cancer?

"Sunscreen — especially on vacations," says Dr. Woolery-Lloyd. "One study showed that children who went on sunny vacations had a greater number of atypical moles."

And what about newborns and infants? "Avoiding the sun when the baby is born is a start and you can start applying sunscreen after the age of 6 months. However the best prevention for all children is to stay in the shade. Since most skin cancers are a result of cumulative sun damage, the less exposure to sun damage and burns, the better the long-term preventive value." says Dr. Hellman.

Dr. Richard Asarch, a board certified Denver dermatologist, also reminds parents that sunscreen needs to be applied daily and not just on sunny days. "Even on a cloudy day, up to 80 percent of the sun’s UV rays can pass through the clouds. Apply an SPF of at least 30 15-20 minutes before sun exposure to allow a protective film to develop." Asarch continues, "Re-apply every two hours or after excessive sweating or swimming. Use enough sunscreen to generously coat all exposed skin."

"Don't forget to apply lip balms with an SPF of 30 or higher to your child's lips to keep them from burning," recommends Beverly Hills cosmetic dentist, Dr. Arthur Glosman. "The mouth is often forgotten when applying sun protection and also a vulnerable area where skin cancer can strike."

"Make sure your dentist is performing a lip exam as part of their routine dental visit — and if you notice any abnormalities either on the lip, around the lips, or inside the mouth of your child, see a doctor right away."

Read on to learn about sunscreen and more >>

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What type of sunscreen should you buy?

SPH, UV, UVA, UVB... Have your eyes ever glazed over as you've stood at the drugstore staring up at the shelf filled with dozens of sunscreen options? There are some simple things to look for on the sunscreen bottle. "It's best to use a broad spectrum sunscreen, to cover UVA and UVB rays. SPF 30+ is a good start. Certain brands carry sunscreens for young children, containing less chemicals. Physical sunscreens containing zinc, titanium oxide are also best," says Dr. Hellman.

Winning the sunscreen battles: Great products kids will let you apply >>

Sunscreen isn't the only way to help prevent skin cancer

But it's important to note that there is more to prevention than just sunscreen. The time of day your child is outside and the clothes your children wear are also factors. Dr. Urquhart points out, "The most intense sun exposure occurs midday between 10 a.m. - 3 p.m. If it is possible to schedule outdoor activity earlier in the day or later in the day, it would decrease the amount of sun damage children receive. When children are out in the sun, it is also important to use sun protective clothing. Long sleeves, hats, swim shirts, sunglasses are all very helpful in preventing sunburns."

What if there is a history of skin cancer in your family? What else should you do?

"In addition to sunscreen," says Dr. Woolery-Lloyd, "Mole mapping should be done for children with multiple atypical moles. Mole mapping involves mapping moles with pictures so changes are easily identified at yearly follow-up visits."

How often should you get your child checked by a doctor?

Dr. Urquhart says she recommends annual skin cancer screenings for children starting around puberty. "This helps children understand their skin and also reinforce messages of sun protection that they have been getting from their parents. However, if a child has a strong family history, a genetic predisposition for skin cancer or has numerous moles at a young age, I will start skin cancer screenings at an earlier age." Dr. Asarch adds that, "Children born with large pigmented birth marks should also be seen yearly."

Be aware of the myths

If you still believe your child may not be at risk for developing skin cancer, Dr. Asarch urges you to consider these myths:

• Tanning or getting a base tan helps prevents skin cancers — False.
• There is little risk of sunburning on cloudy days — False.
• The sun is more intense at the hot summer beach than in the cool mountain elevations — False. Check the UV index for the area you live in to determine the risk.
• My child is not at risk because he has dark skin — False. While it is true that skin cancer is less likely in darker pigmented skin, it is not risk free. Sun protection is essential for all skin types, tones and pigmentations.

Read more about preventing skin cancer

Quiz - Are you protecting your kids from skin cancer?
Protect your child with UV-blocking clothing
How to prevent children's sunburns