Like most 17-year-olds, Alison Griffitt was a carefree high school senior excited about her upcoming prom. She wasn’t a sun worshipper, but Griffitt admits that she would pop into a tanning salon before pageants, dances, and other special events.
“I noticed a spot on my leg while my anatomy class was studying skin,” she recalls. A biopsy revealed that the spot was a serious type of skin cancer known as melanoma. Griffitt underwent two surgeries at UAB Medicine, which was the wake-up call she needed. “I haven’t stepped foot in a tanning bed or missed a day of sunscreen since then.”
Now 26, Griffitt is cancer-free and a doctor of nursing practice at a dermatology clinic in Hoover, Ala. While she survived her brush with melanoma, many young women do not.
UAB Medicine dermatologist Katherine Hunt, MD, tells the story of a female university student with metastatic melanoma, which means the cancer has spread to other parts of her body. “Her prognosis is very poor, and it’s heartbreaking,” Dr. Hunt says. “Melanoma is a cancer that affects people in the prime of their life.”
May is Melanoma Awareness Month, and Dr. Hunt is committed to spreading the word about the increased risk of skin cancer from using tanning beds. “A generation of ladies in their 50s own up to abusing their skin because they didn’t know the dangers,” she says. “But high school girls and college-age women know the risks, and they use tanning beds anyway.”
Tanning Bed Risks
Dr. Hunt cites an article published in the British Medical Journal that calculated a 1.8% increased risk of melanoma for each tanning bed session per year.
“Young people who use tanning beds prior to the age of 35 have a 59% higher risk of melanoma,” Dr. Hunt says. “Tanning bed use increases the risk of melanoma far more than sun exposure alone.”
According to the American Academy of Dermatology, more than one million Americans have melanoma, and about 20 people die from melanoma each day in the United States.
“Melanoma is related to intense intermittent UV exposure, like the exposure you get from a tanning bed or occasional vacation,” Dr. Hunt says. “Once you’ve had a melanoma, your risk of getting another melanoma is eight times higher.”
The Importance of Self-Exams
Dr. Hunt is concerned about the lack of national guidelines for full-body skin cancer screening, so she recommends monthly self-screening exams to check the size and growth of any suspicious moles or lesions on your skin. “When it comes to melanoma, one millimeter can mean the difference between life and death,” she says.
Dr. Hunt says it’s important to ask a family member or friend to help you self-screen. “For men, melanoma is most common on the back,” she says. “For women, it’s the back and the legs. Everyone needs help.”
Knowing what to look for is as easy as A-B-C-D-E, which is a good way to remember the following points:
- Asymmetry: Does one side of the lesion look different from the other?
- Border: Is the border jagged?
- Color: Is it more than one color?
- Diameter: Is it bigger than a pencil eraser?
- Evolution: Is it changing over time?
For people with a concerning mole or lesion, Dr. Hunt recommends seeing a doctor and learning more about melanoma. “Patients often have no idea that you can get melanoma in your nails, in areas protected from the sun, in your eyes, or mouth,” she says.
Dr. Hunt uses a dermatoscope with 10X magnification and polarized light, which allows her to see below the outer layer of skin to better examine the suspicious spot. If the mole or lesion looks concerning, she will numb it and take a small biopsy of the area and send it for testing to determine if it’s cancerous.
The first-line treatment for melanomas that are less than 0.8 mm deep is a technique called wide local excision, which removes the lesion and a 1 cm margin of normal surrounding skin using local anesthetic. If the lesion is thicker than 0.8 mm, something known as sentinel node testing may be recommended. “Melanoma can spread to the lymph nodes,” Dr. Hunt says. “Because it also spreads through the blood, it can spread quickly.”
That’s why prevention and early detection are so important. “If a lesion is less than 0.8 mm deep, there’s only a 2% chance of dying from melanoma within 10 years,” Dr. Hunt says.
Even if the lesion is deeper than 0.8 mm and aggressive treatment is suggested, there are other options, such as a new type of treatment called immune checkpoint inhibitors.
“Melanoma evolves in ways to hide from the immune system,” Dr. Hunt says. “These medicines take the brakes off the immune system, allowing it to better target the cancer. This can change the prognosis for people with advanced melanoma.”
Tanning Bed Alternatives
Unfortunately, because each tanning session damages your skin’s DNA, there aren’t safety measures you can take to protect your skin while using a tanning bed. “The only way to reduce your risk is to stop,” Dr. Hunt says.
Two alternatives for getting the bronzing you want are spray tan salons and self-tanners. With spray tanning, a technician uses an airbrush to apply a fine mist to your body. Self-tanners can be found at cosmetic counters and can produce streak-free tans that produce the sun-kissed look common with using a tanning bed.
Griffitt left her tanning bed days behind her and hasn’t looked back. Instead, she speaks to high school students about her experience as a melanoma survivor and pushes for laws to restrict the use of tanning beds among minors. “In Alabama, it’s now illegal to use a tanning bed if you’re under the age of 14, and you need parental permission if you’re under 18,” Griffitt says.
“It’s important to have people like Alison – people who look like my patients – talk about their first-hand experiences,” Dr. Hunt says. “People don’t think melanoma will happen to them, but it does.”
Click here to learn about skin cancer care at UAB Medicine.