Melanoma, a serious form of skin cancer, can develop in children. While less common than in adults, it remains a significant health concern, with approximately 300 to 500 children diagnosed in the United States each year. Parental awareness of skin health and changes in moles is important. Early detection can significantly improve outcomes, so parents should understand the signs and risk factors.
Understanding Pediatric Melanoma
Genetic predispositions play a role in pediatric melanoma. A family history of melanoma or unusual moles increases a child’s risk. Certain inherited conditions, such as xeroderma pigmentosum and retinoblastoma, also raise the likelihood of developing this skin cancer. Children born with large congenital nevi (moles present at birth) have an elevated risk, especially if these moles are large or numerous.
Sun exposure contributes to melanoma risk. Severe sunburns during childhood can increase the risk of melanoma later in life. Children with fair skin, light-colored hair and eyes, and a tendency to freckle or burn easily are more susceptible. Pediatric melanoma is the most common skin cancer found in children, and its incidence has shown a slight increase, especially among teenage girls.
Identifying Suspicious Moles
Parents can recognize potential signs of melanoma by regularly examining their child’s skin. While the “ABCDE” rule (Asymmetry, Border irregularity, Color variation, Diameter, Evolving) is widely used for adults, pediatric melanoma can present differently. In children, melanoma may not always be dark or black; it can appear as a whitish, yellowish, pink, red, or skin-colored bump or lesion.
A suspicious mole might also be elevated, firm, and growing, sometimes referred to as the “EFG” criteria for nodular melanoma. Other signs include a bump that itches, bleeds, or resembles a wart. Parents should look for any mole or spot that appears different from other moles on their child’s skin, often called the “ugly duckling” sign. Monitor existing moles for changes in size, shape, or color, and note any new or unusual growths.
Medical Evaluation and Care
If a suspicious lesion is identified, a medical evaluation by a dermatologist is the next step. Diagnosis requires a biopsy, where a tissue sample is removed and examined under a microscope. The tissue should be reviewed by a pathologist with experience in pediatric cases, as childhood melanomas can sometimes be misdiagnosed due to their varied appearance.
Following a confirmed diagnosis, the melanoma will be staged to determine if and how far it has spread. Treatment typically involves surgical removal of the melanoma, along with a margin of surrounding healthy tissue, known as wide local excision. For thicker melanomas or those with other concerning features, a sentinel lymph node biopsy may be performed to check for spread to nearby lymph nodes. Additional therapies, such as chemotherapy, radiation therapy, immunotherapy, or targeted therapy, may be considered depending on the stage and characteristics of the melanoma.
Protecting Children from Melanoma
Protecting children from melanoma involves sun protection strategies. Seek shade, particularly between 10 a.m. and 4 p.m. when ultraviolet (UV) rays are strongest. Dress children in protective clothing, such as long-sleeved shirts, pants, and wide-brimmed hats, to provide a physical barrier against UV radiation. Sunglasses that offer 100% UV protection are also beneficial for eye safety.
Apply broad-spectrum sunscreen with an SPF of 30 or higher to all exposed skin. Sunscreen should be applied generously at least 15 to 30 minutes before sun exposure and reapplied every two hours, or more frequently if swimming or sweating. Sunscreen is not recommended for babies under six months old; instead, keep them out of direct sunlight and dressed in protective clothing. Regular skin examinations by parents, along with professional check-ups, especially for children with a family history of melanoma or numerous moles, aid early detection and prevention.