Eczema is a common chronic inflammatory skin condition characterized by dry, itchy, and inflamed patches. This condition weakens the skin’s natural barrier, making it more susceptible to external factors. Many individuals with eczema wonder if the condition or its treatments might increase their risk of developing skin cancer. This article explores the current understanding of this relationship.
Understanding Eczema and Skin Cancer
Eczema, often referred to as atopic dermatitis, manifests as dry, intensely itchy, and inflamed skin. Affected areas can appear red, scaly, or bumpy, sometimes leading to thickened patches. The compromised skin barrier contributes to dryness and allows irritants to penetrate more easily.
Skin cancer involves the abnormal growth of skin cells. The three primary types are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. BCC is the most frequently diagnosed, often appearing as a pearl-like bump or pinkish patch. SCC is the second most common, presenting as a red, scaly patch or a sore that may heal and reopen. Melanoma is the most serious type, as it has a higher tendency to spread.
The Direct Link to Skin Cancer Risk
Current research indicates that eczema, particularly atopic dermatitis, does not directly increase skin cancer risk. Some studies even suggest the immune response triggered by eczema might offer a protective effect against tumor formation. However, debate continues, with some findings suggesting a slightly higher risk of non-melanoma skin cancer with mild atopic dermatitis.
The chronic inflammation associated with eczema can theoretically contribute to cellular changes over time. However, this direct link to skin cancer development is not as clearly established as for some other chronic inflammatory conditions. Eczema symptoms, such as scaly patches, redness, or non-healing sores, can sometimes mimic early skin cancers. This resemblance can make it more difficult for individuals and healthcare providers to detect skin cancer early.
Eczema Treatments and Skin Cancer Risk
Several treatments for eczema involve considerations regarding skin cancer risk.
Phototherapy
Phototherapy, also known as light therapy, uses controlled ultraviolet (UV) light exposure to manage skin inflammation. While excessive sun UV exposure is a known skin cancer risk, studies on UVB phototherapy for atopic dermatitis generally find no increased risk of non-melanoma skin cancer or melanoma in adults, even after numerous treatment sessions. This is because phototherapy is carefully controlled in a medical setting with specific wavelengths and doses.
Systemic Immunosuppressants
Systemic immunosuppressants are oral or injectable medications that dampen the body’s immune system to control severe eczema. Long-term use can be associated with an increased risk of certain cancers, particularly non-melanoma skin cancers like squamous cell carcinoma. This risk is observed in patients with severe, persistent eczema who require prolonged systemic immunosuppression, and these cases are managed with careful medical oversight. Some data also suggest a potential increased risk of lymphoma with severe atopic dermatitis, possibly related to disease severity or treatments.
Topical Medications
Topical corticosteroids, applied directly to the skin, are generally considered safe regarding skin cancer risk when used as directed. While prolonged use can lead to skin thinning, this effect is distinct from cancer development. Topical calcineurin inhibitors, another non-steroidal class, have not been shown to increase skin cancer risk despite historical concerns.
Skin Monitoring and Protective Measures
Regular skin monitoring is an important practice for everyone, and it holds particular significance for individuals managing eczema. Self-examinations, looking for any new or changing moles, lesions, or non-healing sores, are advised. Since eczema can sometimes obscure or mimic the appearance of skin cancer, prompt consultation with a dermatologist for any suspicious skin changes is recommended. Professional skin examinations are especially important for those undergoing phototherapy or systemic immunosuppression.
Sun protection is important for reducing skin cancer risk. For individuals with eczema, whose skin barrier may already be compromised, or who are using light-sensitive treatments, sun protection becomes even more relevant. Seeking shade, especially during peak sun hours between 11 a.m. and 3 p.m., is a simple yet effective measure. Wearing protective clothing, such as long-sleeved shirts, pants, and wide-brimmed hats, provides a physical barrier against UV radiation.
When choosing sunscreen, individuals with eczema often benefit from broad-spectrum formulas with an SPF of 30 or higher. Mineral-based sunscreens, containing zinc oxide or titanium dioxide, are frequently recommended for sensitive, eczema-prone skin because they tend to cause less irritation than chemical sunscreens. Sunscreen should be applied generously to all exposed skin and reapplied frequently, especially after sweating or swimming. Avoiding fragranced products can also help prevent skin irritation. Any concerns about skin changes or treatment-related risks should be openly discussed with a dermatologist or healthcare provider.