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.
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
- Taking a medicine that suppresses the
- Having moles present at birth (congenital melanocytic nevi)
- Certain rare, inherited conditions
such as basal cell nevus syndrome (Gorlin syndrome) or xeroderma pigmentosum
- HPV infection
- Actinic keratoses or Bowen disease.
These are rough or scaly red or brown patches on the skin.
What are the types of skin cancer?
There are 3 main types of skin
Basal cell carcinoma.
This is a very treatable cancer. It starts in the basal cell layer of the skin
(epidermis) and grows very slowly. The cancer often appears as a small, shiny bump
or nodule on the skin. It occurs mainly on areas exposed to the sun, such as the
head, neck, arms, hands, and face.
This cancer is less common and occurs mostly in adults. It
grows faster than basal cell carcinoma, but is also very treatable. Squamous cell
carcinoma may appear as nodules or red, scaly patches of skin, and may be found on
the face, ears, lips, and mouth. In rare cases, it can spread to other parts of
Melanoma. Skin cancer
in children is almost always this type. It's the most dangerous kind of skin
cancer. It starts in the melanocyte cells that make pigment (color) in the skin.
It may start as a mole that turns into cancer. Melanoma may spread quickly.
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
- A rough or scaly bump that may bleed
or crust over
- Wart-like growths
- A raised growth that's lower in the
- Open sores that don't heal or heal and then come back
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
The healthcare provider will
examine your child's skin. Tell the healthcare provider:
- When you first noticed the skin
- If it oozes fluid or bleeds, or gets
- If it’s changed in size, color, or
- 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
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
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.
Types of treatment for
squamous cell cancers include the below.
Curettage and electrodesiccation
This procedure removes tissue
and burns (cauterizes) the area. Your child is given a local anesthetic to numb the
area. The doctor then uses a sharp spoon-shaped tool called a curette to remove the
cancer. This is called curettage. After curettage, the doctor passes an electric
needle over the surface of the scraped area to stop bleeding, and destroy any other
cancer cells. After it heals, a flat white scar may remain.
This is done to cut the cancer
from the skin, along with some of the healthy tissue around it. Your child is given
local anesthetic. Then, the doctor uses a scalpel to remove the tumor from the skin.
The doctor may also remove some of the normal skin around the tumor. This is called
margin. Stitches or a bandage strip may be used to close the wound. The tissue that
was removed is sent to a lab for testing. If the report shows that not all the cancer
was removed, your child will likely need another procedure to remove the rest of the
This method is used for cancer
that is only in the top layers of the skin. Your child is given a local anesthetic.
Then, the doctor uses a small blade to shave off the tumor. The goal is to remove
tumor at its base.
This method uses cold to destroy
the cancer cells. This method is best for very small cancers near the skin’s surface.
The doctor uses a device that sprays liquid nitrogen onto the tumor. This freezes
cells and destroys them. The dead skin then falls off. Your child may have some
swelling and blistering in the area after treatment. A white scar is usually left
behind. The procedure may need to be repeated.
This is medicine applied as a
cream or ointment onto the skin. It’s also called topical chemotherapy. This kind
of medicine is only used if the cancer is just in the top layers of the skin. The
medicine is applied several times a week for a few weeks.
This is treatment with
high-energy X-rays. Electron beam radiation is often used for skin cancer. This
type of radiation doesn’t go deeper than the skin. This helps limit side effects.
The radiation damages the cancer cells and stops them from growing. Radiation
therapy is a local therapy. This means that it affects the cancer cells only in
the treated area.
This procedure removes the
cancer and a small amount of normal tissue. It’s done on sensitive areas, such as
the face. During Mohs surgery, your child is given a local anesthetic to numb the
area being treated. The cancer is removed from the skin one layer at a time. Each
layer is checked under a microscope for cancer. If cancer cells are seen, another
layer of skin is removed. Layers are removed until the doctor doesn’t see any more
cancer. The procedure may take several hours, depending on how many layers need to
be removed. After this surgery, the cancer is fully removed and the wound can be
The goal of surgery is to remove
the melanoma, while leaving as much of the nearby skin as intact as possible.
The goal of chemotherapy is to
destroy cancer cells directly to shrink tumors that can’t be removed by surgery. Or
it may be used to kill cells that have spread to other areas of the body (metastatic
The goal of biological therapy
is to shrink advanced melanoma tumors. This type of therapy is done with medicines
that affect the immune system. It is also called immunotherapy, antibody therapy,
vaccine therapy. The medicine uses the body’s immune defense to attack the cancer
cells. These may also be given along with chemotherapy.
The goal of targeted therapy is
to shrink advanced melanoma tumors. This type of therapy is done with medicines that
target specific parts of melanoma cells. For example, medicines called BRAF
inhibitors target cells with a change in the BRAF gene. This gene is found in about
half of all melanomas.
Possible complications depend on
the type and stage of skin cancer. Melanoma is more likely to cause complications.
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
- Problems with the area healing
- Infection in the area
- Damage to nerves
- Return of the skin cancer after
Melanoma may spread to organs
throughout the body and cause death.
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
- 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
sun. Dress the baby in lightweight clothing that covers most surface areas of skin.
you also may use a small amount of sunscreen on the baby’s face and back of the
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 to Call a Healthcare Provider
Call your child's healthcare
provider if you see any unusual changes in your child's skin.
- 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
- Skin cancer can be treated with
surgery, medicine, and radiation.
- Staying out of the sun is the best way to prevent skin
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.