We’re nearing the tail end of a record-breaking hot summer. For many people, that means afternoons spent basking in the sun are coming to a close. 

While there are heaps of benefits of sunshine (vitamin D and mood enhancement, to name a couple), the end of summer presents a good opportunity to talk about skin cancer screening, awareness of the different ways it can show up based on skin tone, and some new promising research in the treatment for the most severe kind of skin cancer, melanoma. 

Skin cancer is the most common type of cancer in the US — according to the Skin Cancer Foundation, 1 in 5 Americans will develop it by the time they reach age 70. Fortunately, many cases of skin cancer (like basal and squamous cell cancer) don’t spread to other parts of the body and can usually be removed through a minimally invasive surgical procedure. Melanoma, however, can spread to other parts of the body, and it’s necessary to catch it early to minimize the risk of the disease.

New vaccine shows promising results against skin cancer

A skin cancer vaccine is in the works that has, so far, proven to reduce the risk of melanoma returning compared to traditional treatment alone. An mRNA vaccine from Moderna and Merck proved 44% effective at reducing the risk of death and melanoma remission when used with a traditional immunotherapy prescribed for melanoma (pembrolizumab), compared to just immunotherapy alone. 

Positive results of the phase 2b trial were published last spring, and a late-stage clinical trial on the vaccine was set to begin this summer. While this means that we’re likely a few years away from any potential approval from the US Food and Drug Administration, the findings on the mRNA skin cancer vaccine may lead the way for treatment not only in skin cancer but in other types as well, according to Dr. Jeffrey Weber, senior investigator on the study and professor of medicine at the NYU Grossman School of Medicine. 

“Although there have been many different clinical trials of cancer vaccines, there really has never been a cancer vaccine that has clearly shown reproducible clinical benefits,” Weber said. 

How often should I be checked for skin cancer? 

The US Preventive Task Force, which makes preventive health care or cancer screening recommendations, says there’s not “sufficient” evidence to recommend, or not recommend, visual screenings for adolescents and adults without any symptoms of skin cancer from a primary care doctor. But as the American Academy of Dermatology points out, this isn’t a statement on the value of skin examinations by a dermatologist — people with a history of skin cancer or people who notice spots on their skin should see a dermatologist for a professional exam. Everyone is encouraged to do regular checks of their own skin by following these steps. 

In terms of timing, the end of summer may present a great time for a skin examination — waiting until your summer tan has started to fade may make it easier to spot potentially problematic blemishes, according to one report from the Austin American Statesman. 

You should also If you have a mole or freckle that you’re questioning, you should go in for a skin examination.

A warning sign would be a blemish that’s changed its appearance recently. Remember these “ABCDE” signs that a blemish, mole or freckle needs medical attention because it may be melanoma, per the US Centers for Disease Control and Prevention:  

• Asymmetrical (one part of the blemish looks different than the other). 
• Border (it has a jagged or irregular-looking outline). 
• Color (the color is uneven).
• Diameter (it’s larger than a pea).
• Evolving (it’s changed size, shape or color over time).

In addition to melanoma, which the American Academy of Dermatology says is considered the most serious type of skin cancer because of its ability to spread, other, rarer types of skin cancer can spread, too. These include sebaceous carcinoma and Merkel cell carcinoma.

Skin cancer in people with darker complexions may be less common, but more risky

People of Black, Hispanic or Asian descent are much less likely to get skin cancer, including melanoma, than people who are white. This is because darker complexions have more melanin, which helps protect skin from damaging UV rays — the most common cause of skin cancer. 

But that does not mean that having darker skin equals no risk. In fact, people with darker skin tones have higher proportions of melanoma in different places on the body where we haven’t necessarily been taught to look out for signs of skin cancer, such as the palms of the hands, soles of the feet, under the nails and even the rectal and vaginal areas. These types of cancer have “different molecular mechanisms,” Weber said, so they aren’t linked to sunlight or UV exposure. 

These less common types of melanoma may also be more likely to slip past a doctor and lead to later or missed diagnoses in people with darker skin than those with lighter skin. A study published this summer, as reported by The Washington Post, found that Black men had a higher risk of dying from melanoma (a 26% increase) than white men. This builds on a 2019 report from the CDC, which found that melanoma survival rates in Black Americans “lagged” behind white Americans despite fewer cases overall. In the same report, the CDC called for more awareness by providers and patients of acral lentiginous melanoma (cancer of the feet and palms). 

How to reduce your risk of skin cancer 

To minimize your risk of melanoma and other types of skin cancer, you should protect yourself from UV rays — according to the Illinois Department of Health, more than 90% of skin cancers are caused by sun exposure. To do this, look to sunscreen, or consider wearing a hat and other breathable clothing outdoors. 

And you probably already know this one by now, but it bears repeating: refrain from indoor tanning beds. 

Beyond making an appointment with a dermatologist to check your skin, if you’ve spent a lot of time in the sun, have a suspicious blemish or otherwise think it’s a good idea to get checked, you should be monitoring your skin at home. There are even some apps that can assist your search. 

Read more: Sun Damage and the Potentially Lasting Effects on Your Skin. What You Need to Know