Family on the beach under a sun umbrella

Several types of skin cancer remain on the rise. The most common—basal cell and squamous cell carcinomas—are quite curable. But melanoma, which is the fifth most prevalent cancer in the U.S., is far more dangerous. The National Cancer Institute estimates that more than 100,000 people will receive a diagnosis in 2020, and almost 7,000 will die from it.

Skin cancer risk is greatest for whites, but people of all ethnicities can be affected. "There are some patients who believe that skin cancer does not occur in people with brown skin and that is not true,” says Crystal Aguh, M.D., director of the Ethnic Skin Program and assistant professor of dermatology at the Johns Hopkins University School of Medicine. “While skin cancer is less likely to occur as a result of sun exposure compared to fair-skinned patients, all three of the major skin cancers (melanoma, squamous cell, and basal cell) can be found in patients of all skin types.”

For example, the melanoma rate is 28 in 100,000 for non-Hispanic whites, and while lower, it’s still 5 in 100,000 for Hispanics and 1 in 100,000 for non-Hispanic Blacks, Asians, and Pacific Islanders, according to the American Cancer Society. In fact, vigilance is especially important for these groups because their melanoma is usually detected at a later stage.

But a vast majority of skin cancer, melanoma included, is preventable. According to some estimates, about 90 percent of nonmelanoma skin cancers and at least 86 percent of melanoma cases are linked to ultraviolet light exposure. That means covering up and using sunscreen are effective ways to cut your chance of developing them.

Increasing Survival Rates

Other encouraging news: There has been much progress in treatments for advanced melanoma. Up until the last decade, the prognosis for someone diagnosed with metastatic melanoma was pretty grim. The success rate for chemotherapy wasn’t good. But new treatments are beginning to turn the tide. The mortality rate for melanoma dropped 18 percent between 2013 and 2016, according to a 2020 study published in the American Journal of Public Health.

More on Sun Protection & Sunscreens

The new melanoma treatments fall into two categories, says the study’s author, David Polsky, M.D., Ph.D., the Alfred W. Kopf, M.D., professor of dermatologic oncology at NYU Langone Health and researcher at Perlmutter Cancer Center. One type is called an immune checkpoint inhibitor. “These drugs block the ability of cancer cells to switch off your immune system,” Polsky says. So instead of your immune system ignoring the cancer cells, it attacks and kills them.

The other treatment path uses drugs to target the BRAF gene, which helps regulate the growth of new cells throughout the body. The gene is mutated in about half of melanomas, Polsky says, and these drugs can slow the development of new tumors or shrink existing ones.

But, he adds, “even though these new drugs are amazing, there are still too many people who die from melanoma. Preventing sun damage and catching skin cancer early—when it can be cured by surgery—are by far the better approaches.”

The Science of Skin Cancer

Melanoma occurs when pigment-producing cells in the epidermis (the top layer of skin) called melanocytes begin to grow abnormally. Ultraviolet light from the sun is thought to be the most common trigger for this because it can cause inflammation and create molecules called free radicals—reactions that can alter the DNA in skin cells. These changes speed the breakdown of collagen in your skin, resulting in wrinkles, sagging, and uneven skin tone, and—most worrisome—they set the stage for skin cancers.

It doesn’t take much sun damage to increase your chances of developing skin cancer. In a University of Iowa study from 2008, people who had five sunburns in 10 years were three times as likely to develop melanoma as those who didn’t get burned. And a study by the Centers for Disease Control and Prevention revealed that about one-third of adults get sunburned at least once a year. Over time, “your skin’s ability to repair itself slows down,” says Joel L. Cohen, M.D., a dermatologist in Denver and an associate clinical professor of dermatology at the University of California, Irvine.

That’s why experts say that avoiding unprotected time in the sun is probably the most effective step you can take to keep your skin healthy. A new CR nationally representative survey of 2,007 U.S. adults revealed that there’s room for improvement in our habits. While 72 percent of those polled said they used sunscreen, just 40 percent of them said they did so “always” or “most of the time” when heading outside; 34 percent said only “some of the time.” Clearly, people know it works; 58 percent said avoiding skin cancer is “extremely important” when deciding on which sunscreen to use.

Other Strategies That Help

In addition to all-important sunscreen use, there are a few ways to help your body sidestep the sun’s assault and boost your skin’s self-healing ability.

The Mediterranean diet: This way of eating—rich in fruits, vegetables, fish, grains, nuts, olive oil, and very little meat—isn’t just a way to improve heart health. It may also help prevent skin cancer. In a 2019 study published in the American Journal of Clinical Nutrition, French women who followed this diet had a 28 percent reduced risk of melanoma and a 23 percent lower risk of basal cell carcinoma.

Retinoid creams: Derived from vitamin A, they can be found in over-the-counter and prescription products. “Topical retinoids are well-studied and well-understood, with proven pathways leading to sun damage reversal,” says Joel L. Cohen, M.D., a dermatologist in Denver. “They help decrease some of the enzymes that cause collagen to break down, and they actually help produce collagen in the dermis,” the skin’s middle layer.

Lasers: “There are at least three lasers that are not only approved for resurfacing skin and improving wrinkles but are also FDA-cleared for treating precancerous lesions called actinic keratosis,” Cohen says. “Treating these precancerous lesions will hopefully translate to fewer taking the next step and in some cases developing into squamous cell carcinoma.”

Precancer treatments: Topical chemotherapy drugs can be used to treat actinic keratosis and early squamous cell cancers. Because these are powerful drugs, they’re usually prescribed only for people with many precancerous lesions or those at high risk for skin cancer. Your doctor will tell you whether you’re a candidate.

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Consumer Reports’ sunscreen ratings can help you find a sunscreen that will protect your skin and have the right scent and feel for you. These are some of the top performers from our tests.

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Editor’s Note: This article was updated to expand the information on skin cancer risk in people with a variety of skin tones. A version of this article also appeared in the July 2020 issue of Consumer Reports magazine.