What increases your risk of melanoma?
There are a number of factors that can increase your risk of developing melanoma. You can influence the main risk factor yourself – by spending less time in the sun without protection. Sunlight contains UV radiation, which can damage your skin and lead to cancer.
The risk of developing melanoma increases with age: You are also at greater risk if one of your close relatives (a parent, brother or sister) has already developed skin cancer. Other important risk factors include
- how well you protect yourself from UV radiation,
- tanning bed use,
- skin type and
- number of moles.
The ultraviolet (UV) light in sunlight is mostly made up of UVA rays. These penetrate deep into your skin and give you a fast tan. But this kind of tan doesn’t last very long, and doesn’t offer much protection from further sun exposure. UVA light damages your skin and causes it to age prematurely.
The sun’s UVB rays affect the uppermost layer of your skin the most. There they cause a delayed but longer-lasting tan and help the skin to develop some protection from more sunlight. But they also irritate your skin and cause it to redden, and can cause sunburn. UVB rays are believed to be more likely to cause skin cancer than UVA rays.
Being sensible in the sun
There are four basic facts that all experts agree on:
- Spending time in the sun is a normal part of life. Our bodies need UVB rays to make essential vitamin D.
- Sunburn should be avoided whenever possible.
- Too much sun increases your risk of skin cancer.
- Children are at higher risk than adults.
But how much sun is “too much” sun? There is no simple answer to this question. This is partly because the answer will be different for different people, depending on individual factors like the type of skin you have. But it is also because the link between the sun and cancer is not yet fully understood.
The frequency, duration and intensity of exposure to UV radiation varies greatly, too: People who work outside may spend several hours a day in the sun during the summer months. An office worker may be more likely to spend time in the sun at weekends or on vacation. Some people are keen to get a tan, while others aren't.
We also spend time in the sun while doing other things – for example, on the way to work, while out running errands, or enjoying free time outdoors. Some people consider this to be less of a problem than sun exposure while consciously sunbathing.
What’s more, different parts of your skin are exposed to very different amounts of UV light: Your face, neck, hands and arms are exposed to a lot more sunlight than the rest of your body. Some other parts of your body are never, or only rarely, exposed to the sun. But it is still possible for melanoma to develop there too – for instance on your scalp, in your genital area, or on the skin beneath your toenails or fingernails. So the role of the sun depends on many different factors – and UV radiation certainly isn't the only cause of melanoma.
As you go through life, each area of your skin is exposed to different total amounts of UV radiation. Scientists still don't agree on how much of a role the total amount of UV light exposure plays, and whether it makes a difference if you have days or weeks with a lot of sun followed by days or weeks with only very little sun. This is the case when a child plays in the midday sun for hours while on summer vacation, for example, and mostly stays indoors the rest of the year.
Can tanning beds also cause melanoma?
The light used in tanning beds has UV rays in it. Because of this, people who use them regularly probably increase their risk of developing melanoma. This is particularly true for children and teenagers. In Germany and other countries, children and teenagers under the age of 18 are forbidden by law to use tanning beds or sun lamps.
The amount of UVA and UVB exposure from a tanning bed depends on the light tubes used. This varies depending on the make and model of the tanning bed, as well as on how old the light tubes are. Newer models are not allowed to emit more UV light than the midday sun at the equator on cloudless days.
Some people use tanning beds to prepare their skin for the sun in order to avoid sunburn. Although the UVA radiation in tanning beds makes you tan quickly, the tan doesn't last long. And the kind of tan you get by using tanning beds hardly protects you from sunburn.
What types of skin are more prone to damage from UV radiation?
People with fair skin are at greater risk of developing melanoma than people with naturally dark skin.
People who have fair skin (types I and II) have a pale complexion, often with freckles, and never get a tan (type I) or only tan a little (type II). They are very prone to sunburn. People who are sensitive to sunlight usually have light-colored eyes and hair, such as blue or green eyes and red or blond hair.
People with darker skin are less sensitive to UV rays.
The following can help you determine what type of skin you have:
Skin type I:
Skin type II:
Skin type III:
Skin type IV:
Skin type V:
Skin type VI:
Very light skin and light skin (types I and II) are typical in places like Scandinavia and Great Britain, and people who have a medium brown skin tone with dark eyes and dark hair (type IV) mainly live in the Mediterranean and geographically similar regions. People with even darker or black skin (types V and VI) have their roots in places like certain areas of Asia or Africa.
What do moles have to do with skin cancer?
Moles (medical term: nevi) are benign skin growths that are light or dark in color. They may be present at birth or develop later on in life. Lentigines (melanocytic nevi) develop from pigment-producing cells known as melanocytes and are brown in color. But moles and lentigines are often simply called "moles" by many people.
People who have a lot of moles or lentigines are more likely to develop melanoma. The more you have, the higher the risk. Abnormal or large moles are also associated with a greater risk of skin cancer.
What other causes and risk factors are there?
People who have already had melanoma in the past are more likely to develop melanoma in the future. If melanoma returns, it usually does so within five years after the first tumor has been removed. Your risk of melanoma is also higher if other members of your family have had it before.
Some genetic diseases such as xeroderma pigmentosum increase the risk of melanoma. The risk is also greater in people who have a weak immune system. This includes people who take medication to suppress their immune system following an organ transplant.
Flight attendants and pilots also have a slightly higher risk of melanoma, but it's not clear why.
Abbasi NR, Shaw HM, Rigel DS, Friedman RJ, McCarthy WH, Osman I et al. Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA 2004; 292(22): 2771-2776.
Bundesamt für Strahlenschutz (BfS). Optische Strahlung: Hinweise für Solariennutzer. August 03, 2018.
Bundesamt für Strahlenschutz (BfS). Optische Strahlung: Rechtliche Regelungen für Solarien. April 11, 2018.
Burgard B, Schöpe J, Holzschuh I, Schiekofer C, Reichrath S, Stefan W et al. Solarium Use and Risk for Malignant Melanoma: Meta-analysis and Evidence-based Medicine Systematic Review. Anticancer Res 2018; 38(2): 1187-1199.
Colantonio S, Bracken MB, Beecker J. The association of indoor tanning and melanoma in adults: systematic review and meta-analysis. J Am Acad Dermatol 2014; 70(5): 847-857.
Deutsche Krebsgesellschaft (DKG), Deutsche Dermatologische Gesellschaft (DDG). S3-Leitlinie zur Diagnostik, Therapie und Nachsorge des Melanoms. AWMF-Registernr.: 032 - 024OL. April 30, 2018.
Flohil SC, van der Leest RJ, Arends LR, de Vries E, Nijsten T. Risk of subsequent cutaneous malignancy in patients with prior keratinocyte carcinoma: a systematic review and meta-analysis. Eur J Cancer 2013; 49(10): 2365-2375.
Garside R, Pearson M, Moxham T. What influences the uptake of information to prevent skin cancer? A systematic review and synthesis of qualitative research. Health Educ Res 2010; 25(1): 162-182.
International Agency for Research on Cancer Working Group on artificial ultraviolet (UV) light and skin cancer (IARC). The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. Int J Cancer 2007; 120(5): 1116-1122.
Janda M, Green A. Primary prevention of skin cancer. In: Williams H, Bigby M, Herxheimer A, Naldi L, Rzany B, Dellavalle R et al. (Ed). Edvidence-based dermatology. London: BMJ Books; 2014. S. 223-230.
Johnson MA, Armstrong AP. Treatment of cutaneous melanoma. In: Williams H, Bigby M, Herxheimer A, Naldi L, Rzany B, Dellavalle R et al. (Ed). Edvidence-based dermatology. London: BMJ Books; 2014. S. 231-240.
Lautenschlager S, Wulf HC, Pittelkow MR. Photoprotection. Lancet 2007; 370(9586): 528-537.
Lin JS, Eder M, Weinmann S. Behavioral counseling to prevent skin cancer: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2011; 154(3): 190-201.
Miller AJ, Mihm MC. Melanoma. N Engl J Med 2006; 355(1): 51-65.
National Institute for Health and Clinical Excellence (NICE). Improving outcomes for people with skin tumours including melanoma. February 2006. (Cancer service guidelines; Volume 8).
National Institute for Health and Clinical Excellence (NICE). Melanoma: assessment and management. July 2015. (NICE Guidelines; Volume 14).
Olsen CM, Carroll HJ, Whiteman DC. Estimating the attributable fraction for melanoma: a meta-analysis of pigmentary characteristics and freckling. Int J Cancer 2010; 127(10): 2430-2445.
Rivers JK. Is there more than one road to melanoma? Lancet 2004; 363(9410): 728-730.
Sanlorenzo M, Wehner MR, Linos E, Kornak J, Kainz W, Posch C et al. The Risk of Melanoma in Airline Pilots and Cabin Crew: A Meta-analysis. JAMA Dermatol 2015; 151(1): 51-58.
Thompson JF, Scolyer RA, Kefford RF. Cutaneous melanoma. Lancet 2005; 365(9460): 687-701.
World Health Organization (WHO). Global solar UV index. A Practical Guide. August 2002.
IQWiG health information is written with the aim of helping
people understand the advantages and disadvantages of the main treatment options and health
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.