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Skin Cancer In Older Adults: Risks, Prevention & Treatment

Skin health and skin cancer prevention are important for older adults. More than 5 million people are treated for skin cancer every year in the United States, according to the CDC. Many people assume that skin damage was already done in their younger years. Sun protection behaviors are still important later in life to prevent sunburns and decrease skin cancer risks.

What are the most common types of skin cancer? 

Close up of a skin mole on an older woman's neck

Skin cancer is categorized into melanoma, non-melanoma, and pre-skin cancer types. The most common pre-skin cancers and skin cancers in older adults are actinic keratoses, basal cell cancer, squamous cell cancer, and melanoma. 

Pre-skin cancer is a collection of cells that have grown abnormally, causing their size, shape or appearance to look different than normal cells. As pre-skin cancer cells grow out of control they become cancerous cells. Actinic keratoses are precancerous spots caused by sun damage. If not treated, they will become  squamous cell skin cancer.

Non-melanoma type is a broad category of skin cancers that refer to any skin cancer that is not melanoma. These cancers are most often found in areas exposed to the sun such as the head, neck, and arms. Basal and squamous cell skin cancer are very common and treatable. About 5.4 million basal and squamous cell skin cancers are diagnosed each year. Most basal cell and squamous cell carcinomas appear after age 50.

Melanoma develops in the skin’s melanocytes. Melanoma is less common than other types of skin cancer, accounting for about 1% of all skin cancers. It is, however, more likely to grow and spread to other areas of the body. The risk of developing melanoma increases with age. Melanoma, many times, forms in moles on the skin that have been present for a long time. The American Cancer Society estimates about 106 new melanomas will be diagnosed in 2021. The average age of people diagnosed with melanoma is 65.

Skin cancer risks

A senior woman is seen sunbathing in an Adirondack chair

Skin cancer is caused by damage to the skin cells via ultraviolet light. Exposure to the sun’s ultraviolet light can cause irreversible damage to skin. It is important to understand sun safety to reduce the risk of skin cancer.

The sun produces electromagnetic radiation called ultraviolet (UV) radiation. This type of radiation can damage the DNA (genes) in your cells which lead to skin cancer. There are two types of UV rays that reach the ground: UVA and UVB rays.

UVA damage is commonly linked to wrinkles on the skin. UVB rays have more energy than UVA rays, giving them the ability to cause skin damage and sunburns. UVB rays are the most common type of sunlight radiation to cause skin cancer.

Keep in mind there are man-made UV rays that are produced by sunlamps, tanning beds, phototherapy, black-light lamps, and mercury-vapor lamps. These  are also harmful sources of UV light.

Exposure to sunlight or man-made UV light are common risk factors contributing to skin cancer. Other risk factors can be separated into genetic and environmental factors.

A senior woman shows a suspicious spot on her hand during a telehealth visit

Genetic risk factors for skin cancer:

  • Age–The exposure to UV light adds up. Most skin cancers are diagnosed after the age of 50.
  • Ethnicity–Non-Hispanic white individuals have the highest incidence of skin cancer among all ethnicities.
  • Skin type–Fairer skin is more likely to sustain UV damage.
  • Family history–Melanoma can run in families.
  • Gender–Men are more likely than women to get skin cancer.

Environmental risk factors for skin cancer:

  • Amount of time spent outdoors
  • Time of day and season of the year of sun exposure
  • Ozone layer levels (green, yellow, orange, and red)
  • Previous radiation therapy for other cancers
  • Medications that suppress the immune system and make the skin more sensitive to the sun
  • Use of tanning beds increase the risk of all types of skin cancer, including melanoma

Older adults have fragile skin and are exposed to more medications and their side effects. These factors also contribute to the higher incidence of skin cancer. To avoid advanced skin cancer and reduce the need for invasive treatments,

know the risk factors, change the risk factors that you have the ability to change, and talk to your primary care doctor about medications and other health history important in reducing skin cancer risk. 

What Kind Of Skin Cancer Tests or Examinations Will My Doctor Perform?

A doctor is seen inspecting a suspicious skin spot on a senior male's shoulder

Scheduling a full skin exam with your doctor is beneficial in detecting skin cancer. Your doctor will possibly need to check the skin all over your body. Some skin spots may be normal. But, because some skin spots may be precancerous or cancerous, it is important to get your skin checked regularly. An abnormal spot can require additional examinations or a referral  to a skin specialist for further evaluation. 

Suspicious spots that could be skin cancer can be photographed with the assistance of your care team at Iora. Your doctor can consult with a dermatologist, a skin specialist, if needed. Your Iora doctor or a dermatologist can do a biopsy to determine if the spot is cancerous.

A biopsy involves putting numbing medication at the area and removing a small sample of the abnormal spot. Specialists called pathologists, will look at the skin cells under a microscope and tell your doctor if the abnormal spot is skin cancer. Your primary care doctor will refer you to the specialist for treatment if it is skin cancer.

Treatment Options for Skin Cancer

Close up of an actinic keratoses spot with a gloved hand inspecting it

The treatment for skin cancer will depend on the type, size, and location of the cancer. Age and any health problems can also influence treatment plans.

Pre-skin cancer is typically treated at a primary care office. Actinic keratoses are precancerous spots often found on the face, ears, arms, or scalp. They can sometimes become skin cancer. Preventive exams and early treatment are important to remove pre-skin cancer before it becomes cancer.

Treatment of melanoma and non-melanoma skin cancers will usually require a referral to a specialist. To remove or destroy the cancer, treatment may include application of skin creams, surgical removal in the office, scraping and electrical destruction, or photodynamic therapy (drugs that become active when exposed to light and kill cancer cells). 

Early-stage melanomas and non-melanomas are often treated with surgery alone and do not require other advanced treatments. Every situation is different and will require individualized treatment plans. 

How to Prevent Skin Cancer in Older Adults

A senior man is seen putting sunscreen on a senior woman while they enjoy a day at the beach

Skin cancer is often caused by sun exposure and sunburns. The damaging effects of the sun can build up over time. This is why skin health and skin protection are important, especially for older adults. 

Here are some ways to prevent skin cancer:

  • The sun’s damaging UV rays are stronger in the middle of the day. Minimize sun exposure from 10 a.m. to 4 p.m. and stay in shady areas as much as possible.
  • Wear sunscreen and reapply every hour when outdoors or swimming.
  • Wear a wide-brimmed hat, long-sleeved shirt, or long pants to protect your skin
  • Do not use tanning beds
  • Wear UV protectant sunglasses
  • Have your Iora primary care doctor perform regular skin examinations and consult a dermatologist as needed

Screenings allow us to catch potentially life-threatening illnesses like skin cancer early and reduce the chance that they will progress into something life-threatening. If you have any questions, Iora encourages you to contact your Care Team to discuss your screening options for skin cancer. You can also find more information on the Skin Cancer Foundation website: www.skincancer.org.

As temps heat up, skin cancer in older adults isn’t your only concern. Learn how to stay hydrated and reduce your risk of heat stroke during those warm summer days.  

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