Melanoma is on the rise and young people aren’t using enough sunscreen, doctors say

When Christie Garofalo’s husband asked her about a mole on her abdomen, she thought she’d always had it. But after looking through old photos, she realized it was relatively recent and made an appointment with her family doctor just to be safe. After the mole was removed and biopsied, she was shocked when her doctor told her it was melanoma. “I collapsed in her office because you hear cancer and immediately you go down a terrible rabbit hole,” said the 50-year-old mother of five children in Vancouver. Garofalo said she had used sunscreen but “not religiously”—applying it if she was on a tropical vacation but not on a day-to-day basis at home. While talking with her oncologist, she also remembered that she had used tanning beds once a week as a teen in the late 1980s.Garofalo had to undergo some painful lymph node surgery to prevent the cancer from spreading, but is grateful she has a clean bill of health almost five years later. “I am good about sunscreen (now),” she said.Dermatologists say that despite awareness of skin cancer risk, it’s not translating into action and melanoma cases are on the rise. They’re especially worried about young people because, like Garofalo, unprotected exposure to ultraviolet (UV) radiation from the sun in their youth comes back to haunt them when they are older. A variety of factors, including misinformation and cost, are to blame for inadequate use of sunscreen and other sun protection measures, they say. “Unfortunately we’re showing very dangerous, very concerning trends with respect to skin cancer and melanoma,” said Dr. Ivan Litvinov, an associate professor of dermatology at McGill University. According to Melanoma Canada, an estimated 11,300 people were diagnosed with the potentially deadly skin cancer in 2024—up by 17% from the previous year.In a study published in BMJ Public Health in April, Dr. Litvinov and his colleagues found that almost 60% of Canadians aged 18 to 29 spend two or more hours in the sun at a time, but were significantly less likely to use sunscreen than people aged 30 to 59. The data also showed that younger Canadians were more likely to get sunburned. Although the data analyzed in the study was collected in the Canadian Community Health Survey between 2011 and 2018, Dr. Litvinov said there is no reason to believe that more young people are using sunscreen now.“People don’t think this is serious. Our winters are harsh. When the summer comes, people are going out and enjoying the sun, right? Enjoying too much to the point of getting burned,” said Dr. Litvinov, whose clinical practice is at St. Mary’s Hospital Centre in Montreal.Dr. Monica Li, a dermatologist in Vancouver, said there are “alarming trends” of misinformation on social media that discourage the use of sunscreen. They include claims that the chemicals in sunscreen cause cancer, which is false, she said. “We need to basically tailor education and knowledge perhaps towards the younger demographics to debunk some of the stuff that they’re seeing online,” said Dr. Li, who is a clinical assistant professor of dermatology and skin science at the University of British Columbia.It’s also important to raise skin cancer awareness among different ethnic groups because there’s a “long-standing” misconception that people with darker skin don’t need sunscreen, she said. Even though more richly pigmented skin has more natural protection than lighter-coloured skin, it’s not enough, Dr. Li said. Last July, Health Canada issued a warning against using “homemade” sunscreen—a trend that circulates on social media. “Making and using homemade sunscreen products presents risks, as they are unlikely to be effective at protecting you from the sun’s harmful UV rays,” says the warning posted on the agency’s website. Health Canada also called out false claims that sunscreen ingredients are harmful to the skin and can cause cancer. “All authorized sunscreens on the market are safe when used as directed,” it said. There are two types of approved sunscreens: mineral sunscreens, which use zinc oxide or titanium dioxide to create a physical barrier to reflect ultraviolet (UV) radiation; and chemical sunscreens—also called “organic” sunscreens—which absorb UV radiation and convert it to heat. Using a mineral sunscreen is a good option for people who find other sunscreens aggravate their acne, said Dr. Li. Dr. Litvinov said he uses mineral sunscreen on his kids because it doesn’t burn their eyes when they sweat. He noted some people have expressed concern about chemical sunscreens affecting marine life, so those who are worried might opt for mineral sunscreen as well. Whichever sunscreen people choose, it should be at least 30 SPF and protect against both UVA and UVB rays. Another myth that is amplified online is that forgoing sunscreen helps people get enough vitamin D, the Canadian Cancer Society and dermatologists say. If there are concerns about vitamin D deficiency, people should talk to their primary-care provider about vitamin D supplements, said Dr. Li. “That’s a much safer and consistent way” to get the vitamin, she said. Nancy Wirtz, manager of cancer prevention at the Canadian Cancer Society, said even when people do use sunscreen, they often don’t apply enough of it. The average adult needs about a teaspoon of sunscreen to cover their face and neck and another two to three tablespoons to cover their body. That’s about the size of a golf ball in total. Sunscreen should also be reapplied every two hours and even more frequently if you are swimming or sweating, Wirtz said. Dr. Litvinov noted that any sun exposure resulting in a tan causes skin damage. “We talk actually about the ‘sunscreen paradox,’” he said, which is when people want a tan, but they understand there’s something unhealthy about it. “So how are they going to reconcile the two? Well, they put (on) a thin layer of sunscreen and then they go and they get a tan. And unfortunately, because of the sunscreen paradox, people are getting more skin cancer.” Dr. Litvinov’s study showed that people with lower incomes are less likely to use sunscreen—and he says other research has confirmed there’s inequitable access to what is often a high-cost product. “People have told us that sunscreens are more or less a luxury item,” he said, noting that unlike many countries, sunscreen is taxed in Canada. Dr. Li agreed that when people use the recommended amount of sunscreen, “the cost really adds up quickly.”“If they can’t afford it and it’s choosing sunscreen or food on the table, then of course sunscreen is not going to be something that is going to be chosen.”Dermatologists and the Canadian Cancer Society emphasize that in addition to sunscreen, it’s important for people to take other measures to stay safe outside, including seeking shade, wearing sun-protective clothing, a wide-brimmed hat and sunglasses, and minimizing sun exposure in the peak hours of 11 a.m. to 3 p.m.

Melanoma is on the rise and young people aren’t using enough sunscreen, doctors say

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