General Medical · Health

Red Hair, Blue Eyes, Fair Skin: Getting a Tan Impossible, Skin Cancer More Likely

Redheads are more likely to carry a genetic mutation, melanocortin-1-receptor (MC1R), which is expressed on the surface of pigment cells/melanocytes. Melanin protects the body from the ultraviolet light of the sun. Certain variants of MC1R are associated with red hair, fair skin, lack of tanning ability, propensity to freckle along with an association with melanoma and non-melanoma skin cancers.3 Animal studies suggest that the pigment of redheads itself might be a cause of melanoma. The researchers suggest that the increased melanoma risk could be related to the pigment-production process, or a by-product of it, in melanin-containing melanocytes.4

It was not a surprise to me when a small pigmented lesion that was removed from my left shoulder several years ago was diagnosed as a melanoma in situ. In situ refers to the earliest and superficial stage of a cancer, where the abnormal cells have not breached the cell wall and  before extension into lymphatic channels and blood vessels and subsequent metastasis. I had been careful with self-exams but had not noticed that this pencil eraser-sized lesion had changed slightly. My careful dermatologist called it an “outlier lesion” and insisted on removing it. Wide local excision removed all risk from that melanoma in situ. However, my past history of sun exposure, severe sun burns, never tanned but always freckled, along with my red hair, fair skin and blue eyes, caused me to up my game of skin cancer checks.  Since then I have had three more skin cancers: two squamous cell and one basal cell, and all early in situ.

I can’t change my possible genetic risk for these cancers nor my past history of sun damage, but I do make sure that I prevent further damage:

  1. I use broad spectrum sunblock and replenish it frequently, making sure to cover ears and back of the neck thoroughly.
  2. I limit my time outdoors during the day
  3. When I must be in the sun, I try to find a place in the shade.
  4. I do not go outside for any prolonged period from 10 am until 2 pm.
  5. I tinted the car windows to decrease UVA exposure.
  6. I wear a hat with at least a three-inch brim and sun protective clothing with a “UPF” rating  (ultraviolet protection rating) of over 50 whenever possible.
  7. I wear clothing with long sleeves made from fabric that is tightly woven along with pants when I am outside for a long period of time.  
  8. I own several sun protective parasols and do carry them.
  9. I wear sunglasses with SPF lenses.
  10. I do careful skin cancer checks and see the skin cancer specialist on a regular basis.

RELATED: Melissa Papock Upgrades Sun Protective Clothing with Style

I also make sure that I share information about how to avoid damage from sun exposure with my patients, friends and family. I can’t change the past but I can choose to learn from it!  I can’t prevent the increasing skin cancer risk from climate change and ozone layer depletion but I can change how I respond to this new threat. 

In addition, I encourage you to read and share the following excellent posts on sun protection by Anetta Reszko, M.D., Ph.D., a dermatologist and dermatologic surgeon in New York City.  Dr. Reszko is a member of both the Women’s Voices for Change Board and a member of  our Medical Advisory Board. Dr. Reszko is the Director of the New York Skin Institute; a Clinical Assistant Professor of Dermatology at Weill Cornell Medical College; and an Assistant Professor, Dermatology, at New York–Presbyterian Hospital. 

Stay safe in the sun this summer while having fun!


1 Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population. JAMA Dermatol. Published online April 30, 2015.
1 American Cancer Society. Cancer Facts & Figures 2016. Atlanta: American Cancer Society.
2 Rev Med Chil. 2006 Sep;134(9):1185-90. Epub 2006 Dec 12. (J R Soc Med. 2009 Jun 1; 102(6): 215–218.
3 Valverde P, Healy E, Jackson I, et al. Variants of the melanocyte stimulating hormone receptor gene are associated with red hair and fair skin in humans. Nat Genet 11(3):328–30 (1995 Nov).
3 Sturm RA. Skin color and skin cancer-MC1R, the genetic link. Melanoma Res 12(5):405–16 (2002 Oct). New information indicates that carriers of MC1R variants are at increased risk of developing melanoma, independent of sun exposure. (JAMA Dermatology July 2016, Vol 152, No. 7 )
4 Mitra, D. et al. Nature advance online publication. (2012).

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  • Deborah Robinson July 31, 2016 at 7:58 pm

    Dear Dr. Pat,
    Thank you for this informative article. It is very timely for me as
    I have had two basal cell carcinomas in the past year.
    I am a blue eyed blonde with fair skin, so I now know I
    Have to be very careful. Thank you!

  • Margret Avery July 26, 2016 at 9:42 am

    Dr. Pat,

    Thank you for sharing this very important article about skin cancer. I will pass this on to other friends of mine and clients who don’t always take of their skin in the sun.

    Margret Avery
    makeup artist / beauty consultant

  • Patricia Yarberry Allen, M.D. July 25, 2016 at 4:38 pm

    Dear Leslie,

    Melanoma is more likely to happen in older people. But it is a cancer that is also found in younger people. In fact, it is one of the most common cancers in people under 30 and men have a higher rate of melanoma than women.

    He is ready for his first skin cancer check!

    Dr. Pat

  • Leslie in Oregon July 25, 2016 at 3:11 pm

    As a red-headed, hazel-eyed, pale-skinned woman whose 31-year-old son shares those characteristics, I’m wondering at what age he should start seeing a dermatologist for annual full-body skin checks. (Although I’ve just asked him to ask his primary physician this question, I’d appreciate your opinion too.) Thank you, Leslie