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Melanoma is a type of cancer originating in the melanocytes. Melanocytes are cells that produce melanin, which gives skin its pigment (color).

Each year in the United States, melanoma affects about 70,000 and kills about 9,000. Melanoma affects 33% more males than female; 50% more males than females die from the disease.

Risk factors

A number of genetic risk factors for melanoma have been identified:

  • Red or blonde hair
  • Freckles
  • Blue or green eyes
  • Lighter skin.

Diet may play a role in the risk of melanoma. Dietary fat and alcohol may be associated with increased risk of the disease.

On the other hand, carbohydrates, protein, and some antioxidant vitamins may be linked to reduced melanoma risk.

Sunlight exposure and melanoma risk

There are two ultraviolet (UV) regions of interest regarding melanoma:

  • The UVB region (short wave UV) produces vitamin D. Too much UVB exposure also causes sunburn.
  • The UVA region (long wave UV) does neither. But UVA generates free radicals, which can alter the DNA in melanocytes. This may lead to melanoma.

Eumelanin is the dark pigment produced by melaninocytes. Darker skin pigmentation reduces the risk of melanoma. Darker skin reduces the penetration of UV in the skin. It also repairs DNA damage caused by UV. Pheomelanin is the reddish melanin more common in those with red hair and freckles. Pheomelanin does not protect against melanoma.

Europeans who live farther from the equator have lighter skin and increased rates of melanoma. Countries at higher latitudes have less sun. With increasing latitude, UVB decreases more rapidly than UVA. However, for fair-skinned Europeans living outside of Europe, living closer to the equator is associated with increased risk of melanoma since the light pigment does not provide adequate protection at higher UV levels than in their home countries.

According to many studies, the risk of melanoma increases with recreational UV exposure. But melanoma risk does not increase with chronic UV exposure such as from outdoor occupations. People who participate in recreational UV exposure often go in the sun just a few times a year. Their skin has not been prepared for higher UV doses.

However, when the skin is exposed to UV gradually, such as a few minutes longer each day in the spring, the skin develops a protection factor. This protection doubles or quadruples the time of sun exposure without burning. In addition, over a number of years, the skin wrinkles through a process called elastosis. Melanoma has a harder time growing in wrinkled skin. Thus, melanoma often develops on the face and hands in older people.

When sunscreens are used specifically to protect against sunburns, they also protect against melanoma. But when sunscreens are used routinely (when there is no or little danger of sunburning), they are linked to increased risk of melanoma. The reason is that sunscreens do not protect well against UVA and people spend more time in the sun with sunscreen.

Vitamin D and melanoma

Vitamin D levels

A recent study from the Women’s Health Initiative found:

“Vitamin D supplementation at a relatively low dose (400 IU/d) plus calcium (1500 mg/d) did not reduce the overall incidence of nonmelanoma skin cancer (NMSC) or melanoma. However, in women with history of NMSC, CaD supplementation reduced melanoma risk, suggesting a potential role for calcium and vitamin D supplements in this high-risk group.” 

There are also findings for vitamin D and breast, colon, and rectal cancer. The rates of these cancers decrease rapidly as vitamin D levels increase from very low levels [less than 10 ng/mL (25 nmol/L) to 30 ng/mL (75 nmol/L). Cancer rates decrease slowly after that. It is assumed that the results for melanoma would be similar.

How vitamin D works

Vitamin D has been shown to block the growth of cancer tumors. The active form of vitamin D, calcitriol, provides numerous benefits against cancer. This form of vitamin D encourages cells to either adapt to their organ or commit apoptosis (cell suicide). Calcitriol also limits blood supply to the tumor and reduces the spread of cancer.


There is some evidence that dietary vitamin D reduces the risk of melanoma. Based on results for other cancers, raising vitamin D levels to 40 ng/mL (100 nmol/L) might lower the risk of melanoma. The rule of thumb is that vitamin D levels rise by 6–10 ng/mL (15–25 nmol/L) for each 1000 IU (25 mcg)/day of vitamin D3. Vitamin D3 is the active form of vitamin D produced by the skin. However, there is considerable person-to-person variability. Thus, people taking large doses should have their vitamin D levels measured before and three months after taking supplements.


Researchers in the United Kingdom studied the effects of vitamin D on melanoma recurrence. People taking vitamin D supplements and having higher vitamin D blood levels had slightly lower rates of disease recurrence. Vitamin D receptors, which affect gene expression or messages, also played a role. However, this study provides only weak evidence that vitamin D is useful for treating melanoma.


This evidence summary was written by:

William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center (SUNARC)
P.O. Box 641603
San Francisco, CA 94164-1603, USA

The summary was reviewed by:

  • Peter Hutchinsion <dermat@doctors.org.uk>

Last updated

June 2011

Complete bibliography of research used in this summary

The research we have cited in our summary is listed below, with links to PubMed abstracts and full-text for those who wish to explore further.


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  2. Asgari, M. M. Maruti, S. S. Kushi, L. H. White, E. A cohort study of vitamin D intake and melanoma risk. J Invest Dermatol. 2009 Jul; 129 (7): 1675-80.
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  4. Berwick, M. Armstrong, B. K. Ben-Porat, L. Fine, J. Kricker, A. Eberle, C. Barnhill, R. Sun exposure and mortality from melanoma. J Natl Cancer Inst. 2005 Feb 2; 97 (3): 195-9.
  5. Boniol, M. Doré, J. F. Autier, P. Smans, M. Boyle, P. Descriptive epidemiology of skin cancer incidence and mortality. Skin Cancer Prevention. 2007; 203-223.
  6. Boniol, M. Doré, J. F. Autier, P. Smans, M. Boyle, P. Descriptive epidemiology of skin cancer incidence and mortality. Skin Cancer Prevention. 2007; 203-223.
  7. Caini, S. Gandini, S. Sera, F. Raimondi, S. Fargnoli, M. C. Boniol, M. Armstrong, B. K. Meta-analysis of risk factors for cutaneous melanoma according to anatomical site and clinico-pathological variant. European journal of cancer. 2009 Nov; 45 (17): 3054-63.
  8. Chang, Y. M. Barrett, J. H. Bishop, D. T. Armstrong, B. K. Bataille, V. Bergman, W. Berwick, M. Bracci, P. M. Elwood, J. M. Ernstoff, M. S. Gallagher, R. P. Green, A. C. Gruis, N. A. Holly, E. A. Ingvar, C. Kanetsky, P. A. Karagas, M. R. Lee, T. K. Le Marchand, L. Mackie, R. M. Olsson, H. Osterlind, A. Rebbeck, T. R. Sasieni, P. Siskind, V. Swerdlow, A. J. Titus-Ernstoff, L. Zens, M. S. Newton-Bishop, J. A. Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls. Int J Epidemiol. 2009 Jun; 38 (3): 814-30.
  9. Colston, K. Colston, M. J. Feldman, D. 1,25-dihydroxyvitamin D3 and malignant melanoma: the presence of receptors and inhibition of cell growth in culture. Endocrinology. 1981 Mar; 108 (3): 1083-6.
  10. Cust, A. E. Jenkins, M. A. Goumas, C. Armstrong, B. K. Schmid, H. Aitken, J. F. Giles, G. G. Kefford, R. F. Hopper, J. L. Mann, G. J. Early-life sun exposure and risk of melanoma before age 40 years. Cancer causes & control : CCC. 2011 Jun; 22 (6): 885-97.
  11. Delancey, J. O. Hannan, L. M. Gapstur, S. M. Thun, M. J. Cigarette smoking and the risk of incident and fatal melanoma in a large prospective cohort study. Cancer causes & control : CCC. 2011 Jun; 22 (6): 937-42.
  12. Dal, H. et al. Does relative melanoma distribution by body site 1960-2004 reflect changes in intermittent exposure and intentional tanning in the Swedish population?. Eur J Dermatol. 2007 Sep; 17 (5): 428-34.
  13. Dennis, L. K. et al. Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis. Ann Epidemiol. 2008 Aug; 18 (8): 614-27.
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  16. Essa, S et al. VDR microRNA expression and epigenetic silencing of vitamin D signaling in melanoma cells. J Steroid Biochem Mol Biol. 2010 Jul; 121 (1-2): 110-3.
  17. Ferlay, J. Shin, H. R. Bray, F. Forman, D. Mathers, C. Parkin, D. M. GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. 2010; 2011 (6/25/2011):
  18. Field, S. Newton-Bishop, J. A. Melanoma and vitamin D. Molecular oncology. 2011 Apr; 5 (2): 197-214.
  19. Gandini, S. Sera, F. Cattaruzza, M. S. Pasquini, P. Abeni, D. Boyle, P. Melchi, C. F. Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer. 2005 Jan; 41 (1): 28-44.
  20. Gandini, S. Sera, F. Cattaruzza, M. S. Pasquini, P. Picconi, O. Boyle, P. Melchi, C. F. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005 Jan; 41 (1): 45-60.
  21. Gandini, S. Sera, F. Cattaruzza, M. S. Pasquini, P. Zanetti, R. Masini, C. Boyle, P. Melchi, C. F. Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005 Sep; 41 (14): 2040-59.
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  24. Gandini, S. Sera, F. Cattaruzza, M. S. Pasquini, P. Zanetti, R. Masini, C. Boyle, P. Melchi, C. F. Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005 Sep; 41 (14): 2040-59.
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  36. Hu, S. Ma, F. Collado-Mesa, F. Kirsner, R. S. UV radiation, latitude, and melanoma in US Hispanics and blacks. Arch Dermatol. 2004 Jul; 140 (7): 819-24.
  37. Huang, X. X. Bernerd, F. Halliday, G. M. Ultraviolet A within sunlight induces mutations in the epidermal basal layer of engineered human skin. Am J Pathol. 2009 Apr; 174 (4): 1534-43.
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