Skin Cancer Risks and Prevention Tips for Kidney Transplant Recipients

A kidney transplant recipient is at an increased risk of skin cancer because of the immunosuppressant medications they must take to prevent rejection. 

“These medicines keep your body from attacking the kidney,” explained Dr. Cerrene Giordano, a dermatologist and surgeon. “But they take away some of your body’s natural defenses against things like cancer and infections.”

When the immune system is weakened, environmental factors like sun exposure can cause abnormal cells to develop more easily. Without a strong immune response to target and destroy those cells, the risk of skin cancer increases.

“Not all transplant medications carry the same risk,” Dr. Giordano said. “Some have a stronger connection to skin cancer than others.

Your transplant team will carefully choose the medications they believe will give your kidney the best chance to thrive while balancing your overall health.

Watch videos made by recipients to learn what to expect in the first year after transplant and beyond.

According to Dr. Giordano, kidney transplant recipients are more likely to develop one of the following types of skin cancer.

• Squamous Cell Carcinoma (SCC): SCC is the most common and aggressive skin cancer in transplant patients. SCC begins in the flat squamous cells near the skin surface. It may appear as scaly patches, open sores, or raised growths and can spread quickly if untreated.
• Basal Cell Carcinoma (BCC): A slower-growing skin cancer that starts in the cells at the bottom of the skin’s outer layer. BCC often shows as a bump, pink patch, or sore that doesn’t heal and is less aggressive but still requires prompt treatment.
• Melanoma: The most dangerous skin cancer, melanoma arises from pigment-producing cells called melanocytes. It may appear as a new or changing mole with irregular borders or multiple colors. Though less common in transplant patients, it can spread rapidly.

Treating skin cancer after a kidney transplant involves careful coordination between your dermatology and transplant teams. 

Skin cancer treatments include: 

• Surgical Excision (Removal): Removes cancer cells along with some healthy skin to ensure all cancer cells are gone.
• Mohs Surgery: A more precise surgery that removes skin layer-by-layer. It preserves healthy skin and reduces recurrence risk. 
• Radiation Therapy: Used when surgery isn’t possible or to treat cancer that has spread.
• Topical Treatments or Cryotherapy: The use of creams or freezing technology to remove early or surface-level skin cancers. 
• Immunotherapy or Targeted Therapy: For advanced or spreading skin cancers. This treatment requires careful management in transplant patients due to immune suppression.

“I had a surgical excision for melanoma. Thankfully, it was caught early,” said Risa Simon, a transplant recipient. “The surgery was easy. They numbed the area and cut the cancer out. It only took fifteen minutes.” 

Here are three easy ways to protect your skin after a kidney transplant. 

Protecting yourself from direct sun exposure, especially between 10 a.m. and 4 p.m., when UV rays are strongest, is crucial for skin health. 

To protect your skin: 

• Go outside during the hours when the UV rays are weakest. 
• Use broad-spectrum sunscreen with SPF 30 or higher on all exposed skin, even on cloudy days. Reapply every two hours or after swimming or sweating.
• Wear protective clothing, wide-brimmed hats, and UV-blocking sunglasses.
• Avoid tanning beds.

Early detection through frequent professional exams can catch skin cancers before they grow or spread. 

“I also recommend getting checked for skin cancer before your transplant,” said Kent Bressler, transplant recipient. “You're at risk simply from your past exposure to the sun.”

See a dermatologist experienced with transplant patients at least once or twice a year for full skin exams. If you have a history of skin cancer, you may need to go in more frequently. 

Examine your skin monthly for any new or changing spots, moles, or sores that don’t heal. Look for changes in size, shape, color, or texture.

“Do not assume that a little mole or freckle is not cancerous,” Risa said. “I examine myself frequently and generally go to the dermatologist every three months to look at the spots I find.”

Report any suspicious spots to your dermatologist immediately.

Facing skin cancer or a higher risk of developing it after a kidney transplant can feel overwhelming, but you don’t have to face it alone.

• Join NKF PEERS: Talk one-on-one with someone who’s been there.
• Join NKF’s online Transplant Community: Anonymously join conversations, ask questions, and find encouragement.
• Find your local office: Connect with your kidney community in person.