While recent improvements in metastatic melanoma treatment are encouraging, prevention and detection at an early stage remain the ultimate goal with this potentially deadly skin cancer.  

In 2017, Neda R. Black, MD, published a research report in JAMA Dermatology on the promising work she and others had done educating hairdressers on the “ABCDE’s”—a set of standardized criteria to detect melanoma of the scalp, head, and neck.¹ As an oncology nurse, this innovative approach made so much sense to me. Who knows your head better than your hairdresser? If your hairdresser received training in the detection of skin cancers of the scalp, head, and neck, he or she could become the first line in detection.

First Contact
I reached out to Eyes on Cancer, an educational program developed by SkyMD, Inc., which had collaborated on Dr. Black’s project. SkyMD is a telemedicine-driven company that allows patients to upload photos of skin disorders to an online platform where a board-certified dermatologist can diagnose, propose treatment, and may even prescribe medication. Eyes on Cancer was founded by a husband and wife team: Dean Foster, MD, and beauty professional Jeanne Braa Foster, both of whom recognize that a collaboration between the health and beauty worlds can be beneficial for the early detection of melanoma. The program’s mission is to teach beauty professionals how to detect skin cancer. The Fosters introduced me to their dynamic program manager, Yvette Williams, who now runs the Eyes on Cancer program.

Eyes on Cancer has produced a 20-minute online educational video about the different types of skin cancer with photos of each kind, a melanoma lesion photo reference card, and an online 35-question post-test. When hairdressers complete the training, they can print and display a certificate of completion in their salon.

The Eyes on Cancer video emphasizes that it is not the role of the hairdresser to diagnose skin cancer. The only goal is awareness. If a suspicious lesion is spotted, hairdressers are asked to encourage their client to follow up with a physician or dermatologist to get it checked out. Hairdressers can also offer to take a photo of the lesion if it is in a place that the client cannot see, such as the back of the head or neck.

Passing It On
I decided to spread the word starting with my own hairdresser. I watched the video and then gave the link to my hairdresser Lisa Lowe Gaddis to complete. She agreed to watch it and has since become a wonderful ambassador for the training. She saved the photo page of skin cancer examples to her smart phone for easy reference when she is on the job. Lisa’s family has been touched by cancer, and she is proud to participate in this program. “Saving lives is always in style,” says Lowe Gaddis. She mentions that her clients tell her that they are not only grateful for a great haircut, but they are also thankful she is looking out for their skin health, too. “Our clients know that we care about them; not just their hair,” she explains.

The idea for the Hairstylist Melanoma Challenge began in December 2018. It was easy for my hairdresser and I to participate in the Eyes on Cancer online class, quiz, and certification. If we could do it so quickly and easily, why not engage others to do so by challenging them via social media? I presented this idea to my local Oncology Nursing Society (ONS) chapter and to my employers at Advent Health. Both groups enthusiastically endorsed the project. I thought the good-natured social media challenge of the successful ALS “Ice Bucket Challenge” would be a good model to adopt.

Creating the Challenge
Eyes on Cancer typically charges $10 for each hairdresser to take the class. Advent Health Cancer Institute Daytona Beach applied for and received a grant from the Bill Walter III Melanoma Research Fund to pay for free unlimited use of the online program passcode so no one participating in the program would have to pay. The goal of this grant is to use the well-established Eyes on Cancer educational program to train as many hairdressers, oncology nurses, and Advent Health staff members as possible.

To educate others about the Eyes on Cancer program, we engaged my local ONS chapter and Advent Health employees to act as conduits to spread the word about the Hairstylist Melanoma Challenge. Eyes on Cancer would then document the numbers of hairdressers trained using our specific passcode.

Our local ONS chapter board, East Central Florida ONS, worked with our cancer program staff to make this a chapter mission project. ONS members were encouraged to watch the video and take the test. Then they were tasked with giving a coupon code to their own hairdresser for a free registration for the online class. The hope was that once we engaged the hairdressers in our region to participate in the challenge, we would inspire other ONS chapters around the country to do the same.

Advent Health Daytona’s marketing department championed our cause and spread the word about the Hairstylist Melanoma Challenge via local newspapers and TV coverage. The East Central Florida ONS chapter reached out to other chapter presidents in northern Florida to join the challenge. To further encourage participation, we designed our own challenge website and Facebook page.

We originally thought that by having participants post a selfie with their certificates on our Facebook page, the challenge would catch on quickly. We have since found that people are participating, but they are not always posting. Each month, Eyes On Cancer gives us the name of all the participants who use our code, and we can post them on our Facebook page.

At Advent Health Daytona, we are using the momentum of this challenge to launch free skin cancer screenings to all members of our community, including the hairdressers we’ve met through this project. In addition to benefitting our community, the Hairstylist Melanoma Challenge has brought programmatic benefits as well. Advent Health Daytona is using the challenge and the free screening as one of its community outreach projects for its Commission on Cancer (CoC) accreditation. 

Gaining Momentum
I presented a poster on the Hairstylist Melanoma Challenge at the 2019 ONS Congress and received great feedback. Patty Higgins, RN, OCN, in Indiana heard about our project and immediately took the Eyes on Cancer video class. She then started training beauty school students in her town. This is our dream in action.

There are currently 39,000 ONS nurses. If each one encouraged his or her own hairdresser to participate in the challenge, the numbers would be staggering. With approximately 39,000 hairdressers seeing potentially 6 to 12 clients per day, we could affect positive change in hundreds of thousands of people daily.  

We are currently contacting ONS chapter presidents around the country to see if they are interested in joining the Hairstylist Melanoma challenge. We urge ONS national to help us spread the word about this mission. Imagine what we could accomplish as a collective.

We continue to urge friendly competition between salons and have started to share our Hairstylist Melanoma Challenge at local beauty school programs. For example, we’ve had a wonderful response watching the video and talking about melanoma with the students of Daytona College.

Eyes on Cancer has educated more than 10,000 participants through its online video and test combination. The Hairstylist Melanoma Challenge has added 150 participants to that number in 2019. Eyes on Cancer’s goal is to have 20,000 participants educated by the end of 2020.

We invite ACCC members to join us. Please go to our website, watch the video, take the quiz, and then encourage others to join the challenge, too. Thirty minutes of your time could save a life, and saving lives is always in style.

References
1. Black NR, et al. Improving hairdressers’ knowledge and self-efficacy to detect scalp and neck melanoma by use of an educational video. JAMA Dermatol. 2018;154(2):214-216.