Most skin cancers develop on the visible outer layer of the skin (the epidermis), particularly on sun-exposed areas like the face, head, hands, arms, and legs. In addition to sun exposure, family history may also play a role. Keep in mind it’s not usual for cancers to occur on areas of your body that have not had sun exposure. Diagnosing skin cancer usually requires a skin biopsy, where a small piece of skin is removed for examination under a microscope. If skin cancer is detected before it has spread to surrounding tissues, chances of a complete cure are excellent. There are three main types of skin cancers: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma.
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Basal Cell Carcinoma
Info: Basal cell carcinoma (BCC) is the most common type of skin cancer, accounting for 80% of all skin cancers. BCC most often appears on areas of the body that have the greatest amount of sun exposure. This includes the face, ears, scalp, back of the neck, and back of the arms and hands.
Signs & Symptoms: There are three subtypes of basal cell carcinoma. Superficial BCC appears as a reddish spot or patch with a fine scale on the top, sometimes with a small erosion on the surface. Nodular BCC appears as a waxy or translucent nodule with a pearly white or brown pigmentation, and possibly fine blood vessels (capillaries) on its surface. Sclerosing (or morpheaform) BCC appears like a scar with poorly defined, blurred borders. It is usually flat with a thinning of the skin.
Prevention: Basal cell carcinoma (BCC) is relatively easy to detect and cure rates are excellent, if treated early. BCC can resemble other skin conditions, so tell your doctor if you notice unusual skin changes, such as:
- a sore that comes and goes but never completely heals or bleeds.
- a shiny bump or nodule, especially if it appears pearly or translucent or brown/reddish like a mole
- a slightly raised pink growth with a crusted depression in the center, possibly with tiny blood vessels visible on the surface
- a patch of skin that is red or irritated, especially on the chest, shoulders, arms or legs
- a white or yellowish waxy scar with poorly defined borders
Treatment: Your doctor will recommend a treatment based on your medical history and the type of BCC, its size, shape, and location. The best treatment is early detection. Examination by the trained eye of a dermatologist can help assess whether or not a lesion is a basal cell carcinoma.
Squamous Cell Carcinoma
Info: Squamous cell carcinoma (SCC) is the second most common cancer of the skin, with 250,000 people diagnosed annually in the United States. It is found most commonly where the skin is exposed to the sun, including the scalp, upper rim of the ear, face, lips, and shoulders. Older people with fair complexions and frequent sun exposure are most likely to be affected. If left untreated, SCC can destroy much of the tissue surrounding the tumor or spread to the lymph nodes and be fatal.
Signs & Symptoms: Squamous cell carcinoma can appear in a number of forms. If your skin shows any of these symptoms, consult your doctor as soon as possible:
- A dry, crusted, scaly patch of skin that is red and swollen at the base
- A sore that won’t heal and/or bleeds
- Crusted skin
- A thickened, crusty patch of skin with a raised border with a pebbly, granular base
Prevention: Early treatment and detection are essential to a successful recovery. We recommend that you have an annual full body skin evaluation with your dermatologist. Proper protection (staying out of the direct sun, wearing protective clothing and using screen) may help to prevent the development of SCC.
Treatment: It is important to detect and treat SCC early before it spreads to other tissues. Dermatologists use a variety of different surgical treatment options depending on location of the tumor, size of the tumor, microscopic characteristics of the tumor, health of the patient, and other factors. Most treatment options are relatively minor office-based procedures that require only local anesthesia. Surgical excision to remove the entire cancer is the most commonly used treatment option.
Info: Melanoma is the most serious type of skin cancer because it has a tendency to spread quickly to other parts of the body (metastasize). Most melanomas appear as dark growths similar to moles, but some may be pink, red or skin-colored. Melanoma is very treatable when detected early, but can be fatal if allowed to spread throughout the body. The goal is to detect melanoma early, when it is still on the surface of the skin.
Signs & Symptoms: Often, the first sign of melanoma is a change in the size, shape, color, or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new mole. It may be black, abnormal, or “ugly looking”. More advanced melanoma may have a hard or lumpy texture. More advanced tumors may itch, ooze, or bleed, but are usually not painful.
Prevention: Excessive exposure especially severe blistering sunburns during childhood or use of tanning beds can cause melanoma. Early detection and treatment are critical to a successful recovery. We recommend that you get an annual full body skin check with your dermatologist. Monthly, self-exams are important for anyone at risk for developing skin cancer. Watch for these changes in moles and report them to your doctor:
- Asymmetry with one half of a mole a different shape than the other half
- Border edge is ragged, notched or blurred
- Color is uneven with a variety of hues in the same mole, with areas of black, brown, tan, white, grey, red, pink or blue
- Diameter increases to a size larger than the eraser of a pencil (1/4-inch)
Treatment: The best treatment is early detection! Your doctor will recommend a treatment based on your medical history and the size, shape, and location of the melanoma. Treatment usually includes surgical excision performed in the dermatologist’s office. Depending on the location and size of the melanoma, Mohs micrographic surgery may be recommended. Examination by the trained eye of a dermatologist can help to determine whether or not a lesion is suspicious for melanoma.