The two most common types of skin cancer are basal cell cancer and squamous cell cancer. They usually form on the head, face, neck, hands and arms. Another type of skin cancer, melanoma, is more dangerous but less common.

Signs and symptoms

Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day — the palms, spaces between the toes and the genital area. Skin cancer affects people of all skin tones, including those with darker complexions.
A cancerous skin lesion can appear suddenly or develop slowly. Its appearance depends on the type of cancer.

Basal cell carcinoma

This is the most common skin cancer. It’s also the most easily treated and the least likely to spread. Basal cell carcinoma usually appears as one of the following:

  • A pearly or waxy bump on your face, ears or neck.
  • A flat, flesh-colored or brown scar-like lesion on your chest or back.

Squamous cell carcinoma

Squamous cell carcinoma is easily treated if detected early, but it’s slightly more apt to spread than is basal cell carcinoma. Most often, squamous cell carcinoma appears as one of the following:

  • A firm, red nodule on your face, lips, ears, neck, hands or arms.
  • A flat lesion with a scaly, crusted surface on your face, ears, neck, hands or arms.

Melanoma

Melanoma is a disease of the skin in which cancer (malignant) cells are found in the cells that color the skin (melanocytes). Melanoma usually occurs in adults, but it may occasionally be found in children and adolescents. Your skin protects your body against heat, light, infection, and injury. It is made up of two main layers: the epidermis (the top layer) and dermis (the inner layer). Melanocytes are found in the epidermis and they contain melanin, which gives the skin its color. Melanoma is sometimes called cutaneous melanoma or malignant melanoma.
Melanoma is a more serious type of cancer than the more common skin cancers, basal cell cancer or squamous cell cancer, which begin in the basal or squamous cells of the epidermis. If you have basal cell or squamous cell cancer of the skin, refer to the patient information statement for skin cancer.
Like most cancers, melanoma is best treated when it is found (diagnosed) early. Melanoma can spread (metastasize) quickly to other parts of the body through the lymph system or through the blood. (Lymph nodes are small, bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells.) You should see your doctor if you have any of the following warning signs of melanoma: change in the size, shape, or color of a mole; oozing or bleeding from a mole; or a mole that feels itchy, hard, lumpy, swollen, or tender to the touch. Melanoma can also appear on the body as a new mole. Men most often get melanoma on the trunk (the area of the body between the shoulders and hips) or on the head or neck; women most often get melanoma on the arms and legs.
If you have signs of skin cancer, your doctor will examine your skin carefully. If a mole or pigmented area doesn’t look normal, your doctor will cut it out (called local excision) and look at it under the microscope to see if it contains cancer. This is usually done in a doctor’s office. It is important that this biopsy is done correctly.

What Causes Skin Cancer?

Sunburn and UV light can damage your skin, and this damage can lead to skin cancer. There are of course other determining factors, including your heredity and the environment you live in. However, both the total amount of sun received over the years, and overexposure resulting in sunburn can cause skin cancer. Most people receive 80% of their lifetime exposure to the sun by 18 years of age.
Anyone can get skin cancer, but it is more common in people who:

  • Spend a lot of time in the sun or have been sunburned.
  • Have light-colored skin, hair and eyes.
  • Have a family member with skin cancer.
  • Are over age 50.

You should have your doctor check any suspicious skin markings and any changes in the way your skin looks. Treatment is more likely to work well when cancer is found early. If not treated, some types of skin cancer cells can spread to other tissues and organs.

Treatment

Treatment for skin cancer and the precancerous skin lesions known as actinic keratoses varies, depending on the size, type, depth and location of the lesions. Often the abnormal cells are surgically removed or destroyed with topical medications. Most treatments require only a local anesthetic and can be done in an outpatient setting. Sometimes no treatment is necessary beyond an initial biopsy that removes the entire growth.
If additional treatment is needed, options may include:

  1. Freezing:Your doctor may destroy actinic keratoses and some small, early skin cancers by freezing them with liquid nitrogen (cryosurgery). The dead tissue sloughs off when it thaws. The treatment may leave a small, white scar. You may need a repeat treatment to remove the growth completely.
  2. Excisional surgery: This type of treatment may be appropriate for any type of skin cancer. Your doctor cuts out (excises) the cancerous tissue and a surrounding margin of healthy skin. A wide excision — removing extra normal skin around the tumor — may be recommended in some cases. To minimize or avoid scarring, especially on your face, you may need to consult a doctor skilled in skin reconstruction.
  3. Laser therapy:A precise, intense beam of light vaporizes growths, generally with little damage to surrounding tissue and with minimal bleeding, swelling and scarring. A doctor may use this therapy to treat superficial skin cancers or precancerous growths on lips.
  4. Mohs surgery: This procedure is for larger, recurring or difficult-to-treat skin cancers, which may include both basal and squamous cell carcinomas. Your doctor removes the skin growth layer by layer, examining each layer under the microscope, until no abnormal cells remain. This procedure allows cancerous cells to be removed without taking an excessive amount of surrounding healthy skin. Because it requires special skill, the surgery should be done only by specially trained doctors.
  5. Curettage and electrodesiccation: After removing most of a growth, your doctor scrapes away layers of cancer cells using a circular blade (curet). An electric needle destroys any remaining cancer cells. This simple, quick procedure is common in treating small or thin basal cell cancers. It leaves a small, flat, white scar.
  6. Radiation therapy: Radiation may destroy basal and squamous cell carcinomas if surgery isn’t an option.
  7. Chemotherapy:In chemotherapy, drugs are used to kill cancer cells. For cancers limited to the top layer of skin, creams or lotions containing anti-cancer agents may be applied directly to the skin. Topical drugs can cause severe inflammation and leave scars. Other types of chemotherapy can be used to treat skin cancers that have spread to other parts of the body.

Sources: NLM, Maui, Mayo Clinic

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