Cancer & oncology

Skin Cancer: Symptoms, Causes, Prevention, and Treatment

Also known as: Melanoma, Basal cell carcinoma, Squamous cell carcinoma, Nonmelanoma skin cancer

Overview

Skin cancer is the most common cancer in the United States. More than 5 million cases of basal and squamous cell skin cancer are diagnosed each year, and about 112,000 new invasive melanomas are diagnosed annually, according to the American Academy of Dermatology (AAD) and the American Cancer Society (ACS). Skin cancer refers to abnormal, uncontrolled growth of skin cells. The main types are basal cell carcinoma and squamous cell carcinoma (the most common and generally less aggressive), and melanoma, the most serious form because of its high potential to spread. Rates have risen steadily for decades, and while skin cancer affects all age groups, it is more common after age 50.

Causes and risk factors

The main risk factor is exposure to ultraviolet (UV) radiation, whether from the sun or artificial sources such as tanning beds. People with fair skin tones (light skin, eyes, and hair) are especially vulnerable. Other factors include a personal or family history of skin cancer, having many moles (nevi), a weakened immune system (immunosuppression or immunosuppressive treatments), occupational exposure to carcinogens such as arsenic and tar, and repeated sunburns during childhood.

Symptoms

Signs vary by cancer type. For melanoma, the ABCDE rule is essential: Asymmetry of a mole, irregular Borders, uneven Color, a Diameter larger than 6 mm (about the size of a pencil eraser), and a mole that is Evolving in size, shape, or color. Basal cell carcinomas often appear as a small, pearly or pink bump that does not heal. Squamous cell carcinomas show up as a thick, scaly patch or an ulceration. Any change in a mole’s appearance or any sore that will not heal should prompt medical attention.

Diagnosis

Diagnosis is made by a dermatologist through a clinical exam with dermoscopy (a specialized magnifying tool used to examine skin structures). If skin cancer is suspected, a skin biopsy is performed for pathology analysis. For melanoma, additional imaging or a sentinel lymph node biopsy may be done to check for spread and determine the stage.

Treatments

Treatment depends on the type, stage, and location of the tumor, and is discussed by a multidisciplinary care team:

Prevention

Prevention relies mainly on sun protection. Apply a broad-spectrum sunscreen with an SPF of 30 or higher, and reapply about every two hours, or after swimming or sweating. Wear protective clothing, a wide-brimmed hat, and sunglasses. Seek shade when the sun is strongest, between 10 a.m. and 2 p.m., and avoid tanning beds altogether. A monthly skin self-exam helps catch suspicious lesions early. People at higher risk (family history, fair skin, many moles) should ask their doctor how often to have their skin checked.

When should you see a doctor?

See a doctor promptly if you notice a mole that is changing shape, color, or size, a sore that bleeds or has not healed after several weeks, or a lesion that bleeds spontaneously or itches. Any unusual skin change deserves prompt medical evaluation, especially after repeated intense sun exposure.

Sources