Skin Cancer

Of all the cancers that humans can get, skin cancer is the most common.  In the United States, skin cancer is increasing in all races.

Who gets skin cancer?

People of all colors and races get skin cancer.  Those with light skin who sunburn easily have a higher risk.  Risk factors include: sunburns, family history of skin cancer, exposure to x-rays, weakened immune system, scarring caused by a disease or burn, and exposure to cancer-causing compounds such as arsenic.  Using indoor tanning devices such as tanning beds and sunlamps also increases the risk of developing skin cancer.

What does skin cancer look like?

There are different types of skin cancer, and each tends to look a bit different.

ACTINIC KERATOSES (AK)
These dry, scaly patches or spots are considered the earliest stage in the development of skin cancer.  In rare cases, an AK can progress to a type of skin cancer called squamous cell carcinoma (SCC). People who get AKs usually have fair skin.  Most people see their first AKs after 40 years of age because AKs tend to develop after years of sun exposure.  But even teens can have AKs when they live in sunny areas or use indoor tanning.  AKs form on skin that gets lots of sun exposure, such as the head, neck, hands, and forearms.  Because AKs increase the risk of getting SCC, AKs are usually treated. Proper use of sunscreens can help prevent AKs.

BASAL CELL CARCINOMA (BCC)
This is the most common type of skin cancer.  It frequently looks like a flesh-colored, pearl-like bump.  It also can appear as a pinkish patch of skin.  Like AKs, BCC develops on skin that gets frequent sun exposure, such as the head, neck, and arms.  Many BCCs also form on the trunk and lower limbs.  While BCC frequently develops in people who have fair skin, it can occur in people with dark skin.  BCC usually does not grow quickly, and it rarely spreads to other parts of the body.  But it should be treated promptly.  This cancer can invade the surrounding tissue and grow into the nerves and bones, causing damage and disfigurement.

SQUAMOUS CELL CARCINOMA (SCC)
SCC is the second most common type of skin cancer.  This skin cancer often looks like a firm bump, scaly patch, or an ulcer that heals and then re-opens. SCC is usually reddish in color.  It tends to form on skin that gets frequent sun exposure, such as the rim of the ear, face, neck, arms, and trunk.  People who have light skin are most likely to develop SCC, but it can also develop in dark-skinned people, especially those who have scarring.  Because SCC can grow deep, it can cause damage and disfigurement.  Early treatment can prevent this and stop SCC from spreading to other areas of the body.

MELANOMA
This skin cancer frequently develops in a mole or appears suddenly as a new dark spot on the skin.  Either way, melanoma can be deadly.  Every year, more than 8,500 Americans (nearly one person per hour) die from melanoma, making melanoma the deadliest form of skin cancer.

Are there warning signs?

It is estimated that more than 120,000 Americans will develop melanoma this year.  A change is often the first sign of melanoma; therefore, it is important to know where moles appear and what they look like.  When detected and properly treated before it spreads, melanoma has a high cure rate.  The ABCDE warning signs of melanoma can help people detect change:

  • A  stands for ASYMMETRY; one half unlike the other half.
  • B stands for BORDER; irregular, scalloped or poorly defined border.
  • C stands for COLOR; varied from one area to another; shades of tan and brown, black; sometimes white, red or blue.
  • D stands for DIAMETER; while melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, they can be smaller.
  • E stands for EVOLVING; a mole or skin lesion that looks different from the rest or is changing in size, shape, or color.

Other changes that could indicate melanoma are pain, itch, or bleeding in a mole or new spot on the skin.

What are the risk factors?

Several risk factors increase a person’s likelihood of getting melanoma.  One risk factor is sun exposure.  It is important to protect the skin with sunscreen and clothing and never sunburn.

Another risk factor is light skin.  However, people with skin of color do get melanoma.  In skin of color, melanoma usually appears on the palms, sales, under the nails, in the mouth, or on the genitals.

A few risk factors significantly increase a person’s risk of getting melanoma.  If one or more first-degree relatives (parent, sibling, or child) has had melanoma, the risk significantly increases.  Having many moles (50-100 or more) or several atypical moles also increases the risk.  An atypical mole is not cancerous, but because of its different appearance, these moles need to be closely monitored for any changes.  Having had melanoma also increases your chances of having additional melanomas.  Most skin cancer can be found early.

Are skin exams important?

With early detection and proper treatment, the cure rate for BCC and SCC is about 95%.  When melanoma is detected before it spreads, it also has a high cure rate.  Regular skin exams help people find early skin cancers.

One type of skin exam is the skin self-exam.  During a self-exam, people examine their own skin for signs of change.  If a growth, mole, sore, or skin discoloration appears suddenly, or begins to change, see a dermatologist.

People who have spent time in the sun, have a family history of skin cancer (especially melanoma), have many moles or atypical moles or have other risk factors for skin cancer should see a dermatologist for regular skin exams.  Some people should have this exam once a year.  Others need more frequent exams.  A dermatologist will recommend the frequency that is best for each patient.

If during the skin exam, a dermatologist sees a potential skin cancer, the dermatologist will remove the growth (or part of it) so that it can be examined under a microscope.  This is called a biopsy.  A dermatologist can safely and quickly perform this procedure during an office visit.

If the biopsy report confirms that the suspicious growth  is skin cancer, more treatment may be needed.  When caught early and the entire growth is removed, sometimes further treatment is not needed.  If further treatment is needed, the dermatologist will choose from an array of medical and surgical treatments for skin cancer.  Treatment varies with the type of skin cancer, the size and location of the skin cancer, and the needs of the patient. 

How can I protect myself?

Sun exposure is the most preventable risk factor for all skin cancers, including melanoma.  You can have fun in the sun and decrease your risk of skin cancer.  Here’s how to Be Sun Smart.

  • Generously apply a broad-spectrum water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or more to all exposed skin.  Broad-spectrum provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays.  Re-apply approximately every two hours, even on cloudy days, and after swimming or sweating.
  • Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
  • Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m.  If your shadow is shorter than you are, seek shade.
  • Protect children from sun exposure by playing in the shade, wearing protective clothing, and applying sunscreen.
  • Use extra caution near water, snow and sand as they reflect the damaging rays of the sun which can increase your chance of sunburn.
  • Get Vitamin D safely through a healthy diet that may include vitamin supplements.  Don’t seek the sun.
  • Avoid tanning beds.  Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling.  If you want to look like you’ve nee in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
  • Check your birthday suit on your birthday.  If you notice anything changing, growing, or bleeding on your skin, see a dermatologist.  Skin cancer is very treatable when caught early.

Dermatologic Conditions

Acne

Acne is a skin condition which has plugged pores (blackheads and whiteheads), inflamed pimples (pustules), and deeper lumps (nodules).  Acne occurs on the face, as well as the neck, chest, back, shoulders, and upper arms.  Although most teenagers get some...

Allergic Contact Dermatitis

Allergic contact dermatitis is caused by a reaction to substances called allergens that come into contact with your skin. In susceptible people, these contact allergens can cause itching, redness, and blisters that is known as allergic contact dermatitis. What...

Alopecia Areata

Alopecia areata (AA) causes hair loss in small, round patches that may go away on their own, or may last for many years. Nearly 2% of the U.S. population (about four million people) will develop AA in their lifetime. Some people with AA (about 5%) may lose all scalp...

Dry Skin

Dry Skin and Keratosis Pilaris Dry skin and keratosis pilaris are common. Dry skin can occur at any age and for many reasons. Keratosis pilaris is an inherited skin condition that develops in up to 40% of the population. Sometimes a dermatologist's help is necessary...

Eczema (Atopic Dermatitis)

A common skin condition, atopic dermatitis is frequently described as "the Itch that rashes”.  Intensely itchy patches form.  These patches can be widespread or limited to a few areas.  Scratching often leads to redness, swelling, cracking, "weeping" of...

Excessive Sweating (Hyperhidrosis)

Hyperhidrosis is excessive sweating. Sweating is necessary to keep the body cool; however, it should not interfere with a person's ability to interact and function. Hyperhidrosis affects quality of life. It may cause embarrassment and frustration. It can impact one's...

Genital Warts

Genital warts, also known as venereal warts, or condylomata acuminata, are caused by the human papilloma virus (HPV). More than 100 types of HPV are known to exist. Low risk types (HPV 1, 2, and 3) cause warts on the hands, feet, and other parts of the body. Types (6...

Granuloma Annulare

Granuloma annulare is a raised, bumpy, or ring-shaped lesion, which can occur singly or in groups on the skin. It is more common in children and young adults, although it may affect people of all ages. Women are twice as likely as are men to develop granuloma...

Hand Eczema

What causes a hand rash? A hand rash, also called hand dermatitis or hand eczema, may be caused by many things. Hand rashes are extremely common.  Many people start with dry, chapped hands that later become patchy, red, scaly, and inflamed. Numerous items can...

Hives (Urticaria)

Hives, or "wheals", are pale red swellings of skin that occur in groups on any part of the skin.  Urticaria is the medical word for hives.  Each hive lasts a few hours before fading without a trace.  New areas may develop as old areas fade.  They...

HSV (Herpes Simplex)

The herpes simplex virus (HSV) can cause blisters and sores almost anywhere on the skin. These sores usually occur either around the mouth and nose, or on the genitals and buttocks. HSV infections can be very annoying because they can periodically reappear.  The...

Lichen Planus

Lichen Planus (pronounced LY -kin-PLAN-us) is a rather common disease that affects the skin, the mouth, or both. It affects about one percent of the general population. What is lichen planus? How do you get the disease? Can it be cured? This information will help...

Moles

Everyone has moles, sometimes 40 or more.  Most people think of a mole as a dark brown spot, but moles have a wide range of appearances. At one time, a mole in a certain spot on the cheek of a woman was considered fashionable.  These were called "beauty...

Perioral Dermatitis

What is perioral dermatitis? Perioral dermatitis is a common skin problem that mostly affects young women. Occasionally men or children are affected. Perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. In addition to redness,...

Pityriasis Rosea

Pityriasis rosea is a rash that occurs most commonly in people between the ages of 10 and 35, but may occur' at any age. The rash can last from several weeks to several months. Usually there are no permanent marks as a result of this condition, although some...

Poison Plants

Poison Plants: Ivy, Oak, and Sumac Those nasty weeds!  Poison ivy, poison oak, and poison sumac are the most common cause of allergic reactions in the United States.  Each year 10 to 50 million Americans develop an allergic rash after contact with these...

Psoriasis

Psoriasis is a persistent, inflammatory skin condition.  Some cases of psoriasis are so mild that people don't know they have it.  Alternatively, severe psoriasis may cover large areas of the body.  Dermatologists can help even the most severe...

Rosacea

Rosacea is a common skin disease that causes redness, pustules, papules, and swelling on the face.  Often referred to as "adult acne," rosacea frequently begins as a tendency to flush or blush easily.  It may progress to persistent redness in the center of...

Sclerotherapy

Spider Vein Varicose Vein Therapy Spider veins are small superficial blood vessels that appear red or blue in the skin. They commonly occur on the legs, but are also found on the face or other areas of the body. These dilated blood vessels may be short, unconnected...

Seborrheic Dermatitis

Seborrheic dermatitis is a common skin disorder that can be easily treated.  Causing a red, scaly, itchy rash, this condition most commonly develops on the scalp, sides of the nose, eyebrows, ears, eyelids, and middle of the chest. Other areas, such as the navel...

Seborrheic Keratoses

Seborrheic keratoses (SKs) are common skin growths.  These benign (non-cancerous) growths can occur almost anywhere on the skin.  Some people get just one; others develop many.  Having many SKs is more common. Usually beginning as small, rough bumps,...

Shingles (Herpes Zoster)

Anyone who has had chicken pox can develop herpes zoster.  Also known as shingles or zoster, herpes zoster is caused by the same virus as chicken pox.  After the chicken pox clear, the virus remains dormant (inactive) within certain nerve cells of the...

Skin Lesions (Actinic Keratosis)

Actinic keratoses (AKs) are common skin lesions.  Caused by years of sun exposure, AKs also are called "solar keratoses" or "sun spots," Fair-skinned people are more susceptible, and AKs tend to appear on skin that receives the most sun.  The forehead, ears,...

Tinea Versicolor

Tinea versicolor is a common skin condition caused by an overgrowth of yeast on the skin's surface.  The yeast normally live in the pores of the skin and thrive in oily areas such as the neck, upper chest, and back.  An overgrowth results in a fungal...

Vitiligo

Vitiligo is a skin condition of white patches resulting from loss of pigment. Any part of the body may be affected. Usually both sides of the body are similarly affected by a few too many milky-white patches. Common areas of involvement are: face lips hands arms legs...

Warts

What are warts? Warts are non-cancerous skin growths caused by a viral infection in the top layers of skin. The virus that causes warts is called the human papilloma virus, or HPV:  Warts are usually skin colored and feel rough to the touch, but they can be dark,...