More people are diagnosed with skin cancer each year in the U.S. than all other cancers combined. The two most common forms of skin cancer are basal cell carcinoma and Melanoma, which is the deadliest.
To plan the best treatment for each patient, your MedStar St. Mary's Hospital specialists consider the location and size of the cancer, the risk of scarring, and the person's age, general health, and medical history. Fortunately, when treated at an early stage of development, many skin cancers have a very high rate of cure. Treatment for skin cancer usually involves some type of surgery. In some cases, doctors suggest radiation therapy or chemotherapy. Sometimes a combination of these methods is used.
At MedStar St. Mary's, we do not just treat skin cancer; we treat the whole patient, which is why we place so much value on continued care. Even though most skin cancers can be cured, the disease can recur in the same place. And, people who have been treated for skin cancer have a higher-than-average risk of developing a new cancer elsewhere on the skin. That's why it's important for individuals to continue to examine themselves regularly, to visit their doctor for regular check-ups, and to follow the doctor's instructions on how to reduce the risk of developing skin cancer again
Learn more about the types of skin cancer below.
Basal Cell Carcinoma
Basal cell cancer starts in the top layer of the skin called the epidermis. Most basal cell cancers occur on skin that is regularly exposed to sunlight or other ultraviolet radiation.
Individuals are more likely to get basal cell cancer if he or she has:
- Light-colored or freckled skin
- Blue, green, or grey eyes
- Blonde or red hair
- Overexposure to x-rays or other forms of radiation
- Many moles
- Close relatives who have or had skin cancer
- Many severe sunburns early in life
- Long-term daily sun exposure (such as the sun exposure received by people who work outside)
The most common type of skin cancer, basal cell carcinoma frequently looks like a flesh-colored, pearl-like bump, or raised reddish patch that might be itchy. They can also appear to be flat, firm, pale or yellow areas, similar to a scar, or pink growths with raised edges.
Other factors to look for include:
- A skin sore that bleeds easily
- A sore that does not heal
- Oozing or crusting spots in a sore
- A scar-like sore without having injured the area
- Irregular blood vessels in or around the spot
- A sore with a depressed (sunken) area in the middle
Suspicious areas can also look like dry, rough, scaly patches or spots that may be flesh-colored or pink-red. Known as actinic keratoses, these spots usually appear on areas prone to frequent sun exposure: the neck, head, hands, and forearms. People with one actinic keratosis often develop many more. These spots could stay the same, clear up on their own, or develop into squamous cell carcinoma, so seeking a professional opinion is key.
Squamous Cell Carcinoma
Red firm bumps, scaly patches, wart-like growths, sores that heal but then come back could be indicative of squamous cell carcinoma. The rims of the ears, neck, back, face, arms, and chest are frequently affected by these growths, which can develop deep in the skin and spread to other areas of the body. The earliest form (squamous cell carcimoma in situ) can appear as a scaly, crusted, and large reddish patch that can be larger than 1 inch. A sore that does not heal can be a sign of squamous cell cancer.
Merkel Cell Carcinoma
Merkel cells make up one of the skin’s top layers. Merkel Cell Carcinoma is a rare type of cancer that affects these skin cells. It generally affects parts of the skin exposed to the sun, including the limbs, head, and neck. The symptoms of Merkel cell carcinoma may be similar to the symptoms for other problems.
Make sure to talk to a doctor if you notice a lump that:
- Appears on parts of the skin exposed to the sun such as the head, neck, arms, and legs
- Does not hurt
- Grows quickly
- Is red or purplish
Melanoma, the deadliest form of cancer, usually develops in a mole or suddenly appears as a new dark spot on the skin. It is important to notice changes in a mole — such as its size, shape, or color — because that may be a sign that melanoma is developing.
The most important changes to look for in a mole include:
- Growth, bleeding, or itching
- Asymmetrical appearance (left and right sides of mole do not look identical)
- Irregular, blurry, or jagged edges
- Color change including loss, spreading, darkening, loss of color, or the appearance of multiple colors
- Large size: a diameter greater than 6 mm (the size of a pencil eraser)
- Raised above the skin with an uneven surface
You should also consult your doctor if you notice any lesions or areas of damaged skin. This includes lesions that:
- Appear smooth or waxy
- Grow in a cluster that is pink or red with a shiny or scaly appearance
- Heal and reopen repeatedly
- Form as a brown or black streak underneath a nail
Early Detection & Skin Checks
Being aware of your normal pattern of moles, freckles, and blemishes is key. Checking your own skin frequently can help find many skin cancers early, when they are easier to treat. Some skin cancers, such as Basal Cell Carcinoma, can invade the surrounding tissue and grow into the nerves and bones. Preventing permanent damage starts with doing regular skin checks, keeping appointments for routine physicals, and seeing a doctor right away with any skin concerns.
When doing a self-exam, note your standard birthmarks, moles, and other blemishes, and have a partner help inspect hard-to-reach areas like your back and neck. Regular exams are especially important for those at a higher risk of skin cancer: people with reduced immunity; those who have had skin cancer before; and people with a strong family history of the disease.
Spot changes to your skin and moles by doing a monthly skin self-exam, using a full-length mirror, if possible.
- Look at your sides with your arms raised.
- Bend your elbows and look at your forearms and upper arms. Don’t forget to look at your hands.
- Sit down to look at the front and back of your legs and feet. Remember to look between your toes and on the bottom of your feet.
- Check the back of your neck and your scalp. Try using a handheld mirror for a better look.
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Protect Your Skin
- Use sunscreen outdoors. The higher the SPF, the greater the protection.
- Avoid the sun between 10 a.m. and 2 p.m., when the sun is most intense. If you are outside, seek shade.
- Do not participate in indoor tanning.
- Wear sunglasses with UVA and UVB protection.
- Be aware of medications that increase your sun sensitivity, like certain antibiotics, antihistamines, and antidepressants.
What's in a Sunscreen?
While you should use sunscreen every day of the year, it’s even more important during summertime, when the days are longer, the sun is stronger, and it’s easier to spend more time outdoors. Use the following tips when selecting your sunscreen:
- Choose a sunscreen with “broad spectrum” protection. Sunscreens with this label protect against both UVA and UVB rays. All sunscreen products protect against UVB rays, which are the main cause of sunburn. But UVA rays also contribute to skin cancer and premature aging.
- Make sure your sunscreen has a sun protection factor (SPF) 30 or higher. The SPF number is the level of protection the sunscreen provides against UVB rays. Higher SPF numbers do mean more protection, but the higher you go, the smaller the difference becomes.
- No sunscreens are waterproof or sweatproof. For best results, reapply sunscreen at least every 2 hours and even more often if you are swimming or sweating.
- Sunscreens are designed to remain at original strength for up to three years. This means that you can use leftover sunscreen from one year to the next. Some sunscreens include an expiration date — a date indicating when they're no longer effective. Discard sunscreen that is past its expiration date.