What Does Skin Cancer Look Like? Signs, Types and When to Seek Help

Identifying the Warning Signs and Types of Skin Cancer

Skin cancer is common in the UK, and the risk increases with age, particularly for non-melanoma skin cancers. Most skin cancers are linked to ultraviolet exposure from the sun or sunbeds, although individual risk varies according to factors such as age, skin type, sun exposure, family history and previous skin cancer. Around 48% of new non-melanoma skin cancer cases in the UK are diagnosed in people aged 75 and over.

For most, though, there is uncertainty as to what skin cancer actually looks like. Which blemish is of no concern, which one might signify cancer and then which type of skin cancer might it be?

If the surface of the skin has changed, is that cause for concern, which parts of the body should someone particularly focus on if looking for any evidence of problems?

In this post, Anca Breahna, a plastic and cosmetic surgeon with specialist knowledge in the field of skin cancer and its treatment, will provide some key information.

Types of Skin Cancer

✓ Basal Cell Carcinoma (BCC)

Basal Cell Carcinoma, also known as Rodent Ulcer, is the most common type of skin cancer, accounting for around 80% of cases. Basal Cell Carcinoma develops in the basal cells, which are responsible for producing new skin cells as old ones die off. Basal Cell Carcinoma usually grows slowly and only rarely spreads to distant parts of the body, but it can damage surrounding tissue if left untreated and therefore still requires appropriate medical assessment and treatment.

What to Look for:

• New small, pearly, or waxy bumps, usually on sun-exposed areas such as the face, ears, and neck
• Flat, flesh-coloured, or brown scar-like lesions
• Bleeding or scabbing sores that heal and then return
• More common in people with fair skin, but can occur in all skin types
• Risk factors for this carcinoma include excessive sun exposure, tanning bed use, and a
  history of sunburns

✓ Squamous Cell Carcinoma (SCC)

Squamous Cell skin cancer is the second most common form of skin cancer, accounting for about 20% of cases. Squamous Cell Carcinoma develops in the squamous cells, which make up the middle and outer layers of the skin. Squamous Cell Carcinoma poses a greater risk to health than Basal Cell Carcinoma because it can grow larger and spread to other parts of the body if left untreated. Treatment for SCC depends on factors such as its size, location, depth and whether it has spread, and early assessment can help guide appropriate management.

What to Look for:

• Scaly red patches, open sores, or elevated growths with a central depression, often on sun-exposed areas like the face, ears, neck, lips, and hands (areas not covered with clothing)
• Wart-like growths that may crust or bleed
• Persistent, non-healing sores or ulcers
• This non-melanoma skin cancer can spread to other parts of the body (metastasize), requiring prompt treatment
• Risk factors for this carcinoma include excessive sun exposure, tanning bed use, a
  history of sunburns, and a weakened immune system

✓ Melanoma

Melanoma is the most serious and aggressive type of cancer affecting the skin, accounting for about 1% of all skin cancer cases. However, it is responsible for the majority of skin cancer deaths. Melanoma develops in the melanocytes, the cells that produce the pigment that gives skin its colour. Melanoma can spread beyond the skin, so a new or changing pigmented lesion that raises concern should be assessed promptly. Diagnosis may involve examination and biopsy or excision, with further management guided by the pathology result and specialist team.

What to Look for:

• New mole or changes to an existing mole, such as size, shape, or colour
• Asymmetrical moles with irregular borders and multiple colours (shades of brown, black, tan, red, white, or blue)
• Moles larger than 6mm in diameter (about the size of a pencil eraser)
• Itching, bleeding, or crusting moles
• Dark lesions on the palms, soles, fingertips, toes, or mucous membranes (mouth, nose, or genitals)
• Risk factors include excessive sun exposure, tanning bed use, a history of sunburns, a large number of moles, and a family history of melanoma

ABCDE System for Self-assessment

The ABCDE system is a simple and effective method for self-assessment of moles and other skin lesions to help identify potential signs of melanoma, the most serious form of skin cancer. This system focuses on five key characteristics: Asymmetry, Border, Colour, Diameter, and Evolution.

• Asymmetry – uneven halves
• Border –  irregular, crusted, or notched
• Colour – changes or variations in colour
• Diameter – typically 6mm or more, but can be smaller
• Evolving – mole changing over time

– Asymmetry refers to the shape of the mole. If you were to draw an imaginary line through the centre of the mole, the two halves should match. If they don’t, this asymmetry could be a warning sign of melanoma.

– Border irregularity is another important factor. Benign moles typically have smooth, even borders, while melanomas often have ragged, notched, or blurred edges.

– Colour variations within a mole can also be a cause for concern. Benign moles usually have a single, uniform colour. Melanomas, on the other hand, may display a range of colours, including shades of black, brown, tan, red, white, or blue.

– Diameter is the fourth characteristic to consider. Moles larger than 6mm in diameter (about the size of a pencil eraser) are more likely to be melanomas. However, it’s important to note that melanomas can be smaller than this, so don’t ignore a mole just because it’s small.

– Finally, Evolution refers to changes in a mole over time. Benign moles typically remain stable, while melanomas may change in size, shape, colour, or texture. They may also begin to itch, bleed, or crust over.

Using the ABCDE system may help you notice changes in a mole or skin lesion that warrant medical assessment. If you notice a new or changing lesion, or one that bleeds, crusts, itches or looks different from your other moles, contact a doctor or appropriately qualified clinician for assessment.

The ABCDE system can help identify changes worth checking, but it cannot diagnose melanoma and not every melanoma follows all five features.

Are there any additional factors or warning signs beyond the ABCDE system that individuals should be aware of when checking their skin?

Yes, there are several additional factors and warning signs beyond the ABCDE system that individuals should be aware of when checking their skin:

1. The “Ugly Duckling” Sign: This refers to a mole that looks significantly different from the
   surrounding moles. It may be larger, smaller, darker, lighter, or have a different shape or texture. This could be a warning sign of melanoma.
2. Skin sores or skin spots that don’t heal: If you have a sore, cut, or bruise that does not heal within a few weeks, it could be a sign of skin cancer, particularly squamous cell carcinoma or basal cell carcinoma.
3. Persistent redness or irritation: If you have a patch of skin that is consistently red, itchy, or irritated, and does not improve with moisturisers or over-the-counter treatments, it could be a sign of early skin cancer.
4. Tender or painful lesions: While skin cancers are often painless, in some cases, they may be tender or painful to the touch. This can be a sign of a more advanced skin cancer.
5. Scaly or crusted patches: Rough, scaly, or crusted patches on the skin that do not improve with moisturising could be a sign of pre-cancerous skin lesions, such as actinic keratosis, which can develop into squamous cell carcinoma if left untreated.
6. Pimple-like growths: Basal cell carcinomas can sometimes resemble pimples that don’t go away or heal. They may be pearly, translucent, or have visible blood vessels.
7. Nail changes: Melanomas can also develop under the fingernails or toenails. Warning signs include dark streaks or spots under the nail, nail lifting or separating from the nail
   bed, and nail cracking or breaking.

If you notice any concerning changes in your skin, it’s essential to consult a specialist for a thorough evaluation. Depending on the assessment and diagnosis, biopsy or surgical treatment may be appropriate.

Sun Exposure and Risk of Skin Cancer

Sun exposure or exposure to UV light is a significant risk factor for all skin cancer types for darker skin tones and light skin. Priority should be given to checking areas that receive the most sun exposure, such as the face, arms, legs, and the backs of hands where cancer cells can occur.

When to Seek Medical Advice

If you notice a new, changing, bleeding, crusting or non-healing skin lesion, contact your GP or another appropriately qualified clinician for assessment. Depending on the findings, you may be referred for specialist review, biopsy or surgical treatment.

Miss Anca Breahna provides skin cancer surgery and lesion excision where surgical treatment is appropriate following assessment.

FAQs about What Does Skin Cancer Look Like

Further Reading about Skin Cancer Procedures at Anca Breahna Plastic Surgeon

• • Read more about Excision Biopsy
  • Read more about Skin Graft Surgery
  • Read more about What to Expect During and After an Excision Biopsy for Suspected Skin Cancer
  • Read more about Treatment and Solutions for Skin Moles

About Anca Breahna – Consultant Plastic Surgeon

Ms Anca Breahna, PhD, MSc, FEBOPRAS, FRCS (Plast) is a highly regarded Consultant Plastic Surgeon specialising in the field of Aesthetic and Reconstructive Plastic Surgery. Anca performs a range of breast, body and face surgery and minor skin procedures.

As one of the very few female Plastic Surgeons in her region, she is able to offer that unique female perspective, with empathy, attention to detail and personalised care.

Anca Breahna’s surgical training has been largely undertaken within the United Kingdom. She began a rigorous training programme in Plastic and Reconstructive Surgery in 1999, after achieving her medical degree from the University of Bucharest. Miss Breahna attained her PhD degree at the same university in 2007 for her medical research. She then relocated to the UK to further extend her qualifications and training.

Anca’s NHS practice is now focused on Breast Reconstructive Surgery, Skin Cancer Surgery, Hand Surgery and soft tissue reconstruction. Over the last 15 years, through her pursuit of further training and education, Anca has developed a special interest and expert practical experience in a range of Aesthetic Breast and Body Surgery.

It is Anca’s true dedication and commitment to her field, that sets her aside from her peers. Her extensive surgical training means that you are in safe hands. She is renowned for providing exceptional care, support and helping achieve realistic goals for her patients.

Anca will treat you in a straightforward manner, with respect, consideration and empathy to ensure you are comfortable with your choice.