What To Know About Skin Cancer & Skin Checks

Skin cancer is the most common form of cancer, with more than 9,500 people diagnosed every day. In fact, more people are diagnosed with skin cancer in the U.S. each year than all other cancers combined. Thankfully, not all skin cancers are fatal and many can be prevented. Educating yourself on the risk factors, common symptoms, and healthy skin care practices can help you better recognize the signs of the disease and protect your health. Here’s everything you need to know about skin cancer:

Skin cancer occurs when uncontrollable, malignant cell growth takes place in the tissues of the skin. The skin, as the body’s largest organ, has many layers, but most skin cancers begin in the top, outermost layer of skin, known as the epidermis, which is visible to the eye. The three main types, categorized by the kind of cell in which the cancer began, include:

1. Basal cell carcinoma is the most common type of skin cancer, accounting for more than 80% of skin cancers. These cancers start in the basal cells, which make up the lower part of the epidermis. They typically develop on sun-exposed areas, including the face, head, necks. Basal cell carcinoma usually grows slowly and rarely spreads to other parts of the body, unless left untreated.
2. Squamous cell carcinoma is the second most common type of skin cancer, accounting for about 20% of skin cancers. These cancers are most often found on areas of exposed skin, like the face, lips, ears, scalp, shoulders, and neck, but can develop anywhere. Though most squamous cell cancers can be successfully treated and removed completely, they are more likely than basal cell cancers to quickly spread to other parts of the body.
3. Melanoma is a type of cancer that begins in the melanocytes, the cells responsible for producing skin pigment. Melanomas can develop anywhere on the body, including areas that don’t receive much skin exposure, such as the soles of the feet, palms of the hands, or under fingernails. Though less common than squamous cell and basal cell carcinomas, melanomas are more dangerous and more fatal because of their tendency to spread to other areas of the body.

Most skin cancers are caused by exposure to the sun’s harmful ultraviolet rays, which can damage your skin’s DNA. Over time, this unrepaired damage can build up and trigger mutations and uncontrolled cell growth, which can turn into cancers. While everyone is at risk of skin cancer, some individuals are more likely to develop the disease than others. Unique risk factors that may increase your chances of developing skin cancer include the following:

• Fair skin
• Skin that burns, freckles, or reddens easily
• Blond or red hair
• Blue or green eyes
• Atypical or numerous moles
• Older age
• Family history of skin cancer
• Personal history of skin cancer

Not all skin cancers appear the same way and some may not cause many symptoms. The most common warning sign of skin cancer though, is a change in the skin, such as a new growth, a change in a mole, or a sore that won’t heal. As a result, it’s important to regularly examine your skin for any new growths or spots and talk to your primary care provider if you have any concerns. Here are some other common symptoms to watch out for:

Basal cell carcinoma:

• Small, pink, pearly, white, or translucent bumps
• Brown, black, or blue lesions
• Raised reddish patches that might crust or itch
• Pink growths with raised edges and a lower center
• Flat, firm, pale or yellow skin, similar to a scar
• Open sores that ooze or crust and do not heal or heal and come back

Squamous cell carcinoma

• Rough or scaly red patches (sometimes wart like), which might crust or bleed
• Open sores that ooze or crust and do not heal or heal and come back

Melanoma
This will look like a mole that has an irregular shape, size, or color. We recommend using the ABCDE rule as a guide to melanoma symptoms. Consider the following when evaluating a suspicious spot:

• A - Asymmetry: one half of the mole or spot does not look like the other
• B - Border: edges are blurred, irregular, or ragged.
• C - Color: the color of the spot is not consistent and may include different shades of brown, black, blue, pink, or red.
• D - Diameter: the spot is larger than 6mm in diameter.
• E - Evolving: the spot has changed over time.

At this point in time, there is not an established timeline or age recommendation for clinical skin cancer screenings. The U.S. Preventative Task Force has concluded that there is not enough evidence to support a recommendation for or against routine screenings for those who do not have a history of personal skin cancer. That being said, however, at One Medical, our team is here to support you in your personal health journey and develop a care plan tailored to your unique needs. Whether you have a mole you are suspicious about or would simply like to make a skin exam part of your regular preventative care, our team is happy to help. If you have a personal or family history of skin cancer, or are at high risk of the disease, you should have a discussion with your provider about how often you should have your skin checked.

You can also do a self-check of your skin at any time. Be sure to check every part of your skin, including areas that may not be regularly exposed to the sun, such as your scalp, behind the ears, under your arms, between your toes, and between your buttocks. It helps to use a full length mirror and a hand mirror to inspect any hard to reach areas. You may also want to jot down any observations or notes so that you can track the development of any moles, growths, or suspicious spots over time.

After examining your skin, your provider may refer you to a dermatologist for further evaluation or recommend a biopsy if something appears abnormal. During a biopsy, your provider will numb your skin and take a small sample of tissue to send for the lab for testing. If a skin cancer diagnosis has been made, other tests may be ordered to determine if the cancer cells have spread to other parts of the body and what stage it is. Treatment will largely depend on your age, health history, and the type and stage of the cancer. Treatment for skin cancer can include a combination of surgery, chemotherapy, radiation therapy, targeted therapy, hormonal therapy, or other procedures.

As most skin cancers are caused by overexposure to UV rays, protecting your skin from the sun is one of the best ways to reduce your risk of skin cancer. Follow these tips for better, healthier skin

• Wear sunscreen year round, even in cloudy, foggy weather. The American Academy of Dermatology Association (AADA) recommends applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher whenever you are outside. You should also reapply every 2 hours or after swimming or sweating. For more sunscreen tips, see here.
• Look for shade whenever you're outside. The sun’s UV rays are strongest in the U.S. between 10 a.m. and 4 p.m., so it’s especially important to limit your exposure during these times. A good tip from the AADA: if your shadow is shorter than you are, you should probably find some shade.
• Wear protective clothing that covers the arms and legs, as well as a wide-brimmed hat that shades your head, face, neck, and ears.
• Wear sunglasses that block both UVA and UVB rays, as both are harmful to the skin.
• Avoid indoor tanning, such as the use of tanning beds or sunlamps, as the UV light can damage the skin and cause premature aging.
• Be aware of medications that make your skin more sensitive to the sun. These medications may make you more prone to sunburns so it’s especially important to be diligent with sunscreen and to seek shade while using them.
• Perform regular self skin checks. Routinely examining your skin using the method described above can help you detect skin cancer in its early stages when it’s most treatable.

While the thought of skin cancer may be scary or overwhelming, it’s important to remember that you are not alone. Your primary care provider is there to guide you, answer any questions you may have, and support you through any necessary treatment or follow-up care. At One Medical, we will work with you to develop a care plan based on your unique health needs and goals. Schedule a visit with one of our primary care providers today if you think you are at risk for skin cancer or have any other questions about your health.