What is skin cancer?

Skin cancer is when your skin cells grow abnormally, and it’s often caused by exposure to the sun. If
caught early, it’s very treatable. The two main types of skin cancer are non melanoma and
melanoma skin cancer. Non melanoma cancers affect the upper layers of skin and tend to grow
slowly, whereas melanoma cancers affect deeper layers of the skin and spread more quickly.

Basal cell skin cancer (BCC) is the most common skin cancer. It develops in the cells that line the
bottom of the outer layer of skin, or epidermis and accounts for around 75% of skin cancers.
Squamous cell skin cancer (SCC) develops in the cells that line the top of the epidermis above the
basal layer (around 20% of skin cancers). Both BCC and SCC are types of non melanoma skin cancer.

Melanoma skin cancer is less common than non melanoma skin cancer. It develops from abnormal
cells in deeper areas of the skin, known as melanocytes, and can spread faster than non melanoma
skin cancer to other organs in the body.

The primary treatment for skin cancer is surgery. The type of surgery you’ll need depends on the
cancer’s size, type, and location. Skin surgery is used to treat basal cell carcinoma, squamous cell
carcinoma and malignant melanoma. It might involve removing a mole or lesion, and a small area
around it (excisional biopsy). This is used both to diagnose and treat skin cancer. You might also be
offered shave excision, where raised moles can be removed by a shaving technique that doesn’t
involve having stitches. Punch excision is when a blade removes the problem area and takes a
sample for analysis. Elliptical excision is when a section of skin around the lesion is cut to help skin
heal better. And Mohs micrographic surgery treats skin cancer by removing cells layer by layer,
examining each layer under a microscope until the area is free of cancer. Mohs micrographic surgery
has the highest cure rates and the lowest risk of recurrence for certain types of skin cancer.

Other types of skin cancer treatment include radiotherapy, immunotherapy cream, photodynamic
therapy (PDT), chemotherapy cream, or a combination. Treatment options for more advanced types
of skin cancer that have spread to other organs include chemotherapy, immunotherapy, and
radiotherapy.

Signs of non melanoma skin cancer include a new patch of skin or lump that doesn’t heal within a
few weeks. You might see changes to an existing or new mole, usually on the back, legs, arms, or
face. Melanomas are often more noticeable than a normal mole, irregular in shape, and have more
than one colour. Sometimes they itch or bleed.

Although there are no national skin screening programmes in the UK to check for skin, it’s a good
idea to check your skin regularly, particularly on areas exposed to the sun. If you’re worried about
your skin, arrange to see your GP or a consultant dermatologist as soon as possible.

Your GP will examine your skin and decide whether you need to see a skin specialist. They might
take pictures of the area to email a specialist for advice. Alternatively, you may wish to consult a skin
specialist (dermatologist) immediately. If you see a skin dermatologist, they may take a skin biopsy.
This means they remove some or all the affected area to examine the cells in a laboratory. They will
be able to identify the type of cancer and discover whether it is likely to spread and how to treat it.
In some cases, you can be diagnosed and treated during one appointment.

The best way to protect yourself from skin cancer is to minimise the time you expose your skin to the sun and to wear a high-SPF sunscreen (at least factor 15). Wearing clothes that cover up your skin, a hat, and sunglasses that protect you from UVA and UVB light, can also reduce your risk. And avoid using sunbeds or sunlamps.

Rarely, skin cancer can be fatal, particularly if it spreads. But, in most cases, the outlook is good.
Most non melanoma skin cancer can be cured, and it’s rare for basal cell skin cancer to spread.
Although, in some cases, squamous cell skin cancer can spread to other parts of the body, it can still
be cured. But the sooner your cancer is diagnosed, the easier it is to treat successfully.

Although it’s rare, children can get skin cancer. For example, melanoma, the most severe type of
skin cancer, is found in 300-400 children in the US each year. And, because it’s so rare, it’s often
undiagnosed until the later stages, when treatment may be more difficult. Childhood skin cancer can
also look different from adult skin cancers, with areas becoming itchy or bleeding. And childhood
melanomas can look different too. Lesions might look like a flaky or shiny sore that doesn’t heal.

Non melanoma skin cancer is more common in children whose immune system has been weakened
by an illness or medication. Keeping your child protected from the sun, and using high-SPF
sunscreen, can help reduce the risk of skin cancer.

Yes, anyone of any age can get skin cancer, but it’s rare in children and more common in older fair-
skinned people who have spent long periods in the sun or on a sunbed, especially if they’ve had
sunburn. Certain medical conditions, including solar keratosis and HIV, can also increase your risk, as
can medicines that suppress the immune system, radiation therapy, certain chemicals such as
creosote, and a family history of skin cancer, or having had skin cancer in the past.

Melanin is a natural protective pigment in your skin that protects it from sunburn. People who have
albinism (a condition that’s passed down in families where your skin doesn’t have any melanin) are
also at increased risk of skin cancer. The darker your skin, the more melanin protection you have
against most types of skin cancer. However, people with black skin can sometimes develop a rarer
type of cancer, Acral lentiginous melanoma, on their palms, nail beds, and soles of the feet.

No, moles aren’t necessarily a sign of skin cancer; and having moles doesn’t mean you will get skin
cancer in the future. However, research has shown that the more moles you have, the greater your
risk of melanoma. The best advice is to avoid exposure to the sun and be alert to any changes to
your existing moles or new skin changes. Ask your doctor for advice if you’re worried.