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Understanding Skin Cancer: Symptoms
The symptoms of skin cancer can be subtle, meaning you may not notice that there's anything wrong, at least at first. Over time, that changes, and the symptoms become more clear.
"The symptoms of skin cancer become more obvious the longer the skin cancer has time to develop," says Philip Scumpia, MD, a clinical dermatologist and dermatopathologist at the UCLA Health Jonsson Comprehensive Cancer Center in Los Angeles.
The timeline, says Scumpia, can depend on the type of skin cancer that you have.
"Some skin cancers, like melanoma, may grow and change rapidly, while others like basal cell carcinoma, may take months to years to change," he explains.
Diagnosing skin cancer early is critical. Not only does early skin cancer require less invasive treatment, it also has the highest chance of getting rid of the cancer before it spreads to other parts of your body. When the cancer spreads, it becomes what's called metastatic, and it's much harder to treat. This happens most often in a dangerous type of skin cancer called melanoma, which is much less common than some other kinds of skin cancer, such as basal cell carcinoma.
"In many cases, when skin cancer is detected and treated promptly, it can be cured," says Michele Green, MD, a cosmetic dermatologist at Northwell Lenox Hill Hospital in New York City. "To prevent skin cancer from progressing and affecting other systems, it is crucial to identify and treat it as soon as possible."
Basal cell carcinoma may appear on sun-exposed skin as:
Squamous cell carcinoma may appear on sun-exposed skin as:
The general warning signs of skin cancer include:
"Many times, [skin cancers] start as a subtle pink, red, skin-colored, tan, or brown spot that does not go away," says Scumpia.
The following are other general signs of possible skin cancers:
Remember, skin cancer can present differently in different people, so yours may not look like someone else's. As Green points out, your skin color and any existing skin conditions — eczema, for example — can affect what your skin cancer looks like.
"Conditions like eczema, which causes dry patches, can influence how skin cancer appears, as eczema causes red, itchy skin, which can alter the appearance of the cancer," says Green.
Melanoma is the most deadly type of skin cancer. It grows faster than more common types of skin cancer, such as basal cell carcinoma and squamous cell carcinoma. It's more likely to spread to other parts of your body. Though it only accounts for about 1% of all skin cancer cases, it causes the most skin cancer deaths. But it can be cured if caught early. That makes it critical to quickly spot the symptoms of this skin cancer. Warning signs of melanoma include changes to existing moles or new growths on your skin, often — though not always — in places that get exposed to sunlight. Signs to look for include:
Your moles can be cancerous even if they only have one or two of the above signs. Don't ignore any moles that show any of these signs.
In addition to moles, melanoma also can be indicated by open sores, patches of scaly skin, and raised bumps.
You also can develop hidden melanoma, meaning it occurs on parts of your body not exposed to the sun, such as:
Certain types of hidden melanoma can develop inside your body. This can make them very hard to detect. For example, you can develop melanoma in your eye (ocular melanoma), which can cause vision changes. Mucosal melanoma develops in your mucus membranes, found in your nose, mouth, esophagus, and elsewhere. A third type — acral lentiginous melanoma — develops under a fingernail or toenail or on the palms of your hands or soles of your feet. Hidden melanomas are more common in brown or Black people. Acral lentiginous melanoma is also more common in Asian people.
Also referred to as squamous cell carcinoma, this is the second most common type of skin cancer, after basal cell skin cancer. It develops in the squamous cells, which make up the middle and outer layers of your skin. Most of the time, it's caused by ultraviolet (UV) light from the sun or artificial light sources such as tanning beds and tanning lamps. It's not often fatal. But if left untreated, it can grow and spread to other parts of your body, causing serious complications, which can be life-threatening.
The symptoms of squamous cell skin cancer include:
Squamous cell skin cancer can develop anywhere on your body. Most often, though, it occurs on parts that get exposed to the sun. In brown and Black people, it is more likely to develop on skin that does not get exposed to the sun. It can develop on your genitals, inside your anus, and in the tissue under your fingernails and toenails.
The most common type of skin cancer — and, worldwide, the most common of all types of cancer — is basal cell skin cancer, which affects nearly 1 in 5 Americans. It develops in the lower part of your epidermis, which consists of the outer layers of your skin. Commonly referred to as basal cell carcinoma (BCC), it's rarely fatal. But it can destroy skin and be disfiguring if not treated early. Fortunately, it often can be cured with a simple outpatient procedure called Mohs surgery, which removes the cancerous growth. It's very rare for BCC to spread, or metastasize, but if that happens, it can be life-threatening. So make sure to get treated right away.
BCC usually develops on sun-exposed skin, often on your head or neck. But it also can occur on parts of the skin not typically exposed to the sun, such as your genitals.
Here are the symptoms of basal cell skin cancer to watch for:
Basal cell skin cancer can look different in different people. If you see any unusual signs on your skin, even if they don't match the above descriptions, play it safe and call your doctor.
Familiarize yourself with how skin cancers look so that you can recognize anything that appears abnormal on your skin. Set aside time to examine yourself on a monthly basis.
"Regular self-examinations are an effective method for detecting potential skin cancer in your body," says Green. "Everyone should perform these examinations, but it is especially important for those at higher risk of developing skin cancer."
Here's how to do it: Examine your skin from head to toe using a full-length mirror and hand mirror to check your mouth, nose, scalp, palms, soles, backs of ears, genital area, and between the buttocks. Cover every inch of skin and pay special attention to moles and sites of previous skin cancer. You won't be able to see all parts of your body, so ask your spouse, partner, or someone else you feel comfortable with to help. If you find a suspicious growth, have it examined by your dermatologist.
"It is likely that benign conditions may also be identified accidentally, but it is better to be safe than sorry," says Scumpia.
The ABCDE rule is used to help spot melanoma, the most serious form of skin cancer. Each letter in the rule stands for a different sign to look for. It can be helpful when you do your self exams.
A for asymmetry. This means that one half of a mole looks different from the other half.
B for border. Melanoma moles have irregular borders that may appear ragged or notched or have indistinct edges, and the color of the mole may spread into the skin around it.
C for color. A melanoma mole can come in a variety of colors. It may show shades of brown, black, and tan, possibly with areas of white, red, pink, gray, or blue.
D for diameter. Most melanoma moles measure about 1/4 inch in diameter and may grow larger.
E for evolving. A melanoma mole changes in appearance over weeks or months.
To use this rule most effectively, ask your doctor for a brochure with pictures, Scumpia recommends. Go through the pictures with your doctor to better understand what you're looking for. Then, when you do your self exam, you'll have the rule and images to guide you.
"Anything that reminds patients to perform a self exam is a good tool to raise awareness of spots on their skin," says Scumpia.
Remember, the ABCDE rule may not capture all melanomas. If you have suspicious skin growths, changes to existing moles, wounds that don't heal, or other concerning signs, call your doctor.
The ugly duckling sign
In addition to the ABCDE rule, the ugly duckling sign can be helpful when you do a self exam. Basically, what you're looking for is a mole or other spot that's different from those elsewhere on your body.
"Either this is the only spot that the patient has, or this is the only spot that looks different when you compare it to all the other spots," says Scumpia.
If you find an ugly duckling sign, get it checked right away by a doctor.
Skin cancer can appear in many ways. Its symptoms depend on the type of skin cancer as well as how advanced it is.
If you have any concerns about abnormal looking moles, spots, or other growths on your skin, see a doctor as soon as possible.
Skin cancer often can be cured easily when caught early.
What does skin cancer look like?
Skin cancer comes in many forms. It can cause new growths on your skin and changes to moles already there. How it looks depends largely on the type of skin cancer and how far it has progressed. If you notice anything suspicious on your skin, have it checked out.
What are the first signs of skin cancer?
It often begins with subtle spots that may be close in color to the rest of your skin. Such spots do not go away and likely will change over time as the cancer progresses.
Does skin cancer itch?
Not always, but some cancerous growths do cause itching. This usually happens only after they've grown quite a bit.
Does skin cancer hurt?
It can. Skin cancer growths may be painful or tender to the touch, and some may cause a burning sensation when exposed to the sun.
What's Causing The Bumps On My Scalp?
Folliculitis is a skin infection caused by damage to your hair follicles. This infection can result in raised red bumps that look similar to acne pustules. Other symptoms include pain, stinging, and pus drainage from the site of the infection.
Treatment
You can usually treat folliculitis at home. Try applying a warm compress or using antibacterial shampoo. At-home remedies may help reduce pain, discoloration, and drainage.
If you experience additional symptoms, such as a fever, or your symptoms do not improve, you may need to talk with a doctor. Sometimes, the infection may require treatment with an antibiotic or antifungal medication.
Scalp acne refers to breakouts that happen on your scalp. These bumps can be painful, itchy, red, or inflamed. They may also bleed. Like any other kind of acne, they can result from:
Buildup from shampoo or hairspray can also cause scalp acne.
Treatment
Treating scalp acne sometimes starts with switching up your hair care routine. You can try avoiding oil-based hair care products, which can clog pores. Washing your hair often can also help reduce oil buildup.
If changing your hair care routine doesn't work to treat your scalp acne, you may need to talk with a dermatologist for recommendations to avoid scalp acne.
An allergic reaction or hypersensitivity reaction to a hair product or something else in your environment can cause bumps on your scalp.
Hives may itch, peel, or feel dry and scaly. They typically appear quickly and last a short time.
Treatment
After washing your scalp with cool water and rinsing off irritants, your allergic reaction may subside. If it doesn't, or if you are having frequent recurring allergic outbreaks on your scalp, you may need to speak with a doctor. They may be able to help identify the irritant and prescribe treatment to resolve your symptoms.
Head lice are tiny insects that can live on your scalp. They're highly contagious and can cause itching and bumps on your scalp. Scratching may also result in bleeding.
Treatment
Treatment at home for head lice usually begins with a special shampoo with insecticide ingredients. You will also have to comb through your hair with a special fine-toothed tool to find and remove lice eggs (also called nits). Getting rid of lice usually takes multiple treatments and removing nits every 2 to 3 days for 2 to 3 weeks.
If you have lice, you'll need to treat all fabric surfaces in your house (such as pillows, bedding, and upholstered furniture) to prevent re-infestation. If at-home treatment attempts aren't successful, a doctor may recommend a different lice medication.
Pilar cysts are caused by keratin buildup in pockets of skin under your scalp.
The cyst itself is the only symptom, and you shouldn't feel pain to the touch.
Treatment
Pilar cysts usually don't require treatment. These cysts are not harmful to your health, but you may want to treat them for cosmetic reasons or if it feels uncomfortable. Treatment may include draining the cyst or having it surgically removed.
Pilar cysts can last for years or may go away on their own.
Scalp psoriasis is a chronic skin condition characterized by thin, silvery scales in patches on your scalp. Sometimes these scales can feel bumpy to the touch, and they often itch. Scalp psoriasis can occur whether or not you have psoriasis elsewhere on your body.
Psoriasis is considered an auto-immune condition.
Treatment
Your doctor may also recommend a prescription medication if your scalp psoriasis starts to cause other issues, like hair loss.
Skin cancer is the most common type of cancer. Flesh-colored bumps on your head and recurring sores on your scalp can be indicators of skin cancer.
Though uncommon, other types of cancer can also metastasize to the brain or bones and cause bumps on the head.
If you notice a suspicious spot on your head, it's best to let your doctor know at your next appointment.
Treatment
Skin cancer is treatable, especially if it's diagnosed early. Treatment may include:
What Is Skin Cancer?
Skin cancer is the uncontrolled growth of abnormal skin cells in skin tissue. The most common type is nonmelanoma skin cancer, which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These types are highly curable if detected and treated early. Symptoms can include a red, pearly white, or darkly pigmented bump (depending on your skin color). You might develop a patch of skin that bleeds, crusts over, or does not heal.
Melanoma is less common but more dangerous than SCC and BCC. This type may appear as a mole that changes in shape, size, or color. Other melanomas may look like a sore that does not heal or a dark streak under a fingernail or toenail.
Skin cancer is the most common cancer, with one in five Americans developing it in their lifetime. People of all skin tones can develop skin cancer, although light-colored skin and hair increase the risk. Most cases and deaths are due to excess ultraviolet (UV) radiation exposure from the sun or tanning beds.
Skin cancers differ by the type of cell that's affected. The most common skin cancers include nonmelanoma skin cancers and melanoma. Merkel cell cancer is a rare type of skin cancer. Basal Cell Carcinoma (BCC) BCC tends to be a slow-growing cancer, accounting for roughly 80% to 90% of all skin cancers. This type starts in the small, round basal cells of the innermost layer of the epidermis (outer skin layer). Squamous Cell Carcinoma (SCC) SCC is the second most common type of skin cancer. This type develops in the flat, fish-scale-shaped cells located above the basal cell layer of the epidermis. Melanoma Skin Cancer Melanoma is less common than BCC and SCC but is more severe. This type arises from melanocytes, or the skin's pigment-producing cells. Merkel Cell Cancer Merkel cell cancer, or neuroendocrine carcinoma of the skin, is an uncommon skin cancer. This type develops in sensory cells (Merkel cells) that reside in the deepest layer of the epidermis. Merkel cell cancer is among a group of rare cancers of the skin, including cutaneous lymphoma, Kaposi sarcoma, and others. These account for just 1% of all skin cancers. Skin cancer usually develops on sun-exposed areas of the body, such as the scalp, face, ears, neck, chest, arms, and hands. Cancerous lesions can appear anywhere, even in the genital area. People of color may develop skin cancer in the mouth, on the palms of the hands, or underneath the nails. What skin cancer looks like varies widely, and each type has its own features. General skin cancer signs and symptoms include: A brown patch of skin (in people of color) A mole that changes in shape, size, color, or feel A new growth A sore that does not heal Basal Cell Carcinoma BCC might look like: A scar A pink, red, pearly white or black bump A raised, reddish patch An open sore Squamous Cell Carcinoma SCC can present as: A raised growth, possibly with a depression in the middle A rough, scaly patch that might bleed or crust A wart-like lesion An open sore Melanoma Melanoma often shows up as a new spot on the skin. This so-called "ugly duckling" looks different from all other surrounding skin. Melanoma can also show up in an existing mole. It's important to be aware of any spots or moles in either case. The "ABCDE rule" may help you identify potential melanomas: A for asymmetry: One half of the spot or mole does not match the other half. B for border: The perimeter is ragged. C for color: The spot or mole has multiple hues. D for diameter: Melanomas can range in size but are often larger than a pencil eraser. E for evolving: The spot or mole is changing in size, shape, or color. Most skin cancers are due to overexposure to UV radiation from the sun. Sun lamps and tanning beds are also sources of this form of radiation. Skin cancer typically affects skin-exposed areas of the body but can also affect skin that does not get much sun exposure. UVA rays are known for long-term skin aging, while UVB rays are associated with sunburns. UVB can damage the DNA in your skin cells, which is the cause of most skin cancers. Research has shown that UVA rays can also play a role. Risk Factors Skin cancer is most common in older adults, but it can occur in young, otherwise healthy people. People with a weak immune system are also vulnerable. Other risk factors include: A history of excess sun exposure or sunburns A personal or family history of skin cancer Blonde or red hair Certain atypical moles or a large number of moles Light-colored skin Skin that easily burns, freckles, reddens, or becomes painful in the sun The diagnostic process begins with a health history to assess your risk factors for skin cancer. A healthcare provider will then perform a physical exam and a skin biopsy. They may use a magnifying device called a dermatoscope to evaluate any suspicious skin lesions. The healthcare provider will numb any suspicious areas and then take a sample to examine under a microscope. The healthcare provider may also feel nearby lymph nodes to see if they are larger or firmer than normal. They might perform a lymph node biopsy to figure out if the cancer has spread, especially if melanoma has been diagnosed. BCC and SCC do not usually spread beyond the skin. Common diagnostic tools include: Blood tests: Detects whether the immune system is fighting a disease Fine needle aspiration: Extracts a cell sample using a thin needle Imaging tests: Checks whether the cancer has spread to nearby lymph nodes or distant organs Sentinel lymph node biopsy: Uses radiation and blue dye to identify affected lymph nodes and surgically removes them Surgical biopsy: Removes the enlarged lymph node Stages of Skin Cancer A healthcare provider typically does not need to stage BCC and rarely SCC since these cancers do not typically spread. They will stage melanoma, in contrast, based on how big it is and whether it has spread. Staging melanoma helps guide treatment. Melanoma stages range from 0 to IV, including: Stage 0: The cancer is localized in the epidermis, also known as melanoma in situ. Stage I: The tumor is no larger than 2 millimeters (mm) and may be ulcerated. Cancer cells have not spread beyond the epidermis. Stage II: The tumor is larger than 1 mm, might be thicker than 4 mm, and can be ulcerated. Cancer cells are still localized in the epidermis. Stage III: The cancer has spread to nearby lymph nodes or skin, also known as satellite tumors. Stage IV: Cancer cells have spread to nearby lymph nodes and distant body parts, such as the lungs, brain, or spinal cord. Several factors determine the best course of treatment for skin cancer. Treatment often depends on the type, location, and severity of the cancer. Treatment options may include: Chemotherapy: Delivered topically or systemically (i.E., through a vein or by mouth) Cryotherapy: Freezing the skin cancer with liquid nitrogen Immunotherapy or targeted therapy: Specialized cancer medicines Photodynamic therapy: Combining laser light and a topical agent to kill cancer cells Radiation therapy: Often for cancers that are hard to treat surgically or for tumors that have spread Surgery: Scraping and burning off the lesion, cutting it out, using laser light to destroy the cancer, or removing a layer of tissue at a time (Mohs surgery) Topical treatments: Using creams or gels to attack the cancer You can do many things to minimize your risk of skin cancer. These include: Avoid tanning outdoors or indoors. Never use tanning beds Check your skin monthly Consider having a dermatologist perform an annual full-body screening. Get checked out any time you develop a new or suspicious spot on your skin Don a pair of UV-protective sunglasses For days when you know you'll be in the sun a lot, opt for special apparel that offers sun protection Put on a hat with a wide brim to protect your head, face, ears, and neck Seek shade, especially during the midday hours Wear a broad-spectrum, water-resistant sunscreen with an SPF of at least 30 that blocks UVA and UVB rays Wear tightly-knit, dark-colored clothing that covers your arms and legs Skin cancer can increase the risk of health complications. Related conditions include: Anxiety and depression: A skin cancer diagnosis can invoke strong emotions, including anger, fear, and sadness. It's not uncommon for these emotions to result in anxiety and depression. Research has shown that these mental health conditions are common in people with melanoma. Lymphedema: This swelling results from the build-up of lymph (fluid containing white blood cells that fight infections) in soft tissues. Some evidence suggests that people with skin cancer often develop lymphedema within 12 months of treatment. Skin infections: A study published in 2022 found that surgical site infections are one of the most common complications of surgery for skin cancer. The researchers noted that Staphylococcus (staph) bacteria cause nearly 76% of these infections. Staph infections cause painful, red, and swollen skin. Skin cancer can be highly treatable if diagnosed and treated early. BCC and SCC are associated with better outcomes than melanoma, which is more aggressive. Localized melanoma has a five-year survival rate of over 99%, whereas distant melanoma has a 35% survival rate. Research has shown that Asian, Black, and Hispanic men with melanoma are more likely to die from melanoma than women. This is likely because people with darker skin are likelier to be diagnosed with melanoma at later stages when the prognosis is poor. Melanoma often presents differently in people with darker skin than lighter skin. Due to a lack of awareness, healthcare providers might mistake melanoma for other skin conditions. The American Academy of Dermatology (AAD) released a Skin of Color Curriculum in 2022 in an effort to diversify educational materials. This advancement can help experts diagnose melanoma earlier in people with darker skin and improve health outcomes.Thanks for your feedback!
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