Your skin is the largest organ in your body, and it’s often exposed to dangers. The sun’s rays, for example, can alter your cells and cause the development of skin cancer. 

The sun is the top cause of skin cancer, but you can face additional risks based on your lifestyle choices. Every type of cancer looks different, but most cause changes in the way your skin looks or feels. An at-home exam can help you spot skin cancer, but you’ll need help if you see changes.

Skin cancer is often treated with surgery, but other therapies may help if your doctor can’t cut all of the damaged cells away. 

Protecting your skin from the sun is critical. You must be especially careful if you work in an industry that places you outside during the workday. 

People of color can develop skin cancer too, although their doctors may not spot it right away. Self-exams should happen regularly. 

What Is Skin Cancer?

Skin cancer is an abnormal growth of skin cells. One out of every five Americans will develop skin cancer by the time they’ve reached age 70. 

Nearly every cell in your body is growing and changing. Each change is dictated by DNA within the cell that works a bit like a recipe for growth. When that DNA is altered somehow, growth comes with mistakes. Those errors can lead to cancer. 

The four main types of skin cancer include:

• Basal cell carcinoma. The outer layer of your skin contains many basal cells that produce new skin when old versions die off. Basal cell carcinoma is the most common type of skin cancer.
• Squamous cell carcinoma. Your skin’s outer layer also contains squamous cells, and they also help you produce healthy, new skin tissues. Squamous cell carcinoma can form in patches of skin that seem healthy, and tumors can develop from precancerous skin growths called actinic keratoses.
• Melanoma. Moles transform into this deadly form of skin cancer. Some people develop melanoma on otherwise unmarked skin too.
• Merkel cell carcinoma. This form of skin cancer is rare, but it’s also aggressive. People who have it typically have a virus that begins the transformation to cancer. 

Skin cancer can be deadly, but many types can be prevented. And people who are diagnosed with early forms of cancer can benefit from aggressive therapies that remove dangerous cells and leave healthy tissues behind.

What Causes Skin Cancer?

Sun exposure and tanning machines are the two main causes of skin cancer. But plenty of other factors, including some we can’t control, can enhance your risk. 

Both sunlight and tanning beds emit ultraviolet rays that burrow deep into the skin and change DNA within cells. Researchers aren’t sure how these rays alter DNA, but they suggest that exposure could:

• Limit the body’s ability to kill off cells with damaged DNA. That could allow abnormal cells to live longer lives and eventually become cancerous.
• Alter the body’s ability to limit cell growth. Mutations like this could allow for explosive growth of harmful tumors. 

If you’ve had five sunburns or more during your lifetime, you have double the risk of cancer as someone who hasn’t. Clearly, the sun’s rays (including artificial versions) are deeply damaging to your tissues. 

Where you live can also play a role in risk. If you spend every day indoors, working beneath artificial light, but you head outside on the weekends to garden and barbeque, you could face a higher risk of sunburn and cancer. Conversely, if you live in a place bathed in sunlight all day long and your tissues are exposed to rays 365 days per year, your risk is higher too. 

Skin cancer can also be influenced by your genes. If someone in your family develops skin cancer, you’re more likely to have the same problem too. 

People with fair skin and light-colored eyes have a higher risk of some types of skin cancer. But dark-skinned people can get skin cancer too, and precancerous changes might be harder to spot in their skin. 

Other issues that could cause skin cancer include:

• Infections. HPV could also increase your risk of developing skin cancer. Some forms of HPV are sexually transmitted, but you can get the infection from touching surfaces that have been touched by someone with HPV.
• Radiation therapy. Treatment with radiation can help you address cancer, but years later, that treatment can prompt cancerous changes in your skin.
• Prior skin cancer. If you’ve had a tumor in the past, you’re at higher risk for having another in the future.
• Advancing age. Most cancerous tumors are diagnosed in people 50 and older. 

Some skin cancer risk factors are well within your control. Changing your relationship with the sun, for example, can dramatically reduce your chances of developing cancer. But other factors are much harder to alter.

What Does Skin Cancer Look Like?

Skin cancer often begins on the surface, and as the disease progresses, tumors dig down into supportive tissues. The cancer may look different as it grows, but most cancer types have distinctive characteristics anyone can spot, including people without a medical degree. 

Appearance varies by cancer type.

• Basal cell carcinoma: A flesh-colored growth that is round or translucent is common for this cancer type. Tumors may also be flat and firm, and you may mistake them for scars. You may also have an open sore that bleeds or oozes and won’t close back up.
• Squamous cell carcinoma: A scaly patch of skin or a bump that seems firm and red could indicate this form of cancer. You may also have sores that look like warts, or you may have spots that ooze and crust over again.
• Melanoma: Moles change shape or size. Some bleed. And you may develop moles that you never noticed before.
• Merkel cell carcinoma: A pink, red, or purple sore that grows quickly and doesn’t seem painful could indicate this form of cancer. 

Any unusual skin change could indicate cancer. But it pays to understand how moles typically respond when undergoing cancerous changes. Experts explain appearance alterations by using the so-called “ABCDE rule.”

• Asymmetry: Draw an imaginary line down the center of the mole. One side doesn’t match the other.
• Border: The edges of the mole seem rough, ragged, or blurry.
• Color: The mole isn’t a consistent shade from end to end. Sometimes, it’s streaked with red or pink, and sometimes, it’s dotted with black.
• Diameter: The mole is larger than a quarter inch across. That’s about the size of a pencil eraser.
• Evolving: The mole is a different color, shape, or size than you’re accustomed to. It also seems to change with time. 

Most descriptions of cancer’s appearance focus on light-skinned people, but people with dark skin can get cancers too. Their lesions may also involve new or changing spots or speckles. And they may also experience tumors that bleed, itch, or feel rough to the touch. 

The most common sites for skin cancer are the:

• Face, especially the tip of the nose. 
• Scalp, even in people with a full head of hair.
• Ears, especially the tops. 
• Neck, especially the back. 
• Hands.
• Chest and back, particularly in men. 
• Legs, particularly on shins and calves.
• Palms of hands, soles of feet, and nail beds, particularly in Black people. 

Cancer can appear in other spots too, but these are the locations most closely associated with skin cancer’s appearance. 

How to Search for Skin Cancer

Skin cancer is easier to treat when it’s caught in the early stages. Most experts recommend performing a comprehensive self-exam every month to check for problems on your skin. 

You won’t need fancy equipment to keep your skin safe. A bright light, a full-length mirror, and a handheld mirror are all the tools you will need. 

To perform a self-exam:

• Start at the top. Look into the mirror and check your face, neck, chest, and belly. Lift your arms to check beneath them. Part your hair to look over your scalp, and use the hand mirror to check your neck.
• Examine your arms and hands. Pay close attention to your palms, the space between your fingers, and your fingernails.
• Take a seat. Look over your legs, paying close attention to your shins. Examine your feet, including the soles and toenails. Use a mirror if it helps. That mirror can assist you in checking the back of your thighs and calves too.
• Get personal. Assess the skin on your buttocks, genitals, and lower back.
• Open your mouth. Look over your tongue, gums, and lips. 

If inflexibility limits your ability to check your skin, get help. Pair up with a partner and check one another for changes and alterations. You can also ask for help from nail salon technicians, as they come into close contact with your hands and feet. A barber or hairdresser could also check your scalp for problems you can’t see. 

Take These Three Steps

You’ve performed a self-exam, and you’ve seen something that doesn’t seem quite right. What should you do now?

About half of all melanomas are found by individuals, not by doctors. If you spot an issue, you’re certainly not alone. But it can be hard to differentiate a normal patch of skin from a dangerous one. You’ll need help.

When you see something unusual, do this:

1. Take a photo. Grab your phone and take a photo of what the spot looks like right now. Place something like a quarter or an eraser in the image, so you’ll have an idea of scale.
2. Make an appointment. Reach out to your doctor with your concerns. Send along your photo, so your doctor can see it.
3. Document changes. You may need to wait for an open time to talk with your doctor. Keep taking pictures of your skin, and note anything different that happens. 

If your doctor suspects that your skin change is caused by cancer, you may be referred to a dermatologist for more testing and assessments.

It’s a good idea to develop a relationship with a dermatologist for the long term. You can visit this professional once a year for a full-body skin cancer check.

How Is Skin Cancer Treated?

As Elle, our inhouse biochemist and skin specialist, advises, each form of skin cancer is different, and they call for unique forms of treatment. But in general, medical teams follow the same steps when they suspect skin cancer in their patients. 

To confirm the diagnosis, your doctor will take a sample of your skin and send it to a laboratory. Biopsies like this can help your team understand what type of cancer you have, and that can inform your treatment plan. 

If your biopsy indicates cancer, your team must assess if the dangerous cells have spread and how far they’ve penetrated your body. This staging process is based on the results of your:

• Physical exam. How big is the skin change? When did it appear? Has it grown over time?
• Biopsy. How do the cells look underneath a microscope? How deep are the dangerous layers?
• Imaging tests. Do your x-rays, bone scans, or other similar results indicate that the cancer has spread?

Your cancer’s stage is typically expressed in numerical form. Lower numbers indicate a smaller cancer spread. 

Your cancer can spread in one of three ways.

• Tissues: Nearby cells can develop cancer cells too.
• Lymph: The body’s immune system can pick up cancer cells, and they can lodge within the lymph nodes.
• Blood: Cancer can develop within your blood cells, and that can allow cancers to spread throughout the body. 

Skin cancer is often treated through surgery. Your doctor attempts to remove as many cancer cells as possible while leaving enough healthy tissue behind to allow skin to close up and knit together. Your doctor may offer other treatments too, including radiation, chemotherapy, and immunotherapy.

You have choices as a patient. Don’t be afraid to ask about how the treatment works, what it should do for you, and what side effects you might experience. If you have questions or concerns about the treatment, get a second opinion before you get started. 

Four Ways to Protect Your Skin From the Sun

Exposure to UV rays can enhance your risk of cancerous skin changes. You can’t protect your skin too much. 

Take these four important steps to lower your risk:

• Wear sunscreen every day. Choose a product with a sun protection factor (SPF) of at least 30, and apply it at least 15 minutes before you go outside. Reapply the product every two hours when you’re outside in the sunshine. If you sweat or swim, you may need to put it on more frequently.
• Choose the right clothing. If you’re planning to spend time in the sunshine, slip on long-sleeved shirts and long pants. Pop a hat on your head for extra protection, and keep socks and shoes on your feet.
• Seek out shade. UV rays are strongest between 10 a.m. and 4 p.m. Look for ways to stay out of the bright rays and rest in the cool shade.
• Wear wraparound sunglasses. Tissues around your eyes are thin, and it’s common for skin cancers to appear here. Sunglasses with UV protection can keep this skin protected. 

Sunlight isn’t your only skin cancer risk. Remember to avoid smoking too, as the carcinogens in smoke can change your skin and make it more vulnerable to cancer. And never hop into a tanning bed to darken your skin.

Stay Safe From Skin Cancer While at Work

It’s easy to think about skin cancer prevention when planning a vacation or packing a bag for a day at the beach. But what if you’re exposed to dangers every time you head to work?

Some people have higher skin cancer risks due to their professions, including:

• Pilots. Both cabin crews and pilots have melanoma risks about twice as high as the general population. Sitting in a sun-kissed enclosure high above the clouds means significant amounts of sun exposure.
• Construction workers. Whether your worksite is a road, a roof, or a yard, you’re likely exposed to the sun all day long during bright and sunny summer months.
• Farmers. People who work with plants and animals often have the highest levels of sun exposure.
• Athletes. Golf courses, baseball diamonds, and tracks aren’t known for their ample shade. 

If you’re exposed to the sun all day long while at work, it’s critical to take reasonable steps to protect your skin. Applying sunscreen every day, choosing protective clothing, and wearing sunglasses are critical parts of every workday for you.

Experts also say people like this should have yearly skin cancer checks with an expert since the risks they face are so significant. 

Your Skin Color & Cancer Risk

Skin cancer is often associated with bright, white skin. But anyone of any color can develop cancerous changes in their skin. No matter how dark or light your skin, wearing sunscreen and protective clothing when out in the sun is a smart choice.

Doctors may not know how to spot skin cancers in people with darker skin. Textbooks often use light-colored models in illustrations, and that can mean doctors don’t always understand what changes look like in skin that is darker. 

Cancers in people of color can also appear in places that seem unusual. These cancers may form on the bottom of the feet or beneath the fingernails, for example. Light-skinned people may be more likely to develop skin cancers on sun-exposed areas, such as the tip of the nose or the tops of the feet. 

You know your skin better than anyone else does. Perform your monthly skin checks, and document changes carefully. Bring any changes you see to your doctor, and ask for follow-up testing.

You may need to advocate for your health and your recovery, but your hard work will be worthwhile if it helps you to beat back cancer.

References
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Types of Skin Cancer. American Academy of Dermatology.
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Skin Cancer in People of Color. American Academy of Dermatology.
How to Do a Skin Self-Exam. (July 2019). American Cancer Society.
Skin Cancer. American Academy of Dermatology.
Basal and Squamous Cell Skin Cancer Stages. (July 2019). American Cancer Society.
Skin Cancer Treatment (PDQ), Patient Version. (July 2020). National Cancer Institute.
Do’s and Don’ts. Skin Cancer Foundation.
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Sun Safety. (April 2020). Centers for Disease Control and Prevention.
How Do I Protect Myself from Ultraviolet (UV) Rays? (July 2019). American Cancer Society.
Focus on Eyelid Skin Cancers: Early Detection and Treatment. (September 2018). Skin Cancer Foundation.
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