Skin Cancer
Skin cancer is by far the most common type of cancer. In the United States, one in five individuals will develop skin cancer in his or her lifetime. For this reason, getting full skin checks with your dermatologist at least once a year is recommended. Here are answers to some of the most common questions about skin cancer.
Basal Cell Carcinoma
Squamous Cell Carcinoma
Melanoma
1. What does skin cancer look like?
Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma are the three most common types of skin cancers. BCC usually appears as a non-healing pimple, a pearly-colored bump, or a light patch. SCC presents as a scaly patch or bump. Melanoma typically appears as a dark, irregular spot. The ABCDEs of melanoma warning signs include asymmetry, border irregularity, color variability, diameter greater than 6 mm (the size of a pencil eraser), and evolution or change in the lesion.
2. What's the difference between BCC, SCC, and melanoma?
BCC, SCC, and melanoma originate from the three most common types of cells in the epidermis, the top layer of the skin: basal cells, squamous cells, and melanocytes, respectively. BCC tends to be slow growing, stays localized, and is rarely life threatening. When treated early, SCC has an excellent cure rate, but when left untreated can spread and cause serious complications. Melanoma is fast growing, aggressive, and can be fatal if not treated early.
3. What are the best ways to prevent skin cancer?
Most skin cancer is due to prolonged ultraviolet (UV) radiation. For this reason, the best prevention of skin cancer is staying out of the sun during peak hours (10 am to 4 pm), avoiding tanning beds, and wearing broad spectrum sunscreen with regular re-application every two hours.
4. What should I look for in a sunscreen?
The two most important characteristics to look for in sunscreens are: broad-spectrum (protects against UVA and UVB) and has a SPF 30 or higher. If you are active, a sunscreen with water resistance will also be more effective. When outside, sunscreen should be re-applied every two hours.
5. I wear sunscreen every day, why did I still get diagnosed with skin cancer?
Most skin cancers are a result of sun damage before the age of 18. Cumulative sun damage is the main risk for BCC and SCC, whereas intermittent episodes of severe or blistering sunburns at a young age predispose to melanoma later in life. Keep wearing sunscreen – all the sun protection you utilize today will pay off down the road!
6. What is the difference between a standard excision and Mohs surgery?
A standard excision is recommended for treatment of low risk skin cancers in low risk areas (trunk and extremities). Here, the surgeon takes a standard margin of 4 mm around the lesion and sends the tissue out for review, which can take around a week to process. Mohs surgery is recommended in a subset of skin cancers occurring in high risk locations (head, neck, hands, feet), with high risk features (fast growing, large size), or in patients who are immunocompromised. Mohs surgery combines surgery with pathology on the same day, which allows smaller margins and a complete microscopic examination of the tissue. Mohs surgery has the highest cure rate of all skin cancer treatments.
7. After one skin cancer, what are the chances of developing another skin cancer?
In patients who have been diagnosed with one skin cancer, there is an approximately 40% chance of another forming elsewhere on the skin in the subsequent three years. For this reason, it is recommended to have a skin check every six months after a diagnosis of skin cancer.
8. How often should I get full skin checks?
The American Academy of Dermatology recommends a full body skin exam once a year with a board-certified dermatologist to screen for skin cancer for those without a personal history of skin cancer or twice yearly if there is a personal history. Check in earlier if you notice any changing, bleeding, dark, or symptomatic spots on the skin. Partner with your dermatologist to promote lifelong good skin health!