Many people often wonder, “what does skin cancer look like?” It can be difficult to know when to be concerned about a new spot on the skin. As we get older, new spots appear more and more over time. The vast majority of these are harmless, however it is easy to miss a new skin cancer among the benign skin spots. This blog post is to help point out some of the warning signs for a new skin cancer and some of the typical appearances of the three main types of skin cancer.
Basal cell carcinoma
Basal cell carcinoma (BCC) is the most common type of skin cancer. This often appears in areas of our skin that have been exposed to sun on a regular basis over time, such as the face, scalp, neck, or arms. This type of skin cancer has different growth forms, the two most common of which are called superficial and nodular.
A superficial BCC will often appear as a flat pink patch on the skin surface that might be slightly shiny compared to nearby normal skin. You may see small blood vessels in this patch and its edges may be slightly raised. Its edges are often blurred and blend in with surrounding normal skin. This may be slightly itchy but might also be something you don’t feel at all.
A nodular BCC often starts to grow as a small pink bump. Initially this bump is usually smooth, but as it grows over time, it can get slightly flaky. With continued enlargement, a nodular BCC will start to form a sore in the center of the punk bump, which is often described as “never healing” or “bleeding on its own.” This central sore (ulceration) will deepen and cause the edges of the growing cancer to look “rolled” like the crust of a pizza.
Squamous cell carcinoma
Squamous cell carcinoma (SCC) is slightly less common than BCC. This type of cancer can arise on its own or from a precursor growth called an actinic keratosis (AK). AKs tend to be flat light pink spots with round scale light sandpaper. These might initially be confused for rash or dry skin but just don’t heal or resolve.
Certain types of SCC may just be a slowly growing pink area with scale, but what is often different from an AK is it will start to feel raised or thickened rather than completely flat. The redness can be sore or itchy, and an SCC can start to bleed spontaneously and become crusty.
Other types of SCC can appear and grow very suddenly and dramatically, often with a dome shape or volcano shape due to a central crusty depression or crater. These tend to bleed easily and have abundant dry scale on the surface. Redness is a prominent feature compared to surrounding normal skin.
Melanoma
Melanoma is the most serious of the common types of skin cancer, making early diagnosis especially important. Although there are some uncommon cases that have different appearances, most melanomas produce some pigment and create a brown spot on the skin. This brown spot may be new, growing, changing, irregular in shape or color, or particularly darkly pigmented.
There is a mnemonic called the “ABCDE”s of melanoma meant to make it easier to remember some of the warning signs when looking at pigmented spots on the skin:
- Asymmetry: one half is unlike the other half
- Border: an irregular, scalloped, or poorly defined border
- Color: variations of tan, brown, black, and sometimes white, red, or blue
- Diameter: melanomas are usually greater than 6mm (size of a pencil eraser)
- Evolving: anything that looks like a mole but is changing while others aren’t
The cancer.org website has some nice example images of these three types of skin cancer as well as some benign skin growths that can look similar to the skin cancers: skin cancer examples.
There are other types of skin cancer than the three listed above. If you have any questions or concerns about what you are seeing on your skin, please call us at Summit Dermatology in Colorado Springs and Monument, CO to make an appointment with one of our board-certified dermatologists.