What Does Skin Cancer Look Like?

What is skin cancer?

Skin cancer continues to be one of the most common types of cancers in the world, with its incidence rising over the years.

The skin is made up of several skin types and each of these can give rise to skin cancer. The superficial layer of the skin, the epidermis, is composed mainly of squamous cells or keratinocytes which make up its bulk. At the base of the epidermis is a layer of tall, column-shaped cells called the basal cells that rapidly divide and proliferate, giving rise to the squamous cells. Along the basal cell layer, there are also melanocytes - the pigment producing cells.

Types of skin cancer

• Cancer arising from the squamous cells is called squamous cell cancer (SCC).
• That arising from the basal cell layer is called basal cell cancer (BCC).
• Cancer of the melanocytes is called melanoma.

Each of these skin cancers usually present with distinct clinical features, making the diagnosis easy. However, in the initial stages, it may be difficult to diagnose skin cancer as the telltale signs may not be fully developed.

While it is common for people to have several moles all over the body, there are a few signs that are alarming and need a detailed evaluation by an expert.

Signs and symptoms of skin cancer

These different types of skin cancer can all present with distinct features, signs and symptoms However, any lesion on the skin that has the following features should alert you to visit your dermatologist at the earliest:

• Any change in the size of a mole. A rapidly increasing mole is an alarming sign and must be evaluated.
• Any change in the colour of a mole. For example, if it was dark brown to begin with and has been recently appearing black or grey, it is time to get it checked.
• Any itching, redness or soreness in a pre-existing mole.
• Any bleeding or discharge from the mole. Often, cancerous moles develop bleeding due to the rapid and unchecked growth of cancerous cells. Also, faulty blood vessels are present in cancerous lesions, often giving rise to easy bleeding on minor trauma.
• Any ulceration of the skin overlying the mole
• The borders of the mole appear different. This often means that the periphery of the mole has some activity going on and potentially cancerous cells could be spreading from there.

The ABCDEs of moles

A: Asymmetry

If the overall appearance of a mole is asymmetrical, with too much variability in its appearance, it is likely that it may be cancerous. If there are areas in which the mole is thickened and others where it is flat, it further signifies asymmetry.

B: Border

If the border of a mole is uneven, it is another sign pointing to the possibility of malignancy. It may denote the spread of the cancerous cells into the surrounding skin in an uneven manner.

C: Colour

If there are a lot of different colours in a mole - brown, dark brown, black, grey, bluish-grey, it could be a sign of melanoma. This is because pigment placed at different levels in the skin gives a different appearance to the mole at the surface of the skin. For example, pigment in the deeper layer appears greyish blue. Pigment that is more superficial appears brown. Thus, a lot of different colours signify the presence of pigment at multiple levels in the skin. This means that the cells are scattered all throughout the skin, increasing the possibility of the mole being cancerous.

D: Diameter

Any mole with a diameter greater than 6 mm should be thoroughly evaluated.

Benign moles typically remain smaller than 6 mm. Any change in the size of the mole should alert you and you can reach out to your dermatologist.

E: Evolution

Any CHANGE in the appearance of a mole should be evaluated thoroughly. Often, moles that have existed for several years can suddenly turn malignant and this shows up as a change in the appearance - the colour, size and shape of the mole. So it is important to keep an eye on existing moles and do a mole checkup regularly.

What does melanoma look like?

Since melanomas arise from melanocytes which produce pigment, they typically start off as dark brown moles which can eventually develop many other colours - based on the depth of the spread.

To begin with, they are often flat and uneven looking. Over time, melanomas can develop an uneven texture and thickening of the skin surface. They may even develop nodules.

What does squamous cell carcinoma look like?

Squamous cell carcinoma often arises from precancerous lesions like actinic keratoses.

Actinic keratoses are premalignant lesions on the skin. These are most common in individuals with lighter skin tones. They appear red and raised with a rough, dry white-yellow scale on top. Patients can often feel a change in the texture of skin even if the area is not raised. It may sometimes also feel gritty. In some cases, actinic keratoses can turn cancerous, giving rise to squamous cell cancer. Early treatment of actinic keratoses will ensure this does not happen.

SCCs can appear as reddish nodules or patches on the skin, which are raised above the surface. They often ulcerate, causing long standing wounds which tend to bleed.

What does basal cell carcinoma look like?

Basal cell carcinoma is also called rodent ulcer. It is because it eats away into the surrounding skin and spreads locally rather than metastasizing.

It often starts off as a pearly white nodule which has prominent blood vessels on it. It often ulcerates to leave a sore that does not heal.

Some other rare types of skin cancer include Merkel cell carcinoma, dermatofibrosarcoma protuberans, cutaneous T cell lymphoma and sebaceous carcinoma.

What do metastases to the skin look like?

Apart from cancers which arise from the skin itself, it is possible for cancer of the internal organs to spread to the skin. Cancerous cells from any organ such as the lung can enter the bloodstream and spread widely across the body, even reaching the skin (the dermis which has a rich blood supply). Here, the cancer cells take hold and start growing.

These can look as red, fleshy and firm or hard growths on the skin. Often, multiple such masses appear together and start growing suddenly. It is a sign of late stage cancer.

What does skin cancer on your face look like?

Skin cancer on the face can either be BCC, SCC or melanoma.

Often, BCCs arise near the eyelids. This is the most common side for a BCC. Others include the cheek, upper half of the face and forehead. It is a raised nodule that then eventually ulcerates to leave a wound that may bleed.

Melanomas on the face can appear as an irregular mole. They can appear anywhere on the face.

What does skin cancer on the arm or hand look like?

The arms are a highly sun-exposed area, especially the extensor (the outer) aspect of the arms as well as the top of the hands. They are exposed to sun over several years and hence develop uneven, blotchy pigmentation in the form of light and dark spots. They can also develop precancerous lesions called actinic keratosis. As explained, actinic keratosis are precursors of squamous cell carcinoma.

Here, skin cancer can appear as a raised mass or a flat mole, often against a background of uneven pigmentation.

Wearing long-sleeved clothing will ensure that your arms and legs are protected from unnecessary UV exposure. UPF or UV protection factor clothing is available nowadays. Certain fabrics have naturally more UV-blocking capacity based on their weave, thickness and density of the threads. A UPF rating of over 25 will provide a good level of protection against UV radiation. This will also help prevent the typical signs of premature ageing such as fine lines and wrinkles and age spots.

To tackle the appearance of patchy pigmentation and also to prevent the development of skin cancer, it is essential to use sunscreen regularly. The SunsolveMD Mela-Fix Technology is enhanced with clinically-proven ingredients that inhibit the production of melanin pigment, thus preventing signs of premature ageing such as uneven skin tone, age spots and blotchy pigmentation.

Additionally, the Sunsolve SolveVolumeRestore also restores the skin’s lipid barrier and elicits visible plumping and volumizing effects as it contains fatty acids, in addition to providing excellent sun protection. This can also keep the skin on the hands looking plump and fresh.

What does skin cancer on your lip look like?

Here, skin cancer can often present as an ulcer or a longstanding wound that is not healing. It usually begins as a growth or a nodule. The lower lip is a common site for skin cancer. Here, it can either be a squamous cell carcinoma or basal cell carcinoma.

It often spreads onto the skin around the lips, resulting in a deformed appearance.

What does skin cancer on the legs look like?

In women, skin cancer often appears on the legs. It is one of the commonest sites for skin cancer. It can appear as a small mole or bump that then grows bigger.

Here, it can either be a SCC or a melanoma.

Like the arms, there can be other signs of photodamage seen such as uneven pigmentation and blotchiness. Using a sunscreen will reduce the chances of one developing skin cancer. Products such as SunsolveMD TheSolve ™ have the advantage of non-nano zinc oxide to quench free radicals arising from sun damage and pollution in order to shield your skin.

Dermoscopic evaluation of a mole

Your dermatologist can expertly evaluate any mole in order to determine whether it is benign or malignant. Features such as variability in color, border and texture of the mole are noted. A specialised device called a dermoscope is often used to evaluate a suspicious lesion. The terrain as well as the subsurface characteristics of the mole can be determined using a dermoscope.

A dermoscope also allows your dermatologist to take photographs of the lesions which can then be evaluated at a later date to see if there is any change in the appearance of the mole.

Preventing skin cancer

There is significant evidence to show that cumulative exposure to sunlight increases the risk of all types of skin cancer significantly. It is important to avoid unnecessary sun exposure in order to minimise your risk of developing skin cancer.

It is imperative to practise sun safety in order to reduce your risk of skin cancer. The American Academy of Dermatology (AAD) recommends diligent use of a broad-spectrum sunscreen with a SPF of at least 30 or more.

In fact, products such as our Sunsolve Anti Hyperpigmentation Mineral SPF50 are formulated with non nano zinc and also includes other skin brightening ingredients, thus providing powerful UV protection and correction of skin tone complexion. This is a particularly good option for the face.

As explained above, UV rays lead to DNA damage in the skin. Our non-nano zinc oxide sunscreen SunsolveMD SolveDNAReverse ™ utilises a repair enzyme which can reverse UV-induced damage to the DNA. This further minimises the risk of developing skin cancer and can be safely used all over the body.

References

Wen, D., Khan, S. M., Ji Xu, A., Ibrahim, H., Smith, L., Caballero, J., Zepeda, L., de Blas Perez, C., Denniston, A. K., Liu, X., & Matin, R. N. (2022). Characteristics of publicly available skin cancer image datasets: a systematic review. The Lancet. Digital health, 4(1), e64–e74. https://doi.org/10.1016/S2589-7500(21)00252-1

Ahmed, B., Qadir, M. I., & Ghafoor, S. (2020). Malignant Melanoma: Skin Cancer-Diagnosis, Prevention, and Treatment. Critical reviews in eukaryotic gene expression, 30(4), 291–297. https://doi.org/10.1615/CritRevEukaryotGeneExpr.2020028454

US Department of Health and Human Services. The Surgeon General's Call to Action to Prevent Skin Cancer. Washington (DC): Office of the Surgeon General (US); 2014. Appendix 2, Signs and Symptoms of Skin Cancer. Available from: https://www.ncbi.nlm.nih.gov/books/NBK247171/