Skin Cancer

Basal cell carcinoma

Basal cell carcinoma is the most common type of skin cancer. Basal cell carcinoma develops from basal cells, which are found in the deepest portion of the skin’s outermost layer, called the epidermis.

This type typically appears as a pearly or translucent bump, a pink patch, or a sore that does not heal. It may bleed, crust, or scab repeatedly.
Basal cell carcinoma usually grows slowly and rarely spreads to other parts of the body. However, left untreated, it can grow deeper into surrounding tissue and cause local damage. It most commonly develops on areas that receive frequent sun exposure, including the face, scalp, ears, neck, chest and shoulders.

Squamous cell carcinoma

Squamous cell carcinoma starts in the flat skin cells that sit just below the surface of the skin. These cells make up most of the outer layer and help form the protective barrier that shields the body from the environment.

This type often appears as a scaly red patch, a rough bump, or a thickened lesion that may crust or bleed. Some lesions resemble a wart or a sore that does not heal. The most frequent locations include the face, ears, scalp (especially in individuals with thinning hair or baldness), neck, and the backs of the hands.

Squamous cell carcinoma is also strongly linked to long-term sun exposure. Compared to basal cell carcinoma, it carries a higher risk of spreading, especially when it develops on the lips, ears, or in individuals with weakened immune systems. Early treatment significantly reduces this risk.

Melanoma

Melanoma is less common but more serious. It develops from melanocytes, the cells that produce pigment in the skin. Melanoma may arise within an existing mole or appear as a new dark spot.

Unlike other skin cancers, melanoma is more likely to spread to lymph nodes or internal organs if not detected early. Because of this, recognizing suspicious moles and changes in the skin is critical.

Skin cancer is often painless in its early stages. The most important symptom is a visible change in the skin. Patients may notice:

• A new growth or spot that looks different from other marks
• A sore that does not heal within several weeks
• A mole that changes in size, shape, or color
• A lesion that bleeds, itches, or becomes tender
• A scaly or crusted patch that persists

Any spot that stands out from surrounding skin or behaves differently should be evaluated.

Dermatologists use the ABCDE rule to help patients recognize concerning moles. These criteria are especially helpful in detecting melanoma early

A – Asymmetry

If you draw a line through the mole, the two halves do not match. One side may appear different from the other.

B – Border

Benign moles typically have smooth, even edges. A suspicious lesion may have irregular, notched, blurred, or scalloped borders.

C – Color

A harmless mole is usually one shade of brown. A concerning lesion may contain multiple colors, including brown, black, tan, red, white, or blue.

D – Diameter

Melanomas are often larger than 6 millimeters, roughly the size of a pencil eraser. However, smaller lesions can also be dangerous.

E – Evolving

Any change in size, shape, color, elevation, or new symptoms such as itching or bleeding is significant. Evolution is one of the most important warning signs.

In addition to the ABCDEs, patients should watch for the “ugly duckling” sign. This refers to a mole that looks noticeably different from other moles on the body.

The primary cause of most skin cancers is ultraviolet radiation from sunlight or tanning beds. UV rays damage the DNA within skin cells. Over time, repeated exposure can lead to mutations that trigger uncontrolled growth.

Risk factors include:

• Fair skin, light hair, or light-colored eyes
• A history of frequent sunburns, particularly during childhood
• Use of indoor tanning devices
• A large number of moles
• A personal or family history of skin cancer
• A weakened immune system
• Increasing age

Although individuals with darker skin have more natural protection from UV radiation, skin cancer can still occur and may appear in less sun-exposed areas.

Diagnosis begins with a thorough skin examination. During a visit with Dr. Richey, the skin is carefully evaluated from head to toe, including areas not routinely exposed to sunlight. A specialized magnifying device called a dermatoscope may be used to examine structures beneath the surface of a lesion.

If a spot appears suspicious, a biopsy is performed. A biopsy is the only way to definitively determine whether a lesion is cancerous. The procedure involves removing part or all of the growth and sending it to a laboratory for microscopic analysis.

• Shave biopsy, which removes the top layers of skin
• Punch biopsy, which removes a small circular section of tissue
• Excisional biopsy, which removes the entire lesion

The pathology report identifies the type of cancer and provides important information about depth and other characteristics. In melanoma, tumor thickness plays a major role in staging and treatment planning.

If melanoma is found to be deeper or more advanced, additional testing may be recommended to evaluate nearby lymph nodes or check for spread.

Skin cancer is common, and outcomes are strongly tied to how early it is diagnosed. When detected at an early stage, treatment is typically straightforward and highly effective. Delayed evaluation increases the risk of deeper growth and spread, particularly with melanoma.

Monthly self-examinations and regular professional skin checks by a board-certified dermatologist are important preventive steps. Any new, changing, or unusual lesion should be evaluated without delay.

Understanding the types of skin cancer, recognizing the ABCDE warning signs, and seeking prompt diagnosis provide the best opportunity for early treatment and favorable outcomes.