Types of Skin Cancer
The three most common types of skin cancer are:
- Basal Cell Carcinoma
- Squamous Cell Carcinoma
- Malignant Melanoma
Skin Cancer Signs
These skin cancers can vary in appearance. They can appear as:
- Pink spots
- Lighter spots
- Tan or Pigmented spots
- Rough spots
- Skin lesions that bleed or have dried blood on them
Considering the wide variety of presentations, it is important that you examine your skin each month for any changing lesions. We recommend that rather than trying to decide yourself whether you have a skin cancer it is better if you note any suspicious skin lesions or changing lesions to come in for evaluation. In general, the earlier skin cancer is diagnosed the easier the treatment.
Basal Cell Cancers
Basal cell skin cancers usually grow slowly. As such they can initially be difficult to identify. They often appear as persistent pink spots. They can also appear as waxy spots, a spot that bleeds easily or a wound that doesn’t heal. If left untreated, they will grow and ulcerate. Typically, they do not spread to other parts of the body until they invade into deeper tissue layers. Other skin cancers such as squamous cell carcinoma and malignant melanoma tend to spread to other locations quicker than basal cell cancers. If you see any changing skin lesions it is best to have them evaluated.
One example of how skin cancers can be difficult to identify was several years ago a lady came for evaluation of a non-healing facial wound after, an automobile accident. She was interested in having a procedure to improve her facial scars. Since the wound had not completely healed in months, Dr Carniol performed a biopsy of the wound and found a basal cell carcinoma in the wound. Dr Carniol then removed the basal cell carcinoma at the same time as he preformed the scar revision. The auto accident did not cause the basal cell carcinoma. It just happened to be in the facial area injured in the accident.
Squamous Cell Cancers
Squamous cell carcinomas can appear as thickening pink rough areas. They can appear and grow relatively quickly or develop from prior flat pink rough appearing areas which are frequently called actinic or solar keratoses. Ocassionally they will develop a thickened white appearance or even a develop a “horn.” If treated while they are relatively small they do not spread to other areas. However, these skin cancers have a greater tendency to spread if allowed to grow. Therefore it is important to indentify and treat these lesions early before they spread. If you note any changing skin lesions you should have them evaluated in a timely fashion.
Melanomas often present as changing pigmented lesions. They can be changing in terms of color, shape, or thickness. There are even melanomas that are flesh colored rather than pigmented. If found early many melanomas can be treated before they have a chance to spread. Thicker melanomas are at risk for spreading. Therefore it is important to check your skin regularly and have any changing lesions evaluated as soon as you are aware that they are changing.
Skin Cancer Prevention
Cumulative sun exposure increases the risk of developing skin cancers. Dr. Carniol asks all of his patients to avoid excessive sun exposure and use a sunscreen that blocks both UVA and UVB. Also he advises against “sun bathing” as well as not sitting out on the beach or by the pool in the, most direct, midday sun. Dr. Carniol also performs skin checks on patients who have concerns over moles or photodamage. His years of experience allow him to identify moles or spots that should be monitored carefully or biopsied.
Patients often ask whether they should have a Mohs procedure to remove skin cancer. Mohs procedures are a method of checking that the tumor is completely removed. There are also other methods of checking margins. For some procedures the Mohs method is beneficial while for others the added complexity of Mohs is not necessary. It has not been shown to be helpful for invasive melanomas. When Dr Carniol believes that it is appropriate, he will send you for excision by Mohs, which can be followed by reconstruction.