Introduction

Skin cancer is one of the most common types of cancer, particularly in countries with high levels of ultraviolet (UV) radiation exposure. It develops when abnormal skin cells grow uncontrollably, often as a result of damage caused by sunlight or artificial UV sources. Although skin cancer can affect anyone, people who spend significant time outdoors or have a history of sunburn may have an increased risk.

Understanding skin cancer, recognising its early warning signs and seeking timely medical attention are essential for protecting long-term health. With appropriate diagnosis and treatment, many forms of skin cancer can be managed effectively.

What Is Skin Cancer?

Skin cancer only occurs when the DNA of skin cells becomes damaged, causing cells to grow and divide abnormally. It can develop in different layers of the skin and may appear as a new growth, changing mole, unusual spot or persistent sore.

The condition commonly affects sun-exposed areas, including the face, neck, scalp, arms and hands. However, skin cancer can also develop on parts of the body that receive limited sunlight.

There are several types of skin cancer, each with different characteristics, levels of risk and treatment requirements. Identifying the specific type is important for selecting an appropriate treatment approach.

Common Types of Skin Cancer

1. Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) is the most common form of skin cancer. It usually develops in the basal cells, which are found in the lower part of the outer skin layer.

It commonly appears on sun-exposed areas and may look like a pearly bump, pink patch or open sore that does not heal.

BCC generally grows slowly and rarely spreads to distant organs. However, if left untreated, it can damage surrounding skin and deeper tissues.

2. Squamous Cell Carcinoma

Squamous Cell Carcinoma (SCC) develops in the squamous cells that form much of the skin's outer layer.

It may appear as a firm red lump, scaly patch or persistent sore. Some lesions may bleed, crust or become painful.

SCC can grow into surrounding tissues and occasionally spread to other parts of the body. Early diagnosis and appropriate treatment are important for reducing complications.

3. Melanoma

Melanoma develops from melanocytes, the cells responsible for producing skin pigment.

It can develop in an existing mole or appear as a completely new spot. Melanoma is generally more aggressive than BCC and SCC because it can spread to other organs if not identified and treated early.

Changes in a mole's shape, size, colour or appearance should always be taken seriously.

Causes and Risk Factors of Skin Cancer

The primary environmental risk factor for many types of skin cancer is exposure to ultraviolet radiation.

UV radiation can damage the DNA inside skin cells. Over time, repeated exposure may increase the likelihood of abnormal cell growth.

Some common risk factors include:

• Excessive exposure to sunlight.
• Frequent sunburn, particularly during childhood.
• Use of artificial tanning equipment.
• Fair skin that burns easily.
• A personal or family history of skin cancer.
• Having numerous moles or unusual-looking moles.
• A weakened immune system.
• Increasing age and accumulated sun exposure.

Although these factors can increase risk, skin cancer can develop in people of all skin tones and age groups.

Early Signs and Symptoms of Skin Cancer

Recognising early symptoms can help individuals seek medical attention before the condition progresses.

Some warning signs include:

• A new growth or unusual mark on the skin.
• A mole that changes its size, shape or colour.
• A sore that does not heal.
• A spot that repeatedly bleeds or forms a crust.
• A rough or scaly patch that persists.
• A raised lesion that continues to grow.
• A dark spot with irregular borders or multiple colours.

The ABCDE method can help identify suspicious changes in pigmented lesions:

A – Asymmetry: One half of the mole does not match the other.

B – Border: The edges are irregular, uneven or poorly defined.

C – Colour: Different colours or shades appear within the same lesion.

D – Diameter: The lesion is often larger than 6 mm, although melanoma can be smaller.

E – Evolving: The mole changes in size, shape, colour or appearance.

Not every unusual skin mark is cancerous, but any concerning or changing lesion should be professionally assessed.

How Is Skin Cancer Diagnosed?

Accurate diagnosis is essential for determining the type and extent of skin cancer.

The diagnostic process generally begins with a clinical skin examination. A healthcare professional assesses the suspicious area and may examine other parts of the body for unusual lesions.

Dermoscopy is a technique that uses a specialised magnifying instrument to examine skin structures in greater detail.

If a lesion appears suspicious, a biopsy may be recommended. During this procedure, a sample of skin tissue is collected and sent to a laboratory for microscopic examination.

The pathology report helps determine whether cancer cells are present, identify the cancer type and guide further treatment decisions.

Additional investigations may be recommended in certain cases, depending on the type and stage of cancer.

Skin Cancer Treatment Options

Treatment depends on the cancer type, size, location, depth and whether it has spread.

Surgical Excision

Surgical excision involves removing the cancerous lesion along with an appropriate margin of surrounding tissue. The removed tissue is examined to assess whether the cancer has been completely removed.

Mohs Surgery

Mohs surgery is a specialised procedure that removes cancerous tissue in stages while examining the surgical margins. It can be particularly useful for selected skin cancers in areas where preserving healthy tissue is important.

Cryotherapy

Cryotherapy uses extreme cold, usually liquid nitrogen, to destroy certain abnormal or precancerous skin lesions. It is suitable only for selected conditions.

Topical Treatments

Certain prescription creams may be used for specific superficial or precancerous skin conditions. The appropriate medication depends on the diagnosis and should be prescribed by a qualified medical professional.

Radiation Therapy

Radiation therapy uses targeted radiation to destroy cancer cells. It may be considered in selected cases when surgery is unsuitable or as part of a broader treatment plan.

Importance of Early Detection

Early detection is one of the most important factors in managing skin cancer.

When identified at an early stage, many skin cancers can be treated successfully. Delayed diagnosis may allow the cancer to grow deeper, affect surrounding tissues or spread to other parts of the body.

Regular skin examinations are particularly important for individuals with previous skin cancer, significant sun exposure or other recognised risk factors.

Checking the skin regularly and seeking professional advice about suspicious changes can support earlier diagnosis.

How to Prevent Skin Cancer

Although not every case of skin cancer can be prevented, reducing UV exposure can lower the risk.

Some effective preventive measures include:

1. Apply broad-spectrum SPF 50 or SPF 50+ sunscreen as directed.
2. Reapply sunscreen according to product instructions, particularly after swimming or sweating.
3. Wear protective clothing and a wide-brimmed hat.
4. Use sunglasses to protect the eyes and surrounding skin.
5. Seek shade when UV radiation levels are high.
6. Avoid tanning beds and deliberate tanning.
7. Check your skin regularly for unusual changes.

Sun protection should be practised throughout the year, especially in regions where UV radiation levels are high.

Conclusion

Skin cancer is a significant health concern that requires awareness, early detection and appropriate medical care. Understanding its different types, recognising warning signs and knowing the available diagnostic and treatment options can help individuals make informed decisions about their skin health.

From basal cell carcinoma and squamous cell carcinoma to melanoma, each type of skin cancer requires an individual assessment and suitable management plan.

Regular skin examinations, responsible sun protection and timely medical consultation are important steps towards reducing complications and maintaining healthy skin. If you notice a new, changing or unusual skin lesion, seek professional medical advice rather than ignoring it.