The more we learn about the importance of skin health and all the ways to protect ourselves from skin cancer like melanoma, the more often we pull on a hat in the summer, slather on sunscreen in the winter, and check for moles on a regular basis. While you should always get a new spot that pops up checked out by a professional, there are some subtle signs of skin cancers that go beyond a new mark.
Meet the expert: Adam Friedman, M.D., F.A.A.D., director of translational research in the department of dermatology at The George Washington University School of Medicine & Health Sciences
“Non-melanoma skin cancers, like basal cell or squamous cell carcinomas, are what we call skin-derived cancers, not mole-derived,” Adam Friedman, M.D., F.A.A.D., director of translational research in the department of dermatology at The George Washington University School of Medicine & Health Sciences, explained. That means they show up as other unusual skin changes, such as sores, scabs, irritated patches, or waxy bumps—not moles.
Basal cell and squamous cell skin cancers make up the majority of all skin cancer cases, and they are more treatable. Basal cell carcinomas are slow-growing, often painless, and almost never spread beyond their original location, per the National Library of Medicine. Squamous cell skin cancers, meanwhile, are easily cured when treated before they begin to spread. That’s why it’s important to learn their warning signs and symptoms so you can catch them early. On top of that, there are other rare forms of skin cancer that have nothing to do with moles, like Merkel cell carcinoma, that should be on your radar.
So what type of skin changes warrant a visit with your dermatologist? Here, the signs of skin cancer you should never ignore.
Itchy, red patches
Basal cell carcinoma—the most common form of skin cancer—can show up as a small red swatch of irritated skin, Dr. Friedman said. The swatch may be itchy and peely, and so it could seem an awful lot like dry skin. “When you have a cancerous skin lesion, your immune system responds to those abnormal cells,” Dr. Friedman explained. “That reaction can cause the redness or inflammation or scaling you’re experiencing.” If the patch sticks around, have your doctor take a look.
Open sores or scabs
Basal cell carcinomas may also emerge as bloody, open, or scabbed-over sores, Dr. Friedman says. They almost look like the scabby skin that develops after a very bad sunburn. The likelihood of a basal cell spreading or “metastasizing” to other parts of your body are extremely low, “but they can still be destructive, especially if they’re near your eye or mouth,” he said.
Pearly, translucent, or waxy bumps
Shiny, pearly bumps are another sign of skin cancer, particularly basal cell carcinoma. These areas are typically raised, often appear on the face, ears, or neck, and may have blue, black, or brown areas, according to the American Cancer Society (ACS). Blood vessels may be visible, and the lesion could eventually burst open, causing bleeding and scabbing.
Red, scaly lumps
Squamous cell carcinoma, the second most common form of skin cancer, may show up as red or brown rough patches that resemble old warts or scabs. “With these kinds of lumps, and really with any skin wound or lesion, the biggest red flag is that it doesn’t go away,” Dr. Friedman said. A normal skin issue that looks like this should heal in a matter of days. If your lump or lesion persists, you’ll want to get this type of spot checked out, he says.
Craters
Squamous cell carcinomas can also resemble small craters—almost like shallow volcanoes with blood in the center. Like basal cell carcinomas, squamous cell cancers typically aren’t deadly, but they can do damage and cause disfigurement, Dr. Freidman says. Again, you’ll want to see someone if that crater persists or expands, he added.
Fast-growing, painless bump
Merkel cell carcinoma is a very rare type of skin cancer, but may be dangerous and spread to other parts of the body. It’s often characterized by a pink, red, or purple lump commonly found on the face, neck, arms, and legs. The area can look like other types of skin cancer, but is often very firm to the touch, grows quickly, and feels painless.
Non-skin symptoms
While basal cell and squamous cell carcinomas tend to confine themselves to your hide, melanoma—which is typically characterized by a new or changing mole—is deadly because it eventually spreads into your body and causes systemic disease, Dr. Friedman explained.
If a melanoma does metastasize, the types of symptoms you experience depend a lot on the location of your cancer. “If the melanoma is by your lungs, you could have shortness of breath, or if it’s on your head, you may have headaches or vision trouble,” he says. “Really, the symptoms are all over the place.”
Unfortunately, if you don’t catch a melanoma until it reaches this stage, the prognosis is grim. “I hate to be dire, but if you’re experiencing these symptoms because a melanoma has metastasized, you’re already in big trouble,” Dr. Friedman said.
There’s also no predicting where a melanoma mole is likely to show up or take root, because “there’s really no predictable pattern,” he added.
That’s why it’s so important to pay attention to your skin by doing a self-exam at least once per month: Flagging any odd changes to your doctor ASAP can save your life.
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