Skin Cancer and Sun Damage (cont.)

What are the symptoms of skin cancer?

The most common warning sign of skin cancer is a change on the skin, typically a new mole or skin lesion or a change in an existing mole.

• Basal cell carcinoma may appear as a small, smooth, pearly or waxy bump on the face ears and neck; or as a flat, pink/red- or brown-colored lesion on the trunk or arms and legs.



• Squamous cell carcinoma can appear as a firm, red nodule, or as a rough, scaly flat lesion that may itch, bleed and become crusty. Both basal cell and squamous cell cancers mainly occur on areas of the skin frequently exposed to the sun, but can occur anywhere.



• Melanoma usually appears as a pigmented patch or bump. It may resemble a normal mole, but usually has a more irregular appearance.

When looking for melanoma, think of the ABCD rule that tells you the signs to watch for:

• Asymmetry—the shape of one half doesn't match the other



• Border—edges are ragged or blurred



• Color—uneven shades of brown, black, tan, red, white or blue



• Diameter—a significant change in size (greater than 6mm)

How is skin cancer diagnosed?

Skin cancer is diagnosed only by performing a biopsy. This involves taking a sample of the tissue, which is then placed under a microscope and examined by a dermatopathologist, or doctor who specializes in examining skin cells. Sometimes a biopsy can remove all of the cancer tissue and no further treatment is needed.

How is skin cancer treated?

Treatment of skin cancer is individualized and is determined by the type of skin cancer, its size and location and the patient's preference.

Standard treatments for non-melanoma skin cancer (basal cell or squamous cell carcinomas) include:

• Mohs surgery (for high-risk non-melanoma skin cancers)—excision of cancer and some extra tissue



• Electrodesiccation and curettage—physically scraping away the skin cancer cells followed by electrosurgery



• Cryosurgery or freezing



• Laser therapy



• Drugs (chemotherapy, retinoids)

Standard treatments for melanoma skin cancer include:

• Wide surgical excision



• Sentinel lymph node mapping (for deeper lesions)—to determine if the melanoma has spread to local lymph nodes



• Drugs (chemotherapy, biological response modifiers)



• Radiation therapy



• New methods in clinical trials are sometimes used to treat skin cancer.

How can I help prevent skin cancer?

Nothing can completely undo sun damage, although the skin can sometimes repair itself. So, it's never too late to begin protecting yourself from the sun. Your skin does change with age—for example, you sweat less and your skin can take longer to heal, but you can delay these changes by staying out of the sun. Follow these tips to help prevent skin cancer:

• Apply sunscreen with a sun protection factor (SPF) of 15 or greater 30 minutes before sun exposure and then every few hours thereafter.



• Select cosmetic products and contact lenses that offer UV protection.



• Wear sunglasses with total UV protection.



• Avoid direct sun exposure as much as possible during peak UV radiation hours between 10:00 a.m. and 3:00 p.m.



• Perform skin self-exams regularly to become familiar with existing growths and to notice any changes or new growths.



• Eighty percent of a person's lifetime sun exposure is acquired before age 18. As a parent, be a good role model and foster skin cancer prevention habits in your child.

Reviewed by the doctors at The Cleveland Clinic, Department of Dermatology.

Reviewed by Cynthia Dennison Haines, MD, on April 1, 2005.

Portions of this page © The Cleveland Clinic 2000-2003.

Last Editorial Review: 11/20/2007