Mind & Body

How to Recognize Skin Cancer Early

Autumn is prime time for skin cancer screening
TIMEOctober 31, 2014

NEW YORK—Now that fall is here and tans are starting to fade, you may notice some new moles and marks that you didn’t have before this summer in the sun.

These marks may be benign but could also be cancerous, so it’s important to check them carefully.

Here are some guidelines for how to recognize common types of skin cancer. If you find any mark that seems remotely suspicious, have it checked by a professional as soon as possible. As with any cancer, the earlier skin cancer is caught, the easier it is to treat.


Melanoma is the most deadly type of skin cancer. Every year, there are about 100,000 new cases of melanoma diagnosed in the United States and although only 4 percent of diagnosed skin cancers are melanoma, it accounts for 77 percent of deaths from skin cancer.

Melanoma starts in the pigment cells, melanocytes, of the skin. It can occur on any skin surface, but in men it’s more common on the head, neck, and surrounding skin, as well as the hips. In women, it is typically more common on the lower legs, shoulders, or hips.

Melanoma appears as skin lesions that are brown or black in color (though there may also be shades of red) and is usually asymmetrical.

How To Do a Self-Exam. To do a self-exam, you should note any new moles or changes to existing ones that follow the ABCDE rule:

A – Asymmetrical
B – Border (uneven)
C – Color: multiple colors or multiple shades of one color
D – Diameter: larger than a quarter inch (6 mm) or about the size of a pencil eraser
E – Evolving: changes in physical traits or painful symptoms develop

Risk Factors. Melanoma is rare for people with dark skin. Factors that increase risk include sun exposure, fair skin, weakened immune system, and a family history of melanoma. Survivors of melanoma are nine times more likely than the average person to develop melanoma again.

Basal Cell Skin Cancer

Basal cell skin cancer is the most common skin cancer in the United States with 2.8 million diagnoses each year. It is also the most common type of skin cancer for people with fair skin.

Basal cell skin cancer starts in the lower portions of the first layer of skin, in places that have been exposed to the sun, such as the face.

It may look similar to noncancerous skin conditions such as psoriasis or eczema. It appears as raised bumps that are pink and waxy. These bumps may bleed and have a depression in the center.

It can also have open sores that bleed or crust and/or a red patch that can be irritating or itchy.

There are other signs of basal cell skin cancer: a shiny bump or nodule that ranges in color from translucent to red, pink, or white or a shiny area that appears similar to a scar, which is often white or yellow.

Risk Factors. Risk factors include sun exposure and fair skin. Although the average age is decreasing, basal cell skin cancer remains most common in older adults.

Death is less common than from melanoma (approximately 2,000 people die each year from nonmelanoma skin cancers). This is because it typically remains local and does not spread to other parts of the body. The elderly and those with suppressed immune systems are at a higher risk of death.

Squamous Cell Skin Cancer

Squamous cell skin cancer is the most common type of skin cancer for people with dark skin, but also occurs frequently in fair skinned individuals. It starts in the keratinocyte cells, which compose most of the skin’s upper layers. For people with dark skin, it may be found in places that are not typically exposed to the skin such as the legs and feet. For people with light skin, it is found in places that have been exposed to the skin, such as the face and neck.

Squamous cell skin cancer can appear similar to a thick patch of warts. It can look like a red patch, which appears scaly with irregular borders, and may rapidly increase in size. It can also develop an open sore that crusts or bleeds, especially when touched.

Risk Factors. Risk factors include sun exposure, fair skin, and a history of basal cell skin cancer. Squamous cell skin cancer appears more often in the elderly and in males. There are approximately 700,000 diagnoses of squamous cell skin cancer in the United States each year. It has a high survival rate with only around 2 percent patients dying from it each year. The elderly and those with suppressed immune systems are at a higher risk of death.

Dr. Michael Shapiro, M.D., FAAD, ACMS, is a board-certified dermatologist in New York City. He is a fellowship-trained skin cancer surgeon and the medical director of Vanguard Dermatology, an academically affiliated private practice, with locations in SoHo, Greenpoint, Sheepshead Bay, Forest Hills and Staten Island. VanguardDermatology.com