In the south, many of us have been exposed to more than our fair share of sunshine. This extra sunshine can lead to damage to the skin cells’ DNA, ultimately resulting in precancerous lesions and skin cancer. Melanoma is the best known type of skin cancer, as it is the most serious. However, nonmelanoma skin cancer is much more common. Basal cell carcinoma is not only the most common type of skin cancer, but the most common type of cancer period. Knowing what to look for can lead you to getting checked by your dermatologist much sooner, with will result in less growth of the skin cancer and less wounding during treatment.
Often the first sign of developing skin cancer is the formation of actinic keratoses. These are precancerous lesions that your body’s immune system may be able to fight off, but about 10% of the time these can progress into squamous cell carcinoma. Actinic keratosis, or AKs, can feel like a rough patch, or like sandpaper on the skin. There may be redness at the base and sometimes these can thicken up and become hypertrophic, or large, AKs. You often feel these before you see them, and they may wax and wane as your immune system works against them. Treatment options vary from liquid nitrogen, to creams, to photodynamic therapy, also known as blue light.
Basal cell carcinomas are the most common skin cancer, but also the least worrisome. They present as a painful, bleeding, non-healing bump that may resemble a pimple at first. If left untreated, these cancers will continue to grow and cause large ulcerations, but should not have distant spread. Excisions with a Mohs surgeon or with your dermatologist are the most common way to treat these, but some early basal cells can be treated with creams and photodynamic therapy.
Squamous cell carcinomas are not as common as basal cells, but can have distant spread known as metastasis. These can also present as a nonhealing wound, but tend to be crustier and more painful than basal cells. Treatment options are mostly the same as with basal cells, and usually surgical removal is preferred.
Checking your skin regularly can help identify both melanoma and nonmelanoma skin cancer in its earliest, easiest to treat stage. If you have any spots you are concerned about, you should make an appointment with a board certified dermatologist for a screening.
Meg Cherry, MD