The skin is the largest organ in our body. It provides protection against
heat, cold, light, and infection. The skin is made up of two major layers
(epidermis and dermis) as well as various types of cells. The top (or outer)
layer of the skin-the epidermis-is composed of three types of cells: flat, scaly
cells on the surface called squamous cells; round cells called basal cells; and
melanocytes, cells that provide skin its color and protect against skin damage.
The inner layer of the skin-the dermis-is the layer that contains the nerves,
blood vessels, and sweat glands.
What Is Skin Cancer?
Skin cancer is a disease in which cancer (malignant) cells are found in the
outer layers of your skin. There are several types of cancer that originate in
the skin. The most common types are basal cell carcinoma (70 percent of all skin
cancers) and squamous cell carcinoma (20 percent). These types are classified as
nonmelanoma skin cancer. Melanoma (five percent of all skin cancers) is the
third type of skin cancer. It is less common than basal cell or squamous cell
skin cancer, but potentially much more serious. Other types of skin cancer are
Basal Cell Carcinoma
Basal cell carcinoma is the most common type of skin cancer. It typically
appears as a small raised bump that has a pearly appearance. It is most commonly
seen on areas of the skin that have received excessive sun exposure. These
cancers may spread to the skin around the cancer but rarely spread to other
parts of the body.
Squamous Cell Carcinoma
Squamous cell carcinoma is also seen on the areas of the body that have been
exposed to excessive sun (nose, lower lip, hands, and forehead). Often this
cancer appears as a firm red bump or ulceration of the skin that does not heal.
Squamous cell carcinomas can spread to lymph nodes in the
Melanoma is a skin cancer (malignancy) that arises from the melanocytes in
the skin. These cancers typically arise as pigmented (colored) lesions in the
skin with an irregular shape, irregular border, and multiple colors. It is the
most harmful of all the skin cancers, because it can spread to other sites in
the body. Fortunately, most melanomas have a very high cure rate when identified
and treated early.
Who Gets Skin Cancer?
Skin cancer is a disease that has shown a steady increase over the past 20
years. Fortunately, with early diagnosis and treatment, it remains a very
curable disease. A variety of factors have been identified that place a person
at a higher risk to develop skin cancer (see "Am I at risk?").
Skin Cancer Diagnosed?
The vast majority of skin cancers can be cured if diagnosed and treated
early. Aside from protecting your skin from sun damage, it is important to
recognize the early signs of skin cancer.
- Skin sores that do not heal,
- Bumps or nodules in the skin that are enlarging, and
- Changes in existing moles (size, texture, color).
If you notice any of the factors listed above see your doctor right away. If
you have a spot or lump on your skin, your doctor may remove the growth and
examine the tissue under the microscope. This is called a biopsy. A biopsy can
usually be done in the doctor's office and usually involves numbing the skin
with a local anesthetic. Examination of the biopsy under the microscope will
tell the doctor if the skin lesion is a cancer (malignancy).
Skin Cancer Treated?
There are varieties of treatments available, including surgery, radiation
therapy, and chemotherapy, to treat skin cancer. Treatment for skin cancer
depends on the type and size of cancer, your age, and your overall health.
Surgery is the most common form of treatment. It generally consists of an
office or outpatient procedure to remove the lesion and check edges to make sure
all the cancer was removed. In many cases, the site is then repaired with simple
stitches. In larger skin cancers, your doctor may take some skin from another
body site to cover the wound and promote healing. This is termed skin grafting.
In more advanced cases of skin cancer, radiation therapy or chemotherapy (drugs
that kill cancer cells) may be used with surgery to improve cure rates.
Am I At Risk?
People with any of the factors listed below have a higher risk of developing
skin cancer and should be particularly careful about sun exposure.
- long-term sun exposure
- fair skin (typically blonde or red hair with freckles)
- place of residence (increased risk in Southern climates)
- presence of moles, particularly if there are irregular edges, uneven
coloring, or an increase in the size of the mole
- family history of skin cancer
- use of indoor tanning devices
- severe sunburns as a child
- nonhealing ulcers or nodules in the skin.
Early identification of skin cancer can save your life.
How Can I
Lower My Risk?
The single most important thing you can do to lower your risk of skin cancer
is to avoid direct sun exposure. Sunlight produces ultraviolet (UV) radiation
that can directly damage the cells (DNA) of our skin. People who work outdoors
(farming, construction, boating, outdoor sports) are at the highest risk of
developing a skin cancer. The sun's rays are the most powerful between 10 am and
2 pm, so you must be particularly careful during those hours. If you must be out
during the day, wear clothing that covers as much of your skin as possible,
including a wide-brimmed hat to block the sun from your face, scalp, neck, and
ears. In addition to protective clothing, the use of a sunscreen can reflect
light away from the skin and provide protection against UV radiation. When
selecting a sunscreen, choose one with a Sun Protection Factor (SPF) of 15 or
more. Sunscreen products do not completely block the damaging rays, but they do
allow you to be in the sun longer without getting sunburn. In addition to being
sun-smart, it is critical to recognize early signs of trouble on your skin. The
best time to do self-examination is after a shower in front of a full-length
mirror. Note any moles, birthmarks, and blemishes. Be on the alert for sores
that do not heal or new nodules on the skin. Any mole that changes in size,
color, or texture should be carefully examined. If you notice anything new or
unusual, see your physician right away. Catching skin cancer early can save your
Ultraviolet Index: What You Need to Know
The new Ultraviolet (UV) Index provides important information to help you
plan your outdoor activities and avoid overexposure to the damaging rays of the
sun. Developed by the National Weather Service and the Environmental Protection
Agency , the UV Index is issued daily as a national service.
The UV Index gives the next day's amount of exposure to UV rays. The Index
predicts UV levels on a 0-10+ scale (see chart).
Always take precautions against overexposure, and take special care when the
UV Index predicts exposure levels of moderate to above (5 - 10+).
Index Number Exposure Level
|0 - 2
|3 - 4
|5 - 6
|7 - 9
© 2004 AAO-HNS/AAO-HNSF
Please read our disclaimer. Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with Dr. Hector N. Hernandez or other healthcare professional. If you have a medical problem, contact us for diagnosis and treatment.