Q: What is skin cancer?

A: Simply put, skin cancer is a tumour or growth of abnormal cells in our skin. The most common types of skin cancers are basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Of the three, malignant melanomas are the most dangerous and more likely to spread.

Q: What causes skin cancer?

A: Most skin cancers are caused by exposure to the ultraviolet (UV) radiation in sunlight and in tanning beds. But there are parts of the skin not exposed to sunlight which also develop skin cancer. These skin cancers may be formed by exposure to toxic substances or by having a weakened immune system.

Find out how to lower your skin cancer risk here.

Q: What would increase the risk of getting skin cancer?

A: The most common factors that could increase your risk of developing skin cancer are:

• Fair skin. Anyone can get skin cancer. However, having fair skin greatly increases your chances. If you have blond or red hair, light-coloured eyes, and you freckle or sunburn easily, you’re more likely to develop skin cancer than a darker skinned person.
• A history of sunburns. Having had one or more blistering sunburns especially as a child or a teenager, increases your risk of developing skin cancer as an adult. However, sunburn at any age is also a factor.
• Excessive sun exposure. Here is what most people don’t know – a tan is your skin’s injury response to excessive UV radiation. If you spend a lot of time in the sun, without protective clothing or sunscreen you may develop skin cancer. Tanning beds are a high-risk factor, especially for malignant melanoma.
• Sunny or high-altitude climates. You are more at risk if you live in a sunny, warm climate and at a higher elevation than people living in colder climates with much less sunshine.
• Moles. People who have many moles or abnormal moles which look irregular and generally larger, are more likely to develop skin cancer. Pay close attention to your moles, check them regularly. If they change or worry you, visit your doctor as soon as possible.
• Precancerous skin lesions. A skin lesion is a part of the skin that has an abnormal growth or appearance compared to the skin around it – rough, scaly patches varying in colour from brown to dark pink. Known as actinic keratosis, they are usually found on sun damaged skin on fair-skinned people and usually on their face, head and hands. They can increase your risk of developing skin cancer.
• A family history of skin cancer. If anyone in your family has had skin cancer, you need to be extra careful to always wear sun-screen and wear protective clothing.
• A personal history of skin cancer. If you developed skin cancer once, you are at risk of developing it again.
• A weakened immune system. Having a weakened immune system increases your chances of developing skin cancer. People living with HIV/AIDS and those taking immunosuppressant drugs after an organ transplant are at greater risk.
• Exposure to radiation. If you received radiation treatment for skin conditions like eczema and acne, you may have an increased risk of developing basal cell carcinoma.
• Exposure to toxic substances. Exposure to certain substances, such as arsenic, may increase your risk of skin cancer.

Find out how to avoid getting skin cancer here.

Q: What are the signs of skin cancer?

A: Different types of skin cancer share some of the same signs, which is why it is important to have your doctor look at anything suspicious as quickly as possible. Skin cancers can appear as moles, scaly patches, open sores or raised bumps. Here are some signs to look for:

Squamous Cell Carcinoma

Squamous cells lie just below the surface. They are your skin’s inner lining. While squamous cell carcinoma usually occurs on areas of your body, such as your face, ears and hands which are exposed to the sun most frequently, people with darker skin are more likely to develop squamous cell carcinoma on areas not often exposed to the sun. Squamous cell carcinoma may appear as:

• A firm, red nodule
• A flat lesion with a scaly, crusted surface
• A flat, scaly red patch (may look similar to a skin rash)
• A small, smooth, shiny or waxy bump (bumps may bleed or develop a crust)
• A red or brown scaly skin patch

Basal Cell Carcinoma

Basal cells, which produce new skin cells, sit beneath the squamous cells. Basal cell carcinoma usually occurs in sun-exposed areas of your body, such as your neck or face. Basal cell carcinoma may appear as:

• A pearly or waxy bump
• A flat, flesh-coloured or brown scar-like lesion
• A flat, scaly red patch
• A small, smooth, shiny or waxy bump (bumps may bleed or develop a crust)
• A patch with large blood vessels (may look like a birthmark)
• A brown or black raised bump
• A lesion with rolled edges and a central ulcer

Malignant Melanoma

While Melanoma can develop anywhere on your body, it most often appears on the face or the trunk of affected men, and most often develops on the lower legs of women. It can occur on skin that hasn’t been exposed to the sun, otherwise normal skin or in an existing mole. In darker skin tones, melanoma occurs more often on the palms or soles, or under the fingernails or toenails.

Melanoma signs include:

• A large brownish spot with darker speckles
• A mole that changes in colour, size or feel or that bleeds
• A small lesion (an area of skin that looks different to the skin around it) with an irregular border and portions that appear red, white, blue or blue-black
• Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus
• A new mole
• A mole that is getting bigger
• A mole that changes colour or shape
• A mole that bleeds
• A mole that itches or causes pain
• A mole with an uneven border or shape

Q: Who is most at risk for skin cancer?

A: The following people are most at risk for skin cancer:

• People with a lot of freckles
• People who get sunburned
• People with a family history of skin cancer
• People with light skin
• People with blue/green eyes

Q: How can I tell if I have skin cancer?

A: If you have a mole or other skin lesion that is causing you concern, show it to your health care provider. After examining your skin, she may remove the mole or bump herself or may ask you to see another doctor. The removed tissue will be sent to a laboratory and when the results, positive or negative, are back your doctor will contact you.

Q: How is skin cancer treated?

A: Where your skin cancer begins determines its type and your treatment options. Treatments include removal by your doctor, cryotherapy – freezing, electrodesiccation and curettage – scraping and burning, radiation therapy, and Moh’s surgery or wide local excision. The earlier skin cancer is removed, the better are your chances for a full recovery.

Q: Can skin cancer be prevented?

A: Yes, in many cases, skin cancer can be prevented. The best way to protect yourself is to avoid too much sun. You can do this by following these tips:

• Avoid the sun during the middle of the day, 10am to 4pm, and don’t spend long periods of time in direct sunlight.
• Wear sunscreen year-round. Remember that cloudy or overcast days are as dangerous as hot, sunny ones. Use broad spectrum sunscreens with a SPF of 30, preferably higher – ideally SPF 50, which protect against the sun’s UV-A and UV-B burning and tanning rays. Apply the sunscreen 30 minutes before you go outside and then reapply every 2 hours. More if you’re swimming or perspiring. Be generous in your application and put it on all exposed skin, including your lips, the tips of your ears, and the backs of your hands and neck.
• Use a lip balm with sunscreen at all times.
• Wear protective clothing. Sunscreens don’t provide great but not complete protection from UV rays. Wear preferably dark, tightly woven, long-sleeved shirts and pants to protect your arms and legs. Wear a broad-brimmed hat, which provides more protection than a baseball cap does. A brimmed hat protects your face, ears and neck.
• Wear sunglasses to protect your eyes. Look for brands that block both types of UV radiation.
• Avoid tanning beds. Lights used in tanning beds emit UV rays and can increase your risk of skin cancer.
• Some common prescription and over-the-counter drugs, including antibiotics, can make your skin more sensitive to sunlight. Check with your doctor or pharmacist.
• Check your skin regularly and report changes to your doctor. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks.
• Check your entire body carefully, even the nooks and crannies. You may need to use a mirror.
• Show any changing mole to your doctor, the earlier, the better.

Learn more about how to protect yourself from UV Rays here.

If you have any concerns about any moles or other sun-related skin concerns, contact your doctor as soon as possible.

The lenmed Group is a world-class chain of Private Hospitals that brings quality healthcare to communities across Southern Africa.

For more information please contact:
Dr F Spruyt (Plastic & Reconstructive Surgeon)
MBChB (UFS) FCS (SA) Plastic Surgery | MMED Plastic and Reconstructive Surgery (UFS)
Royal Hospital & Heart Centre
Tel: +27 (0) 53 045 0580
Email: info@drfritsspruyt.com

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.