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What is skin cancer?

Skin cancer is the irregular abnormal growth of skin cells. Skin cancer generally arises and progresses on skin which has been exposed and visible to the sun and sun-tanning machines (UV light). A skin cancer arises when the DNA damage in the skin cells cannot repair itself. The abnormal cells grow out of control mainly in the outermost later of the skin, the epidermis, hence are visible making skin cancer fortunately easy to detect and diagnose.

However, skin cancer can also develop on any place on the skin even with limited exposure to sun, from scalp to feet, where you least expect it. Therefore, it is important to be vigilant even about new skin growths on non-sun exposed skin.

 

What causes skin cancer?

Ultraviolet (UV) radiation in sunlight and lights used in tanning beds damage the DNA in skin cells so that their growth becomes uncontrolled and cancerous.

Sun and sun-tanning bed exposure doesn’t explain skin cancers that appear on skin not typically exposed to sunlight. This reveals that other considerations may be a factor to your individual risk of skin cancer, such as being exposed to toxic elements or having an ailment that impairs your immune system, or a genetic predisposition.

 

What are the major types of skin cancer?

The three major types of skin cancer are:

  • Basal Cell Carcinoma  (BCC)
  • Squamous Cell Carcinoma (SCC)
  • Malignant Melanoma (MM)

BCC and SCC are regarded as non-melanomatous skin cancers and are more common than MM.

 

What are the signs and symptoms of skin cancer?

Skin cancer occurs on areas of the skin visible to the sun, including the scalp, face, ears, lips, upper chest, neck, shoulders, back, arms, hands and legs.

However, it can also develop on parts of the skin that infrequently see the light of day. These could be on your palms or soles of feet, below your fingernails or toenails and in your genital area. People of all skin tones can be affected by skin cancer, with paler skin types being more vulnerable.

Skin cancer should be suspected whenever there are visible changes on your skin, which can be flat or elevated, pigmented or not. They are usually not painful. Growth can be slow or fast. Sometimes they bleed or ulcerate. The appearance and growth pattern will vary according to which skin cancer you have.

It is vital to investigate any new, altering or abnormal skin growths as suspected skin cancers

 

Basal cell carcinoma (BCC) signs and symptoms

Basal cell carcinoma (BCC) is a common skin cancer known to appear in sun-exposed regions of the body such as your neck or face, your back and shoulders, back of hands and front of legs. Nevertheless, along with early discovery and treatment, nearly all BCCs can be effectively cut off completely without complications. Of all the skin cancers, BCCs are easiest to care for and cure in the early stages, either with a medical treatment or surgical excision. BCCs do not spread across your blood stream or lymphatics, being restricted to their foriginal ocal location. When treated they have a very good medical outcome!

Basal cell carcinoma may appear as:

  • A pearly or clear bump.
  • A flat, flesh-coloured or brown scar-like lesion.
  • A bleeding or scabbing sore that heals and returns.
  • A reddish/irritated patch.

 

Squamous cell carcinoma (SCC) signs and symptoms

Squamous Cells are flat cells situated close to the surface of the skin that sheds incessantly as new ones form. Squamous Cell Carcinoma (SCC) occurs with DNA injury of these cells from ultraviolet radiation (or other harmful agents) which activates abnormal changes in the squamous cells in the skin. SCCs may be painful as they emerge as a skin sore that bleeds, oozes, crusts and does not heal. They often grow quickly and occur more commonly in people whose immune systems are weak, for instance post-transplant surgery or on immune suppressive drugs. SCC can spread along nerves in the skin and sometimes enter blood vessels therefore be mindful to investigate and catch any skin lesion that may be a skin cancer, early.

Squamous cell carcinoma may appear as:

  • Continual, scaly red patches with abnormal borders that may bleed easily.
  • Open sores that do not go away for some time.
  • High growth with a rocky surface that is indented in the middle.
  • A wart-like growth.

 

Malignant melanoma (MM) signs and symptoms

Malignant melanoma (MM) can grow in any place on your body, in otherwise normal skin or in a current mole that becomes cancerous. MM grows from skin cells called Melanocytes, which are the pigment forming cells deep in the epidermis of your skin. These are cells which produce melanin, the pigment that provides skin with its colour. Melanocytes generate more melanin when you’re exposed to the sun to support protection of the deeper layers of your skin. People with fair skin colouring are at a much higher risk of MM than people with darker pigmented skin. Exposure to UV light is a major risk factor for MM.

N.B. Not all MM are darkly pigmented in colour, some are pale, called amelanotic melanoma. Although MM is rarer than BCC and SCC it is imperative that it is detected early as otherwise it risks local deformity and even death because it risks spreads beyond its original focal location.

Malignant melanoma may appear as:

  • An existing or new mole that changes in colour, size, texture or bleeds.
  • A small skin lesion with an unusual border.
  • A small skin lesion with sections that appear red, pink, white, blue or blue-black.
  • A painful skin lesion that itches or burns.
  • Dark patches or lesions on your palms, soles, fingertips or toes, or under a fingernail.
  • A large brownish spot with darker dots within it and irregular edges.
  • Any of the above which is transforming and growing.

 

How can I tell if a dark skin spot is cancerous? 

Use your ABCDE’s as a guide to help in recognizing the threat of malignant melanoma (MM).

  • Asymmetry – Two halves of the mole are different and have an irregular shape from a common circular/oval shaped mole.
  • Border – The border is ragged, while ordinary moles have smoother and even borders.
  • Colour – Has a mixture of 2 or more colours as benign moles are frequently a single shade of brown.
  • Diameter – Most lesions are larger than 6mm in diameter, however its ideal to detect melanomas when it’s small.
  • Evolving – Any difference in size, shape, colour or elevation of a spot on your skin, or sudden bleeding, itching or crusting, may be an indication of melanoma.

 

How can I reduce the risk of getting skin cancer?

You can reduce the possibility of skin cancer by decreasing or avoiding exposure to ultraviolet (UV) radiation. When you go out in sunlight you should wear protective clothing and sunscreen against UVA and UVB with a high ultraviolet protecting factor level such as 50.

Seek the advice of the Dermatologists at Clinica London who will examine your skin for questionable changes as this can help identify skin cancer at its initial stage. Prompt detection of skin cancer greatly increases your chance for successful skin cancer treatment.

 

What does skin cancer look like on the scalp, face and eyelids?

A few Basal Cell Carcinoma (BCC) skin cancers on the scalp, face and eyelids may look brown and pigmented like a mole. Squamous cell skin cancer (SCC) frequently starts with a rough, scaly patch, but can quickly get quite raised, firm, red and crusty. They can also turn out to be tender when pressed. There are several pre-cancerous skin cancer lesions which if caught early and treated, can stop their progression and transformation to cancer.

Skin cancers can occur on the eyelids and around the eyes in the peri-orbital region. Although small, their delicate excision and reconstruction is vital for a good cosmetic result by the Dermatologist and Ophthalmologist.

If your skin cancer is on your face around your eyes the Dermatologists work closely with the two Clinica London Oculoplastic surgeons to safely treat, remove and reconstruct the eyelids and surrounding face. Oculoplastic Surgeons are ophthalmologists specially trained in plastic surgery and reconstruction of the eyelids after tumour excision.

 

How can I prevent skin cancer?

Most skin cancers are avoidable. To safeguard yourself, follow these skin cancer prevention tips:

  • Restrict unprotected sun exposure.
  • Avoid the dangerous sun during the middle of the day.
  • Wear sun screen with a high protective level against UVA and UVB all year round.
  • Wear protective attire including shady hat and UV protective sports wear.
  • Avoid tanning beds.
  • Be mindful of sun-sensitizing medicines.
  • Examine your skin regularly and report differences to your doctor.
  • Ask someone else to examine your back for skin lesions as you cannot see your back.

 

How is skin cancer treated?

The Dermatologist at Clinica London will first assess your condition to determine the diagnosis, then advise on the best treatment. The Dermatologist uses a special microscope called the Dermatoscope to examine the skin lesion and its blood vessels and appearance of its cells. Often they will do a small biopsy to determine the skin cancer. If an existing mole looks suspicious they will do a mole screen and biopsy.

Where necessary they work closely in a team with the oculoplastic surgeons if the skin cancer is on or around the eyelids.

The treatment options depend on which skin cancer you have, the size and position of the tumour, the phase of the disease, and your general health. There are many good and effective medical and surgical treatments for skin cancer.

Options include:

  • Cryotherapy
  • Surgical removal
  • Targeted therapy
  • Chemotherapy
  • Immunotherapy
  • Radiation

 

SKIN CANCER – BE AWARE – GET ADVICE AND TREATMENT FROM OUR DERMATOLOGISTS

Book an appointment with one of Clinica’s Dermatologist if you observe any changes to your skin that concern you. Our dermatologists will investigate your skin changes to establish a cause and start treatment or surgery. A chaperone is present for the assessment and treatment and your privacy is respected. Both our Dermatology Consultants are female medical experts.

We are looking forward to excaping this dull winter climate with short days and getting our skin freedom in the sun later in the summer. Please be Skin Aware in 2021.

Wishing you healthy glowing and cancer free skin from the The Clinica London Team.

Dr Jennifer Crawley

Consultant Dermatologist
Children & Adults

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Dr Angela Tewari

Consultant Dermatologist
Children & Adults

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