Skin cancer is the most common type of cancer in the United States. Anyone can get it regardless of skin color. Estimates of skin cancer prevalence conducted by Stern, R.S. in 2007 show that one out of five Americans is likely to develop this disease in their lifetime. The National Cancer Institute also reported that there were more than 1 million living with melanoma in 2019.

Most skin cancer cases are associated with exposure to UV from different sources, including the sun and tanning beds. Other factors like a family history of skin cancer, immune suppression, light skin tone, and smoking could also increase one’s risk of developing the disease.

If detected early and treated appropriately while they have not spread yet, skin cancer is highly curable. Detecting it early does not only mean going to a doctor for a test but also performing self-exams. Half of the skin cancer cases were, in fact, self-detected. The American Academy of Dermatology and the Skin Cancer Foundation encourage everyone, especially those with increased risks, to perform regular skin self-exams (about once a month) to watch for signs of skin cancer.

How to perform skin self-exams

  • Use a full-length or body mirror: Examine both your front and back and raise your arms to check the areas behind them.
  • Look at your underarms, forearms, and palms: Bend your elbows and raise your arms to reach all areas.
  • Look at your legs, soles of your feet, and between toes
  • For hard-to-reach areas like the neck, scalp, back, and buttocks, use a hand mirror: Part your hair to check your scalp better.

Common signs to watch out for

Skin self-exams can be done at home in a well-lit room. Use the “ABCDE” rule to check for some of the common signs of one of the deadliest forms of skin cancer, melanoma.

  • Asymmetry: Most melanomas appear asymmetrical, which means that if you draw a line through the middle of a mole or birthmark, the two sides would not appear identical.
  • Border: Normal moles tend to have more even and smoother borders, while melanoma borders appear to have irregular, blurred, or notched edges.
  • Color: Benign moles often appear as a single shade of brown or black, while melanomas may have various shades of these colors. And as they grow, patches of other colors like red, white, or even blue may appear. For example, amelanotic melanomas are not as dark as other moles because it lacks melanin. They may appear pinkish, reddish, clear, or the same color as the skin, making them sometimes hard to recognize.
  • Diameter: Although melanomas may exist even in a small size, they are often detected when a lesion reaches ¼ inch or 6mm (the size of a pencil eraser) or larger.
  • Evolving: Melanoma changes in terms of color, size, shape, or elevation. Other symptoms like bleeding, crusting, or itching must also be examined.

In addition to the “ABCDE” rule, another simple method to recognize warning signs of melanoma is the “Ugly Duckling”. This strategy is based on the principle that most benign moles resemble one another, while melanomas appear differently like ugly ducklings. This means that it is important to not just check for irregularities but to compare any suspicious growth from its surrounding moles or those from other parts of the body.

Take note that not all types of melanomas display these common signs, but it’s important to remember that about 20-30% of this type of skin cancer develops in existing moles while the rest develops on normal skin. For example, acral lentiginous melanoma, the most common one, often appears in hard-to-locate areas like toenails, fingernails, palms of the hands, or soles of the feet.

More typical skin cancer types like basal and squamous cell carcinomas are easier to identify since they usually appear in areas of the body that get the most sun, such as the face and neck. Here are some signs to look out for carcinomas:

  • Basal cell carcinomas:
      • Raised reddish patches which can be itchy sometimes
      • Flat, firm, pale, or yellow skin areas that look like a scar
      • Small, translucent, pink, or red bumps that may have brown, black, or blue areas
      • Pink growths with elevated edges and a center that has abnormal blood vessels spreading out
      • Open sores that are slow to heal and come back after healing
  • Squamous cell carcinomas:
    • Raised skin growth or lumps, which have a shallower center
    • Rough or scaly red patches, which may sometimes bleed or crust
    • Open sores that do not easily heal, or come back after healing
    • Wart-like growths

If you are experiencing any of the warning signs and symptoms or notice something suspicious, consult with a dermatologist promptly. While monthly skin self-exams are important, especially to those who previously had skin cancer, an annual visit with a dermatologist for a professional skin exam is just as important.

Since not all skin cancers look like the descriptions above, you may also point out to your doctor things like:

  • Recurring itch, pain, or tenderness in an area
  • Redness or swelling beyond the edges of a mole
  • Oozing, scaliness, or a bum on the surface of a mole

To confirm the presence of skin cancer, a dermatologist will perform specialized tests like biopsies and imaging tests. In many cases, a biopsy is conducted by removing a tissue sample from the suspected growth. The dermatologist may also use a special microscope to conduct a dermatoscopy, a procedure that allows a closer examination of the suspicious spot.