Skin Cancer Symptoms: What to Watch For and When to Seek Care

This updated guide describes common skin cancer types and their typical symptoms: actinic (solar) keratoses as rough scaly patches; basal cell carcinoma as pearly bumps or flat growths; squamous cell carcinoma as nodules or red scaly patches; and melanoma as changing or irregular moles. It highlights the ABCDE rule for melanoma, notes Kaposi's sarcoma and Paget's disease as rarer forms, and stresses early evaluation, biopsy for diagnosis, sun protection for prevention, and appropriate treatments ranging from topical or surgical options to advanced systemic therapies for metastatic disease.

Overview

Skin cancers arise from different skin cells and vary in behavior. Many common types grow slowly and rarely spread, but others can be aggressive. Early recognition and evaluation by a clinician improve outcomes.

Actinic (Solar) Keratoses - Precancerous Lesions

Actinic keratoses appear as small, rough, scaly patches on sun-exposed areas such as the face, ears, scalp, and hands. They are common in fair-skinned people with long-term sun exposure. These lesions can be tender, crust, or bleed and are considered precancerous because some progress to squamous cell carcinoma. Treating or monitoring them reduces that risk.

Basal Cell Carcinoma (BCC)

Basal cell carcinoma typically appears as a pearly or flesh-colored bump, a rolled edge sore, or a flat, scaly patch. It most often develops on the head, neck, and hands. BCC usually grows slowly and very rarely spreads to distant sites, but it can invade and damage nearby tissue if not treated.

Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma can present as a firm nodule, a scaly red patch, or an ulcerated area that may crust or bleed. SCC most commonly arises on sun-exposed skin. Compared with BCC, SCC has a higher risk of spreading (metastasizing) if left untreated.

Melanoma - More Aggressive and Needs Prompt Evaluation

Melanoma originates in melanocytes, the pigment-producing cells. It is less common than BCC or SCC but more likely to metastasize if not detected early. Watch for changes in existing moles or the appearance of new, unusual lesions.

Use the ABCDE guideline to help spot suspicious moles:

• A - Asymmetry: one half differs from the other

• B - Border: irregular, scalloped, or poorly defined edges

• C - Color: varied shades within the same lesion

• D - Diameter: larger than about 6 mm (a pencil eraser)

• E - Evolving: changing in size, shape, color, or symptoms (itching, bleeding)

Other Rare Forms

Kaposi's sarcoma appears as pink, red, or purple patches or nodules and is associated with human herpesvirus 8 (HHV-8). Paget's disease of the breast is a rare form that causes eczema-like changes around the nipple and often links to underlying breast malignancy.

When to See a Healthcare Provider

See a dermatologist for any new, changing, bleeding, or tender lesion. Also consult for persistent scaly patches (possible actinic keratoses) or sores that do not heal. A biopsy is the standard test to confirm a diagnosis.

Prevention and Common Treatments

Sun protection - broad-spectrum sunscreen, protective clothing, and avoiding intense midday sun - reduces risk. Treatment depends on type and stage: options include cryotherapy or topical therapy for actinic keratoses, surgical excision or Mohs micrographic surgery for many BCCs and SCCs, and targeted or immunotherapies for advanced melanoma. Early detection offers the broadest treatment choices and the best outcomes.