Understanding Skin Cancer: What You Need to Know

Skin cancer is a malignant growth of abnormal skin cells. These diseased cells multiply uncontrollably due to damage to the cell’s DNA or an imbalance in the normal process of cell creation. While skin cancer is common, understanding its causes, types, and treatment options can empower you to catch it early and take preventive steps.

What Is Skin Cancer?

The skin is composed of different types of cells, organized into layers—like a peanut butter and jelly sandwich. Skin cancers develop when specific cells within these layers begin to grow uncontrollably. The type of skin cancer depends on the layer and cell type involved. For instance, a disease in the “jelly” layer might be humorously referred to as a “jelly cell carcinoma.” In reality, the most common types of skin cancer include: Basal Cell Carcinoma (BCC),  Squamous Cell Carcinoma (SCC) and Melanoma.

The term non-melanoma skin cancer (NMSC) refers to all types of skin cancer except melanoma.

Types of Skin Cancer

Basal Cell Carcinoma (BCC)

BCC is a malignant disease of the basal layer of the skin, where keratinocytes—the skin's building blocks—are born. This layer plays a crucial role in forming a protective water barrier by producing fatty cells called lipids. BCC is the most common and least aggressive type of skin cancer but still requires prompt treatment.

Squamous Cell Carcinoma (SCC)

SCC is caused by uncontrolled growth of abnormal keratinocytes in the squamous layer of the skin. These cells are found both on the outside of the skin and inside mucosal surfaces like the mouth and esophagus—imagine both slices of bread in a peanut butter and jelly sandwich. Due to this, we now often specify "cutaneous" SCC when referring to the skin version. The squamous layer serves as a gatekeeper, involved in both protection and transport, thanks to its production of keratin, a tough protein found in skin, hair, and nails.

Melanoma

Melanoma is a serious form of skin cancer involving melanocytes—cells responsible for skin pigment and some immune responses. When melanocytes become damaged, they may grow uncontrollably and spread (metastasize) throughout the body, as they are found across all layers and areas of the skin. Think of it like the calories in every part of a peanut butter and jelly sandwich—melanocytes are everywhere.

Who Gets Skin Cancer?

Skin cancer most commonly affects older adults but can also impact younger adults and, rarely, children. It is more frequently seen in individuals with fair skin (Fitzpatrick skin types I, II, and III), but people with darker skin are not immune. Other risk factors include:

• A personal or family history of skin cancer
• Genetics linked to skin cancer risk
• Previous sunburns or tanning bed use
• Immunosuppression (e.g., HIV, organ transplant)
• Smoking (especially for SCC)
• HPV infection (notably in mucosal areas)
• Radiation exposure or chemical carcinogens like arsenic or coal tar

Causes of Skin Cancer

The most common skin cancers are primarily caused by ultraviolet (UV) radiation from the sun or tanning beds. Aging also contributes to the breakdown of DNA repair mechanisms. Other contributing factors include:

• Smoking (SCC) HPV infection in mucosal areas
• Weakened immune system
• Exposure to ionizing radiation
• Chemical exposure, such as arsenic and coal tar

Signs and Symptoms

Skin cancer may present as: agrowing lump or nodule, an ulcer that doesn’t heal, or a changing or multicolored lesion.

To visualize it, imagine a wall of blue polka dots—if one red polka dot appears, it stands out. That’s the "ugly duckling" we look for.

Complications of Skin Cancer

When caught early, most skin cancers are treatable and curable. However, if left untreated, complications may include: bleeding or ulceration, local invasion of nearby tissues, or spread to lymph nodes or distant organs (metastasis).

Patients who have had one skin cancer are at higher risk for developing others.

How Is Skin Cancer Diagnosed?

Skin cancer is typically diagnosed by a dermatologist or trained medical provider during a physical exam. Suspicious lesions may be biopsied—a small sample is removed and examined under a microscope. A biopsy helps determine the type and severity of the cancer, which influences the treatment plan. Lab results usually take a few days, but may require more time if special testing is needed.

Treatment Options

Early treatment usually leads to a full cure. Most skin cancers are treated with local procedures performed under local anesthesia. Treatment methods include:

• Excision biopsy
• Wide local excision
• Mohs micrographic surgery
• Cautery and electrosurgery
• Cryotherapy (freezing)
• Topical treatments (e.g., fluorouracil or imiquimod)
• Photodynamic therapy
• Radiotherapy
• Lasers
• Systemic or intralesional immunotherapy

How to Prevent Skin Cancer

Preventing skin cancer starts with being proactive about your skin health. Follow these tips:

• Use sunscreen daily, even on cloudy days
• Avoid tanning beds and excessive sun exposure
• Perform regular self-exams
• Schedule annual skin checks with a dermatologist or dermatology PA
• Seek evaluation if you notice new or changing moles or lesions

Take Control of Your Skin Health

Skin cancer is common—but it’s also highly treatable when caught early. At Charlotte Dermatology, we’re here to help you understand your skin, recognize potential problems, and get the care you need. Come in and see us to better understand the skin you’re in! Make an appointment today!