Skin Cancer Frequently Asked Questions What is basal cell carcinoma and what does it look like? Basal cell carcinoma is the most common type of skin cancer. It usually appears as a sore that won't heal or a pearly, shiny bump or knot that sometimes has small blood vessels within the affected area. The area may bleed with minor trauma. There are several other presentations including one that appears like a red, rough patch. Sometimes, they are mistaken for pimples, cysts and rashes. Basal cell carcinoma does not progress to invade the blood stream except under extreme circumstances. However, it can invade and destroy the local area and cause deformity if left unchecked. What is squamous cell carcinoma and what does it look like? Squamous cell carcinoma is the second most common type of skin cancer. It arises from the outer layer of the skin. Squamous cell carcinoma can occur anywhere on the skin but is most common on the face and arms. It often appears as an opaque or scaling patch or bump in sun‐exposed areas, and may be mistaken for a wart or patch of dry skin. Unlike basal cell carcinoma, squamous cell carcinoma can progress far enough to get into the lymph nodes and blood stream and become a threat to a patient's life. This is more common in large, aggressive squamous cell carcinomas or in cancers on the ears, upper head, lips or genitalia, or skin cancers that have been treated before, but have now come back. The overall chance of any squamous cell carcinoma spreading outside the local region is about 2%, but this can be much higher depending on the location of the cancerous site or other features. What is melanoma and what does it look like? Melanoma is the most deadly skin cancer, but has an excellent prognosis if it is caught early. Though melanoma may occur any where on your skin, melanoma is found most often on the legs of women or the backs of men. It is usually a brown to black lesion which is not uniform in border, color or surface. The "ABCDE's of melanoma" have been described to help distinguish a regular mole from melanoma. The acronym stands for Asymmetry (most healthy moles are uniform), Border (irregular), Color (irregular or change in), Diameter (larger than a pencil eraser‐not reliable), and Evolving (changing). Melanomas on chronically sun‐damaged skin like the face may appear like a brown patch or freckle with irregular color. Melanomas may be treated with Mohs Micrographic Surgery. What is actinic keratosis and what does it look like? Actinic (solar) keratosis is the most common type of pre‐cancer. They are caused by chronic, cumulative sun exposure. Actinic keratosis looks like a scaly patch of dry skin, either flesh‐colored or pink, which occurs on sun‐exposed areas such as the head and neck, arms, chest and legs. Patients often describe a small area of dry skin that recurs in the same place after picking it off. Actinic keratoses should be treated early, as they may lead to squamous cell carcinoma. Can I get skin cancer anywhere on my body? While skin cancers usually appear on skin that has been chronically exposed to the sun (like the head, neck, arms, and chest), you can get skin cancer anywhere ‐ even on skin that has rarely or "never" been exposed to the sun (for example, the genitals). What can I do to prevent getting skin cancer? The damage that your skin has already received from the sun cannot be completely reversed. However, several precautions can be taken to reduce your risk of developing further skin cancers: Sun Safety Tips • Minimize sun exposure from 10:00 AM to 4:00 PM when the sun's rays are the strongest. If you enjoy outdoor activities such as golfing, gardening, running, walking, or boating, try to schedule them outside of these "peak sun hours." • Apply a sunscreen with an SPF of 30 or greater at least one half hour before going outdoors and reapply as directed on the product label. Look for products containing avobenzone, titanium dioxide, or zinc oxide. Choose a cream‐based sunscreen if you have dry skin, and a gel‐based, or non‐comedogenic formula if you have oily or acne‐prone skin. Choose a "very water resistant" formula if you will be sweating or in water, however remember that even these must be reapplied every 80 minutes. If the ears or portions of the scalp are exposed due to short or thinning hair, remember to apply sunscreen to these areas as well. • Protect your lips with lipstick or a lip balm containing sunscreen. • Wear protective clothing, including a long‐sleeved shirt, wide‐brimmed hat and ultraviolet blocking sunglasses. • Avoid use of the UV beds at tanning salons. • Don't forget to use your sunscreen on overcast days. The ultraviolet rays can be as damaging to your skin on cloudy, hazy days as they are on sunny days. • Use a sunscreen while at lower latitudes or high altitudes. The sun is stronger near the equator and at high elevations where the sun's rays strike the earth most directly. • If you need a little "color," use a sunless tanning lotion or get a spray tan. Will my cancer come back (recur)? The goal of Mohs Micrographic Surgery is to remove your skin cancer while preserving your normal healthy surrounding skin. The cure rate for Mohs surgery is very high, even for the most difficult tumors. The cure rate is approximately 99 percent for new skin cancers and 95 percent for recurrent skin cancers (those which have been treated in the past and have come back.) However, no one can guarantee a 100 percent cure rate with any treatment method. Will I develop more skin cancers? Studies have shown that once you develop a skin cancer, there is an increased risk of developing others in the years ahead. For this reason, it is important for you to continue seeing your primary Dermatologist at regularly scheduled intervals, and to schedule an appointment if you are concerned about new or changing growths on your skin. You can reduce your risk of developing more skin cancers by protecting your skin from further sun damage, but continued vigilance on your part is required (along with scheduled visits to your Dermatologist) to help detect further skin cancers at an early stage.