May, a month to review screening and prevention efforts for skin cancer

May is Skin Cancer Awareness Month. The Skin Cancer Foundation reports that there are over 5 million cases of skin cancer diagnosed throughout the United States every single year. Skin cancer comes in three forms: the most aggressive is melanoma, with basal or squamous cell carcinomas making up the rest. Most skin cancers develop because of sun exposure on the face, lips, ears, scalp, chest, arms and legs, but genetics and other environmental factors have been implicated.

The designation of a Skin Cancer Awareness Month affords an opportunity to draw more attention to this form of cancer and provide information on screening and prevention efforts.

Why is screening important?

Skin cancer can present in different ways where the skin is exposed to sunlight. However, it can also develop in areas that are not usually exposed to sunlight, such as palms and soles, fingernails, genitals, and even in the eye. Dermatologists perform skin exams to screen for cancer before the person has symptoms. This can lead to early treatment before the cancer spreads and helps to better ensure a full recovery. The National Cancer Institute notes that screening options for skin cancer include a full-body visual exam where a dermatologist checks for moles, birth marks, or other pigmented areas that may have an abnormal presentation.

For example, basal cell carcinoma usually appears on sun-exposed portions of the body.  It may appear as:

• A skin bump (pearly or waxy)
• A flat scar-like lesion (flesh-colored or brown)
• A scabbing or bleeding sore that usually heals but frequently returns

Squamous cell carcinoma (SCC) is commonly found on body parts with frequent sun exposure but can develop in scars or sores, and rarely in the nails, vulva, or anus. It may appear as:

• A rough, scaly red or brown patch, that may be thick or crusty
• A raised growth or lump with some looking like they have a collapsed center
• An open sore that bleeds easily and does not heal

Melanoma usually presents as a mole that changes in shape, color, size, or feel, but can appear as a new mole. Most melanomas are dark, but a small percentage are not. It may appear as a mole with “ABCDE”:

• Asymmetry where one half doesn’t match the other
• The border is irregular, notched or blurred with pigment spreading into the surrounding skin
• Color is uneven and can include shades of black, brown, tan, as well grey, pink or blue
• Diameter increases in size and is usually larger than ¼ inch
• Evolves and changes over recent months or weeks

A recent example gained attention through a series of TikTok videos where a young woman explained how a mark on her fingernail turned out to be melanoma. The 25-year-old believed the dark brown streak on her right thumbnail was just a mole, but when she had it checked out, a biopsy showed that the streak was melanoma.

Because skin cancer can present differently for different people, it is a good idea to take advantage of screening options and see a dermatologist. If a concerning area is found, your doctor may recommend a biopsy. This involves an excision of the suspicious tissue and test by a pathologist to check for cancer cells.

How can I reduce my risk of skin cancer?

The best way to reduce your risk is to protect your skin from the sun’s ultraviolet (UV) rays. Wear a hat. Avoid tanning beds and sunlamps. Use sunscreen. These relatively easy and well-known precautions work. Patients can use these prevention methods and screening opportunities to better ensure early detection if a cancer forms. These efforts can help patients reduce the risk of a more serious skin cancer that could spread throughout the body.