What does that spot mean?
You’re taking a shower and notice that you have a spot on your skin that looks like a mole but it doesn’t like quite right. Most of us don’t think that much about our skin unless we have a cut or sunburn. Since small changes can signify a problem, we should pay closer attention to our skin. Should you be concerned about a mole that appears different? When should you see a doctor to have it checked to see if it is cancerous?
Definition
Skin cancer is an abnormal growth of skin cells due to damage to the DNA of the cells from UV radiation in sunlight and tanning bed lights. It starts in the top layer of skin (epidermis), which is a thin layer that provides protection of deeper skin cells. Your body continually sheds this layer of skin as new skin cells form and grow beneath it before moving up to replace the old ones. There are three types of cells in the epidermis: squamous cells, basal cells and melanocytes. Squamous cells lie just below the outer surface and are designed as an inner lining. Basal cells lie just below squamous cells and produce new skin cells. Melanocytes are in the lowest part of the epidermis (below basal cells) and produce melanin, which is what gives our skin its normal pigmentation. When your body is exposed to the sun, it makes more melanin in order to protect the deeper layers of the skin. Skin cancer usually affects one of these types of cells (ex. squamous cell carcinoma, basal cell carcinoma and melanoma). There are more types of skin cancer than these three, but they are the most common.
Most often, skin cancer appears on sun-exposed areas of the body, such as the scalp, face, lips, ears, neck, chest, arms, hands and legs. It can also occur in non-exposed areas, such as palms, beneath fingernails/toenails and genital area. It is important to note that skin cancer can affect all skin tones and for those with a darker complexion, it usually occurs in non-exposed areas more frequently.
Treatment
The first step in treatment is recognizing that something is different about your skin. The best way to do this is be aware of what your skin normally looks like and check it frequently for any changes that look suspicious. Early detection is key to getting the appropriate treatment. When you go to the doctor, they will do a thorough physical exam to look at all areas of your skin in order make sure that they haven’t missed anything. They might do a biopsy of the area of concern to see if it is cancerous. Your doctor will want to know when you first noticed the changes to your skin, has the area grown/changed since then, does the area bleed/itch and do you have any other symptoms? Most skin cancers are superficial and are easily treated. Some are more extensive and need a longer course of treatment. Once your doctor determines if you have skin cancer, he/she will verify the size of it and establish the best treatment plan.
Prevention
There are several things that you can do to prevent skin cancer. The first is to be aware of the risk factors that can contribute to it. They are being fair skinned, history of sunburns, excessive sun exposure, being in a sunny/high altitude climate, having moles, having precancerous skin lesions, family history of skin cancer, personal history of skin cancer, having a weakened immune system, exposure to radiation and/or exposure to certain substances. The best thing you can do to help prevent skin cancer is to avoid UV radiation from the sun and tanning beds as much as possible. These means don’t use tanning beds at all. As far as the sun, avoid being exposed to it during the middle of the day (roughly from 10:00 AM until 4:00 PM) and wear sunscreen of SPF 15 or greater year-round (it is key to reapply every 2 hours). It is important to wear protective clothing (dark, tightly woven clothes that cover your arms/legs), broad-brimmed hat or photo-protective clothing. Also, it is essential to wear sunglasses to protect your eyes and face from the sun. Some medications can increase your skin’s sensitivity to the sun—it is imperative to ask your doctor or pharmacist about this any time you take a new medication (antibiotics are especially known for this). After avoiding UV radiation as much as possible, the next best thing you can do is check your skin regularly for changes and get screened for skin cancer by your doctor.
Skin cancer is not a diagnosis you want to hear from your doctor, but it is treatable and preventable with a few simple steps. If you have any concerns that you might have skin cancer, please speak with your doctor. If you would like further information about skin cancer, please visit the American Cancer Society’s skin cancer page at https://www.cancer.org/cancer/skin-cancer.html or The Skin Cancer Foundation at http://www.skincancer.org/