What Does Early Skin Cancer Look Like? - Verywell Health

It can be challenging to tell if a skin change is unimportant or, in fact, is a sign of developing skin cancer. Skin cancer is not uncommon, as one in five Americans will develop skin cancer before age 70. Learning to spot the warning signs is vital. When identified early, skin cancer is highly curable. Do you know what to look for or when to seek medical advice?

Ivan-balvan / iStock / Getty Images

Precancerous Lesions

Precancerous lesions do not always progress to cancer. However, if left untreated, some lesions can develop into skin cancer, which is why it is good to know what to look out for.

Actinic Keratosis

Actinic keratosis, also known as solar keratosis, is a condition that produces large, scaly patches of skin caused by chronic exposure to ultraviolet (UV) radiation, such as from sunlight. The patches commonly appear on areas of the body often exposed to the sun, including the face, neck, scalp, hands, shoulders, arms, and back. Fifty-eight million Americans have actinic keratosis, and 5%–10% of the patches become cancerous.

The patches that form from actinic keratosis are small, scaly, and dry, and their color varies, appearing as different shades of pink, white, and brown, or resembling the color of one's skin. Due to their rough texture and depending on their location on the body, actinic keratosis may be felt before being seen.

Actinic Cheilitis

Actinic cheilitis, also known as farmer's lip or sailor's lip, is similar to actinic keratosis, but the rough and scaly patches appear on the lips, more often the lower lip. Actinic cheilitis is caused by chronic UV exposure, and men are affected more than women.

If left untreated, actinic cheilitis can evolve into squamous cell carcinoma (SCC), a type of skin cancer. Every year there are over 3,500 new lip cancer cases in the United States, and 90% of these are SCC.

Cutaneous Horns

Cutaneous horns are skin lesions made of keratin (the fibrous protein that makes up your nails and hair) that typically appear in sun-exposed areas of the body. The keratin forms growths that resemble small animal horns. Cutaneous horns can vary in size and shape and are more commonly seen in older adults.

Sixty percent of cutaneous horns are benign, but they should be examined by a healthcare provider since SCC can develop at the base.

Seek Medical Advice ASAP

If you find a lesion, seek medical advice as soon as possible. There is no way that your healthcare provider can determine which precancerous lesions will progress to skin cancer without being examined. Treatment or removal of a precancerous lesion can prevent skin cancer from developing.

Basal Cell Carcinoma (BCC)

Basal cell carcinoma (BCC) is the most common type of skin cancer, with over 2 million Americans diagnosed annually. BCC appears in the basal cells, the new skin cells produced as others die off. In most cases, BCC grows slowly, rarely spreads to other parts of the body, and is highly treatable if detected in the early stages.

BCC can occur anywhere on the body but is more common in areas exposed to the sun. It is important to know the signs and symptoms of BCC. The main skin changes to look for include:

• A nodule, or bump, that is shiny and can be skin-colored, pink, white, red, or varying shades of brown to black and look similar to a mole 
• An open sore that doesn't heal or one that heals but keeps returning 
• A scaly, rough, raised patch of skin that may be red, itchy, and painful or causes no discomfort at all
• A scaly patch or growth close to the ear
• A pink or red growth with an indentation in the center
• Scar-like shiny and waxy lesions

Although these are the most common signs to watch out for, BCC can easily be mistaken for other skin disorders. Be aware of new or unusual symptoms. If in doubt, seek advice from a medical professional as soon as you notice a skin change.

Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma (SCC) is the second most common form of skin cancer, with over 1 million diagnoses each year in the United States. If left untreated, it can grow rapidly and spread. Regular checks for unusual or new skin changes can help catch SCC early.

SCC warning signs include:

• Wartlike or hornlike growths
• Persistent, red, rough, scaly patches that may have irregular borders and may sometimes bleed or crust
• Persistent open sores, with or without raised edges, that don't heal
• Flat, brown spots that may be mistaken for age spots 
• Raised growths with a dip in the center that occasionally bleed

Melanoma

Although not as common as BCC or SCC, melanoma is the most threatening form of skin cancer. If left untreated, it can spread rapidly to other organs and the lymphatic system. Melanomas can appear anywhere on the body, but the most common location in women is on the arms and legs and in men, the head, neck, back, and trunk.

The most common warning sign of melanoma is a spot or mole on the skin changing in size, color, or shape. Most moles or spots are entirely normal and harmless. However, it is vital to get checked by a healthcare provider if you notice any changes to moles or other spots.

When checking your moles, the two most important techniques to remember are:

These are discussed in more detail below, along with how to conduct a skin examination at home.

Atypical Moles (Dysplastic Nevi)

Atypical moles, or dysplastic nevi, are not cancerous but can develop into skin cancer if left untreated. In most cases, atypical moles appear larger and are more irregular in shape than regular moles. They also may have an uneven border and be of more than one color.

If you have atypical moles, it is good to map them and keep an eye on them. You have a higher risk of developing melanoma if you have more than four atypical moles.

How to Check Yourself

By checking your skin regularly, you will learn to recognize what spots, moles, and marks are already present and how they typically appear. The more you get to know your skin, the easier it will be for you to detect changes, such as new lesions or spots and moles that have changed in shape, size, or color, or have begun bleeding. 

It is best to use a full-length mirror when checking your skin for changes or early signs of skin cancer. Observe your body in the mirror from all angles—front, back, and on each side.

Taking each part of the body in turn, start with your hands and arms, carefully examining both sides of the hands and the difficult to see places like the underarms. Move on to your legs and feet, making sure to check the backs of your legs, soles of your feet, and between your toes. 

Use a small mirror to get a closer look at your buttocks and your back. You can also use a small mirror to examine your face, neck, head, and scalp. Don't forget to part your hair and feel around your scalp.

ABCDE Procedure

When checking moles, this is what to look for:

A - Asymmetry: Is the shape asymmetrical? Melanomas tend to be uneven, with one half not matching the other. Moles are much more symmetrical in shape. 

B - Border: How does the border look? Melanomas often have an irregular, poorly defined, or jagged edge, while moles tend to have a smooth, even border.

C - Color: Is the color even? Each melanoma can have more than one color or have varying shades of one color. Moles tend to be even in color.

D - Diameter: How big is the mole, spot, or lesion? Most melanomas are larger than 6 millimeters (about 0.25 inches). 

E - Evolving: Is the mole evolving? Melanomas change in size, shape, and color, while normal moles tend to remain the same.

The Ugly Duckling Sign

The "ugly duckling sign" is another warning method to help identify melanomas. Usually, moles on your body look quite similar to each other. However, compared to other moles, melanomas tend to stand out like an ugly duckling. The more you check your skin and become familiar with it, the easier it becomes to spot an ugly duckling early. 

When to See a Healthcare Provider

It is always vital to seek medical advice early for a skin change, no matter how small it may appear. Make an appointment with your healthcare provider for a skin exam if you notice:

• Any new changes, lesions, or persistent marks on your skin
• A mole that is asymmetrical, has an irregular border, is multicolored, is large in diameter, is evolving, or has begun to crust or bleed
• An "ugly duckling" mole on the skin
• Any changes to your skin that you are concerned about

A Word From Verywell

Self-monitoring skin examinations are a necessary and effective form of skin cancer prevention. Be sure to point out to your healthcare provider any areas of concern. The sooner you identify skin changes, the better in preventing skin cancer. When caught early, skin cancer is highly treatable.