12 silent signs of skin cancer you’re probably ignoring
Subtle signs of skin cancer you shouldn’t ignore
When the weather gets warmer and daylight hours longer, people are more likely to spend time outdoors in the sun. This also means there’s an increased risk for skin cancer. Australia has one of the highest rates of skin cancer in the world, according to cancer.org.au, which account for around 80% of all newly diagnosed cancers. Although common, it’s also the most preventable and curable cancer if caught early. It’s recommended that you do monthly self-check exams from head to toe to look at moles and any other abnormalities on the skin. But aside from monitoring spots throughout your body, there are other subtle signs of skin cancer you may be ignoring.
We asked dermatologists to tell us what skin cancer symptoms people might miss.
Skin growths or moles that aren’t brown or black
While you might focus on brown or dark moles when you think of skin cancer, there are actually several types of skin growths to keep an eye on. The major types of skin cancer are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. Both BCC and SCC are known as non-melanoma skin cancer or keratinocyte cancers, says Cancer Council Australia.
- BCC is the most common type of skin cancer. It often has no symptoms and tends to grow slowly without spreading to other parts of the body. Symptoms include a pearly lump or a scaly dry area.
- SCC is the second most common form of skin cancer. Symptoms may include thickened red, scaly spots; rapidly growing lump; looks like a sore that has not healed; and may be tender to touch.
- Melanoma is the rarest but the deadliest form of skin cancer. Often melanoma has no symptoms, however, the first sign is generally a change in an existing mole or the appearance of a new spot. Melanoma is projected to be the third most common cancer diagnosed in Australia, which along with New Zealand has the world’s highest incidence rate for melanoma.
If you find yourself bleeding after shaving, it may not be due to clumsiness: “Basal cell carcinoma and squamous cell carcinoma can bleed after shaving or other minor trauma, and sometimes spontaneously bleed with no known inciting event,” says Dr Haimovic. “This is because skin cancer leaves the skin more fragile than healthy skin.” If you find yourself bleeding in the same spot, get it checked out.
Your family tree
Having a first-degree relative with melanoma approximately doubles an individual’s risk of developing melanoma, according to the Royal Australian College of General Practitioners (RACGP). Having relatives who have multiple melanomas or who are diagnosed at a younger age further increases the risk of developing melanoma.
A pimple that doesn’t go away
“Basal cell carcinoma may look like a translucent, skin-coloured or pink pimple that does not resolve or recurs in the same spot,” says Dr Haimovic. Usually, pimples go away on their own in two to three weeks; if one sticks around longer than that, it should be evaluated by a dermatologist.
A dark band on your nail
If you notice a fairly defined, dark vertical line on your fingernail or toenail, you might think you banged the nail. Take a closer look: “If the band has multiple different shades of brown and black, that is a concern. Also, if the width of the band is greater than three millimetres, that is another concerning feature,” says dermatologist Dr Steven Wang. Although there are other causes (such as an injury), a dark vertical line can sometimes be a sign of a melanoma, so make sure to ask your doctor to take a look.
One of your moles is not like the others
“A reddish- or light-brown-coloured mole in a sea of dark moles is what dermatologists call ‘the ugly duckling sign,’” says Dr Wang. Basically, one of the moles doesn’t belong in the group or doesn’t look like the others, so it could be a sign of melanoma. If you have a dominant mole pattern on your back and it’s disrupted by a darker, larger mole, it could be an ugly duckling sign. Another example: You have two patterns of small and dark moles on your back, but there’s a smaller, pale mole. The only way to confirm if this is a malignant melanoma is to have it checked by a dermatologist.
You’ve had PUVA treatments
Psoralen and UV-light treatments (PUVA) are a type of ultraviolet radiation treatment for severe skin conditions such as psoriasis and dermatitis. A previous study published in the Journal of the American Academy of Dermatology found an increased risk of malignant melanomas 15 years after a patient’s first PUVA treatment. In fact, patients who have had 250 or more treatments have five times the risk of people who have never had PUVA.
You’ve had an HPV infection
There are many forms of human papillomavirus (HPV), with some increasing the risk of cervical cancers. But other kinds of HPV (there are more than 100 in this family of viruses) can cause warts on the skin, often the hands or feet.
It’s thought that these skin wart-causing viruses may also increase the risk of non-melanoma skin cancers. In a 2012 study published in the American Journal of Epidemiology, the participants with antibodies against certain types of HPV had a higher risk of developing non-melanoma skin cancer.
Your immune system is weak
People with weakened immune systems because of disease or certain types of treatment can have a higher risk of skin cancer. HIV/AIDS and lymphoma patients may have an elevated risk, according to the American Cancer Society. This is also true of people who get chemotherapy or other medications that suppress immunity.
You have the XP gene
Xeroderma pigmentosum (XP) is a rare inherited disorder. According to the Genetics Home Reference, it’s estimated that about one in one million people have it. People with the disorder have an extreme sensitivity to ultraviolet rays from the sun. The gene limits the skin cells’ ability to repair damage to their DNA. According to the American Cancer Society, people with XP have a high risk of developing melanoma and other skin cancers when they are young – when the condition usually reveals itself – especially on the eyes and sun-exposed areas.
You work with industrial chemicals
People who work in the fields growing produce, in steel and iron foundries, or in coal and aluminium production plants have a higher risk of skin cancer, according to a 2014 study published in BioMed Research International. Also at risk are people who work with industrial carcinogens. These include arsenic – used in pesticides – and polycyclic aromatic hydrocarbons – which are in raw paraffin, creosote, chimney soot, asphalt, shale oil, tar and pitch, and even diesel-engine exhaust fumes.
You already had skin cancer
Just because you’ve had a squamous cell carcinoma or another type of skin cancer removed doesn’t mean you can relax – if anything, you should be more concerned. SCC recurrence is relatively common on the ears, nose and lips; it typically occurs during the first two years following surgery. In fact, having any type of skin cancer makes it more likely that you will develop another type of skin cancer. “During your regular skin check, your dermatologist will examine old scars to make sure there is no evidence of the cancer returning,” says Dr Haimovic.
Dermatologists recommend that you do a monthly self-check of your moles and any other skin abnormalities to help catch trouble early. This will help you keep tabs on any changes. Be on the lookout for moles or lesions that change in colour (including fading), shape or size, or if you’re experiencing pain, itching or bleeding in these areas, Dr Wang advises.
If you do have a growth, use the guideline called ABCDE to evaluate it. That stands for:
- Asymmetry (melanomas are less likely to be symmetrical),
- Border (melanoma borders tend to be uneven),
- Colour (multiple colours aren’t good),
- Diameter (if it’s the size of pencil eraser or bigger, that’s a red flag), and
- Evolving (a change in size or behaviour, such as bleeding, itching, or crusting).
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