Skin cancer is one of the most common forms of cancer worldwide, affecting millions of people each year. In Singapore, it is the 6^th and 7^th most common cancer in men and women, respectively. Skin cancer arises when skin cells undergo mutation, resulting in uncontrolled proliferation. The most common cause of mutation in skin cells is ultraviolet radiation (UVR). Understanding the different types of skin cancer, their symptoms, risk factors, and methods of prevention, is crucial for early detection and effective treatment by a skin cancer surgeon. This guide explores the most common types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma.

 

1. Basal Cell Carcinoma (BCC)

 

Overview:

 

Basal cell carcinoma is the most common type of skin cancer, accounting for about 80% of all cases. Most BCCs arise on the face, but they can also appear on the trunk and limbs. Fortunately, BCCs generally grow slowly and only rarely metastasize (spread to other parts of the body), hence they do not usually cause any risk to life.  However, if left untreated, BCCs will continue to grow and cause destruction of the local tissue and any surrounding structures such as the nose, eyes or ears. For this reason, BCCs were given a colloquial name “rodent’s ulcer”.

 

Risk Factors:

 

• Prolonged or repeated exposure to UV radiation from the sun or tanning beds.
• Fair skin complexion
• Age, with a higher risk in individuals over 50.
• A personal or family history of skin cancer.
• Occupations with increased exposure to radiation e.g. Agriculture, aviation.
• Weakened immunity, for example from taking immune-suppressing medications, and in organ transplant recipients.
• Certain genetic conditions, such as Gorlin-Goltz syndrome.

 

Symptoms:

 

• Skin-colored, pink, brown or black bump with a pearly or waxy appearance, often accompanied by visible blood vessels.
• Ulcers that bleed or crust over repeatedly and do not heal.

 

Prevention:

 

• Regular use of a broad spectrum sunscreen with a high SPF (more than 30).
• Protective clothing, wide-brimmed hats and sunglasses.
• Limiting outdoor activities during peak sun hours (between 10 a.m. to 4 p.m.).
• Avoiding tanning beds.
• Regular skin self-examinations and skin checks by a dermatologist.

 

2. Squamous Cell Carcinoma (SCC)

 

Overview:

 

Squamous cell carcinoma is the second most common type of skin cancer, making up about 20% of cases. They can sometimes arise from pre-cancerous growths called actinic keratoses. Unlikely basal cell carcinomas, SCCs carry a risk of metastasis (spread) to the lymph nodes or other organs. SCCs are most common on the face, scalp (in men with spares hair), forearms and back of the hands.

 

Risk Factors:

 

• Prolonged or repeated exposure to UV radiation from the sun or tanning beds.
• Fair skin complexion
• Age, with a higher risk in individuals over 50.
• A personal or family history of skin cancer.
• Smoking
• Occupations with increased exposure to radiation eg. Agriculture, avation.
• Weakened immunity, for example from taking immune-suppressing medications, and in organ transplant recipients
• Chronic wounds (such as leg ulcers) from which SCCs can sometimes arise
• Certain genetic conditions, such as albinism, xeroderma pigmentosa.

 

Symptoms:

 

• Firm nodule that is either pink, red, brown, or black.
• Flat sore with a scaly crust.
• New sore or raised area on an old scar or ulcer.
• Wart-like growth.

 

Prevention:

 

• Regular use of a broad spectrum sunscreen with a high SPF (more than 30).
• Protective clothing, wide-brimmed hats and sunglasses.
• Limiting outdoor activities during peak sun hours (between 10 a.m. to 4 p.m.).
• Avoiding tanning beds.
• Regular skin self-examinations and skin checks by a dermatologist

 

3. Melanoma

 

Overview:

 

Melanoma is the most dangerous type of skin cancer, accounting for a smaller percentage of cases but causing the majority of skin cancer related deaths. It develops in melanocytes, the cells responsible for pigment production. Melanoma can spread rapidly to other parts of the body, making early detection and treatment critical. Unlike basal and squamous cell carcinomas, melanomas have a greater tendency to afflict younger individuals.

 

Risk Factors:

 

• History of intense sun exposure and sunburns.
• Fair skin complexion having red or blond hair, or green or blue eyes
• Having many moles or atypical (dysplastic) moles.
• Family history of melanoma.
• Weakened immunity, for example from taking immune-suppressing medications, and in organ transplant recipients

 

Symptoms:

 

Melanoma can resemble normal moles, except with certain features such as

• Asymmetry – where the top and bottom, or left and right sides do not appear symmetrical.
• Borders which are irregular, scalloped, or poorly defined.
• Having a chaotic mixture of colors including shades of brown, black, white, red, or blue.
• Diameter larger than 6mm (about the size of a pencil eraser).
• Evolving shape, size, or color over time.

 

Prevention:

 

• Consistent use of high-SPF, broad-spectrum sunscreen.
• Wearing sun-protective clothing, hats, and sunglasses.
• Avoiding tanning beds and reducing sun exposure during peak sun hours (between 10am and 4pm).
• Routine skin checks by a dermatologist and performing regular self-examinations using the ABCDE rule (Asymmetry, Border, Color, Diameter, Evolution).

 

Conclusion

 

Understanding the most common types of skin cancer—basal cell carcinoma, squamous cell carcinoma, and melanoma—is essential for early detection and effective treatment. Each type has unique characteristics, risk factors, and symptoms, but all share the commonality of being influenced by UV exposure. Preventive measures such as regular sunscreen use, protective clothing, and routine skin checks are critical in reducing the risk of skin cancer. By staying informed and vigilant, individuals can protect their skin and overall health, potentially saving lives through early intervention.

If you’re facing a skin cancer diagnosis, rest assured that we are here to help. At TSN Dermatology, you consult our Mohs micrographic surgeon, who has extensive experience handling skin cancers. Reach out to us for more information.