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Skin Cancer Screening in Singapore

Skin Cancer Screening in Singapore

Dr Koh Hong Yi

Dr Koh Hong Yi

Senior Consultant Dermatologist

Dr Tham Siew Nee

Dr Tham Siew Nee

Senior Consultant Dermatologist

Skin cancer screening is a vital proactive health practice designed to detect early-stage changes in the skin before they progress into more serious conditions. Because skin cancer is one of the most common malignancies in Singapore, regular clinical surveillance is essential—particularly for individuals with a history of significant sun exposure, those with a high number of moles, or those with a family history of skin cancer. While skin checks are often associated with identifying existing issues, a professional screening is primarily a preventative measure that provides peace of mind and identifies high-risk lesions at their most treatable stage.

Although skin cancer is a serious health concern, it is highly manageable when identified early. Success in skin health maintenance relies on three core pillars: regular self-monitoring for changes in skin lesions, professional dermatological assessment using dermoscopy to view beneath the skin's surface, and personalised, long-term surveillance schedules calibrated to your individual risk profile.

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What Are Skin Cancers?

What Are Skin Cancers?

Skin cancers are abnormal growths that develop when DNA damage in skin cells—often triggered by UV radiation—leads to uncontrolled cell division. Unlike benign growths, which remain localised, some skin cancers have the potential to invade surrounding tissues or spread (metastasise) to other parts of the body.

The most common types are basal cell carcinoma, squamous cell carcinoma, and melanoma. Because early-stage skin cancers can mimic the appearance of harmless spots or moles, specialised dermatological care is required for accurate assessment and timely management.

What Are Common Types of Skin Cancer?

Accurate diagnosis is vital, as different types of skin cancer vary in their growth patterns and potential risks.

Basal Cell Carcinoma (BCC)

  • Accounts for 70-80% of all skin cancers.
  • Presents as skin-coloured or slightly reddish, pearly-looking bumps or chronic ulcers.
  • Generally slow-growing, though they may bleed easily with minor trauma.
  • Rarely metastasise, but require treatment to prevent local tissue destruction.

Squamous Cell Carcinoma (SCC)

  • Makes up around 20% of skin cancers.
  • Usually appears as reddish, rough, scaly bumps, often on chronically sun-exposed skin like the scalp, face, or back of the hands.
  • Can occasionally break down to form an ulcer and has a higher risk of spreading to lymph nodes compared to BCC.

Malignant Melanoma

  • A less common but highly aggressive form of skin cancer arising from melanocytes (pigment cells).
  • Often mimics the appearance of normal moles, making professional dermoscopy essential for accurate diagnosis.
  • Requires early detection and treatment to prevent spread to lymph nodes or other organs.

Actinic Keratosis (Pre-cancerous)

  • Often described as pre-cancerous patches of dry, rough skin.
  • Commonly found on the scalp, face, or hands of individuals with a history of long-term sun exposure.
  • Essential to treat to prevent potential progression into squamous cell carcinoma.

Common Symptoms of Skin Cancer to Look Out For

Skin cancers often demonstrate progressive or distinct warning signs. Recognising these features early is the most effective way to ensure successful treatment. Monitor your skin for these signs:

Common Symptoms of Skin Cancer to Look Out For
1

Changes in Appearance (The ABCDE Rules)

A key indicator of melanoma is a change in a mole's profile. Watch for Asymmetry (one half not matching the other), Border irregularities (jagged, notched, or blurred edges), Colour variegation (mixing of brown, black, blue, white, or red), Diameter (larger than 6mm), and Evolution (any change in size, shape, or elevation).
2

Persistent Non-Healing Sores

If a spot, crust, or ulcer fails to heal after several weeks—or if it heals temporarily only to recur in the same location—it requires urgent evaluation. This is a classic sign of basal cell or squamous cell carcinoma that should never be ignored.
3

Unusual Surface Textures

Observe the surface quality of your lesions. Be alert for growths that appear shiny, pearly, translucent, or waxy, as well as patches that feel persistently rough, scaly, or crusty. Unlike a typical dry patch, these textures often do not resolve with moisturising.
4

Physical Sensations

While early-stage skin cancers are often painless, any previously quiet spot that becomes persistently itchy, tender, or painful is a red flag. If a lesion is consistently hot to the touch or feels different from your other moles, seek a professional opinion.
5

Spontaneous Bleeding or Crusting

Most benign growths only bleed if they are injured. A lesion that begins to bleed, weep, or form a persistent crust without any clear history of trauma or injury is a significant warning sign that the lesion's integrity is compromised by abnormal cell growth.
6

The Ugly Duckling Sign

Watch for any spot that stands out as being different from the rest of your skin. If you have a collection of similar-looking moles, but one spot looks darker, larger, or more irregular than the others, it is the ugly duckling that needs to be examined by a dermatologist.

What Causes or Triggers Skin Cancer?

Skin cancer arises when genetic mutations occur within skin cells, causing them to grow uncontrollably and form malignant lesions. While some factors are beyond our control, understanding these triggers is essential for effective prevention and early detection.

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Cumulative Sun Exposure

Ultraviolet (UV) radiation from the sun and tanning beds is the primary driver of DNA damage in skin cells. Chronic, cumulative sun exposure over a lifetime—as well as a history of intense, blistering sunburns, particularly during childhood—significantly increases the risk of basal cell carcinoma, squamous cell carcinoma, and melanoma.
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Genetic Predisposition

If you have a family history of melanoma or other skin cancers, your risk is statistically higher. Additionally, individuals with fair skin, light hair, blue or green eyes, and a tendency to burn easily rather than tan have less natural protection against UV-induced DNA damage.
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Weakened Immune System

A robust immune system helps the body identify and repair damaged or abnormal cells. Individuals with weakened immune systems—whether due to medical conditions, immunosuppressive medications (such as those used following an organ transplant), or chronic illness—are at a higher risk of developing various forms of skin cancer.
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History of Pre-cancerous Lesions

Previous development of pre-cancerous growths, such as Actinic Keratoses, indicates that your skin has already sustained significant UV damage. These areas of sun-stressed skin are more prone to progressing into invasive squamous cell carcinoma if left unmonitored.
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Chronic Inflammation or Scarring

While rare, skin cancer can sometimes develop in areas of chronic inflammation or old injury. Conditions such as long-standing ulcers, burn scars, or chronic inflammatory skin diseases can lead to a type of squamous cell carcinoma that arises from the scarred tissue rather than from sun damage.
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Chemical and Environmental Exposure

Long-term exposure to certain environmental carcinogens, such as high levels of arsenic or industrial chemicals, has been linked to an increased risk of developing non-melanoma skin cancers.

How Are Skin Cancers Diagnosed?

Accurate diagnosis is the cornerstone of effective skin cancer management. Because skin cancers often masquerade as harmless spots or benign growths, a structured, professional evaluation is essential to identify malignancy at the earliest possible stage.

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Clinical Examination

The process begins with a head-to-toe skin examination. A dermatologist will assess all suspicious lesions for the ABCDE features (Asymmetry, Border, Colour, Diameter, and Evolution) and investigate areas that are difficult for you to monitor yourself, such as the scalp, back, and between the toes.
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Medical History Review

The doctor will review your history of sun exposure, past sunburns, family history of melanoma, your skin type, and any history of pre-cancerous lesions or prior skin cancers. This context helps us determine if a spot requires aggressive investigation or simply vigilant monitoring.
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Advanced Dermoscopy

Dermoscopy is the gold standard for clinical assessment. By using a specialised, high-magnification instrument that polarises light, we can peer beneath the superficial skin layers to view subsurface structures—such as atypical blood vessel patterns or chaotic pigment networks—that are completely invisible to the naked eye. This allows for highly accurate, real-time assessment of whether a spot is suspicious.
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Skin Biopsy

If a lesion shows concerning features during clinical examination or dermoscopy, a biopsy is necessary to confirm the diagnosis. Under local anaesthesia, we remove a small sample of the tissue (or the entire lesion) to be analysed by a pathologist under a microscope. This provides a definitive, tissue-level diagnosis and determines the specific type and stage of the cancer.

How Are Skin Cancers Screened at TSN Dermatology?

A skin cancer screen or mole check is a thorough skin examination by a specialist. This can sometimes take more than 30 minutes. A dermatologist will usually use a dermatoscope, a specialised tool that helps to identify unique patterns under the skin, to help make a more accurate diagnosis.

How Are Skin Cancers Screened at TSN Dermatology?

At TSN Dermatology, evaluation usually begins with a comprehensive medical history assessment to identify the risk level a patient has for skin cancer. This is followed by examination, firstly of the growths that the patient is worried about, and then the rest of the skin from head to toe. We aim to be thorough, but will protect your modesty and make you comfortable at all times.

If any suspicious growth is identified, our doctor will discuss with you the options available, ranging from close observation of the growth to taking a skin biopsy. The consultation ends with education on how to perform self-monitoring of the skin and sun protection. Regular skin checks by the doctor should be performed every 6 to 12 months.

Tips on Daily Care and Prevention of Skin Cancer

While skin cancer is often driven by genetics and past cumulative UV damage, consistent daily habits are your most powerful tool for prevention and early detection. Whether you are proactively protecting your skin or recovering from a recent treatment, these habits are essential for long-term health.

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Sun Safety: Your First Line of Defence

  • Use Broad-Spectrum Sunscreen
    Apply a high-SPF (30 or higher), broad-spectrum sunscreen daily to all exposed skin, regardless of the weather. Reapply every two hours if you are outdoors.
  • Practice Sun-Smart Living
    In Singapore's intense tropical climate, minimise direct sun exposure between 10 AM and 4 PM. Use protective gear like wide-brimmed hats, UV-blocking sunglasses, and long-sleeved, breathable clothing to create a physical barrier against harmful radiation.
  • Seek Shade
    Whenever possible, stay under cover. Remember that reflective surfaces like sand, water, and concrete can increase your UV exposure even when you are not in direct sunlight.
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Perform Monthly Self-Exams

  • The ABCDE & Ugly Duckling Check
    Spend 5-10 minutes once a month examining your skin. Use a full-length mirror and a hand mirror to check areas you cannot easily see, such as your back, scalp, soles of your feet, and between your toes.
  • Know Your Baseline
    Familiarise yourself with your existing moles. The goal of these self-exams is to identify the Ugly Duckling—any spot that looks, feels, or behaves differently than your other moles, or a spot that is evolving in size, shape, or colour.
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Maintain Skin Health and Immunity

  • Be Mindful of Lifestyle Factors
    While UV is the primary trigger, maintaining a healthy, balanced lifestyle supports your immune system—your body's internal defence against abnormal cell growth.
  • Monitor High-Risk Areas
    If you have a history of chronic inflammation, long-standing ulcers, or burn scars, keep a close watch on these areas. Skin cancer can occasionally develop in tissues that have been chronically damaged or scarred.
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Post-Treatment Aftercare

  • Strict Wound Care
    If you have undergone a procedure (such as excision or Mohs surgery), strictly follow your dermatologist's wound care instructions to prevent infection and promote optimal healing.
  • Protect the Healing Site
    The skin at a surgical site is fragile. Keep it protected from the sun with clothing or high-SPF sunscreen to prevent permanent hyperpigmentation and ensure the best cosmetic outcome.
  • Attend All Follow-up Appointments
    Regular surveillance is critical for patients with a history of skin cancer. Even if an area looks fully healed, these check-ups ensure that no recurrent or new lesions are missed.
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When Should You See a Dermatologist for Skin Cancer Screening?

Early detection is the most significant factor in successfully treating skin cancer. Because many malignancies can deceptively mimic harmless moles or benign spots, you should not rely on a wait-and-see approach if you have concerns. You should schedule a professional skin cancer screening or a dedicated mole check if you experience any of the following:

When Should You See a Dermatologist for Skin Cancer Screening?
1

New or Evolving Spots

Any new mole appearing after age 30, or any existing spot that is visibly changing in size, shape, symmetry, or colour, requires immediate evaluation.

2

Non-Healing Sores

If you have a sore, ulcer, or crusted patch that fails to heal after several weeks—or one that heals and then repeatedly returns in the same spot—it must be assessed to rule out basal cell or squamous cell carcinoma.

3

The Ugly Duckling Sign

If you notice a spot that looks significantly different, darker, or more irregular compared to the rest of your moles, it stands out as a potential red flag and should be examined.

4

Persistent Symptoms

A growth that becomes persistently itchy, tender, or painful, or one that bleeds or weeps without any clear history of injury, requires urgent clinical investigation.

5

Risk Factor History

If you have a personal or family history of skin cancer (especially melanoma), a history of severe blistering sunburns, or a fair complexion, you should undergo regular, proactive skin checks even if you don't notice any specific changes.

6

Total Body Surveillance

If you have an extensive number of moles, it can be difficult to track changes at home. A professional skin check every 6 to 12 months provides a baseline and the expert oversight needed to detect subtle, dangerous changes that may be missed during self-examination.

FAQs About Skin Cancer Screening

No. Skin cancer is not contagious and cannot be spread through physical contact, sharing personal items, or social interaction. It is the result of uncontrolled cell growth caused by internal genetic mutations, typically triggered by external factors like cumulative UV radiation.

Yes, especially when detected early. For the vast majority of skin cancers, complete surgical removal—often requiring only minor, localised excision—is curative. For advanced cases, modern therapies like immunotherapy or targeted treatments can also achieve excellent control. Because skin cancer is often a marker of cumulative sun damage, however, patients remain at a higher risk of developing new lesions elsewhere, which is why regular long-term surveillance is crucial.

It is often a combination of your genetic blueprint and your unique history of sun exposure. Factors like skin type (fairer skin provides less natural protection), the amount of time spent outdoors, a history of blistering sunburns, and the efficiency of your immune system all play a role in whether your cells successfully repair UV-induced damage or develop into cancer.

No. Unlike some rare inflammatory skin conditions, skin cancers do not regress or disappear on their own. While a lesion might occasionally scab over or seem to shrink temporarily, this is often a deceptive sign of healing that masks underlying tumour growth. Any lesion that changes or fails to heal must be evaluated by a professional.

Seek Proper Dermatologist Care for Skin Cancer

If you suspect you or your child might have skin cancer, a consultation with our specialists at TSN Dermatology Skin Specialist Clinic can help clarify the diagnosis and establish an effective, personalised treatment plan focused on long-term skin health and quality of life. For more information or appointments, please contact us today.

Meet The
Doctors Behind Your Care
Dr Koh Hong Yi
Dr Koh Hong Yi

Senior Consultant Dermatologist

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    Bachelor of Medicine, Bachelor of Surgery (MBBS)

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    Member of the Royal College of Physicians (United Kingdom)

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    Master of Medicine (Internal Medicine)

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    Fellow of the Academy of Medicine, Singapore (Dermatology)

Dr Koh Hong Yi is a Ministry of Health-accredited dermatologist with over 20 years of experience in medical, surgical and aesthetic dermatology.

He trained in Singapore and the UK, and is particularly interested in Skin Cancer Screening, Mohs micrographic surgery, dermatologic surgery, skin cancer care, and inflammatory skin diseases.

Prior to private practice, he founded the Mohs Surgery Service at Singapore General Hospital and served as consultant dermatologist and Adjunct Assistant Professor with Duke-NUS Medical School, contributing to clinical research and education.

About Dr Koh

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