Causes and Risk Factors
Most basal and squamous cell cancers are caused by cumulative ultraviolet (UV) damage from the sun or tanning beds. Risk is higher with:- Long-term sun exposure: Outdoor work, outdoor sports, and decades of Florida sunshine add up, even without memorable sunburns.
- Fair skin, light eyes, or light hair: Less natural pigment means less built-in UV protection.
- Older age and male sex: These cancers become much more common after age 50.
- A weakened immune system: Organ-transplant medicines and blood cancers such as chronic leukemia or lymphoma substantially raise risk.
- Previous sun damage or skin cancer: Actinic keratoses (rough, scaly precancerous spots) and any prior skin cancer increase the chance of another.
- Chronic wounds and prior radiation: Long-standing scars, non-healing ulcers, and previously irradiated skin are occasional sites for squamous cell cancers.
Symptoms
These cancers usually appear on sun-exposed skin — the face, ears, scalp, neck, arms, and hands. Basal cell cancers grow slowly and almost never spread internally, while squamous cell cancers can occasionally spread if neglected, which makes early recognition worthwhile. Warning signs include:- A pearly or waxy bump: Often with tiny visible blood vessels; typical of basal cell carcinoma.
- A sore that heals and reopens: Any spot that bleeds, crusts, or fails to heal within a month deserves evaluation.
- A firm, red nodule or a flat, scaly patch: Typical of squamous cell carcinoma, which can be tender or crusted.
- A persistent rough spot mistaken for a rash: Unlike dermatitis, a skin cancer does not come and go or respond to moisturizers.
Diagnosis
A clinician examines the spot and the rest of your skin, and a small biopsy taken under local anesthetic confirms the diagnosis and the cancer type. Because these cancers rarely spread internally, imaging is seldom needed for early lesions. The biopsy takes minutes in the office under local numbing, and results typically return within one to two weeks. If a squamous cell cancer looks aggressive, your clinician may also examine nearby lymph nodes.Treatment
Treatment depends on the size, depth, location, and type of the cancer:- Surgical removal: Simple excision cures most tumors; Mohs micrographic surgery spares healthy tissue for cancers on the face or other delicate areas.
- Destruction techniques: Freezing (cryotherapy) or scraping and cauterizing can treat certain small, superficial lesions.
- Topical and other options: Prescription creams, photodynamic therapy, or radiation may be used for selected superficial cancers or patients who cannot have surgery.
- Follow-up care: Having one skin cancer significantly raises the chance of developing another, so scheduled full-skin examinations become part of routine care afterward.