Skin Cancer

Overview

What is skin cancer?

Skin cancer is the abnormal growth of skin cells, usually triggered by DNA damage from ultraviolet (UV) radiation whether from the sun or artificial sources like tanning beds. While it typically arises in sun-exposed areas like the face, neck, and arms, in people of color, it often develops in less-exposed regions such as the palms, soles, or beneath fingernails.

Types of skin cancer

There are three primary types:

  • Basal cell carcinoma (BCC): The most common and slowest-growing form. It rarely spreads but can be locally destructive if unaddressed.

  • Squamous cell carcinoma (SCC): Also common, with a higher likelihood of spreading if not treated promptly.

  • Melanoma: The deadliest form aggressive and more likely to metastasize, though it is less common overall.

How common is skin cancer?

Skin cancer is one of the most frequently diagnosed cancers globally. The World Health Organization estimates around 2–3 million non-melanoma and 132,000 melanoma cases occur annually. In Africa, misconceptions specially the belief that darker skin confers full protection often lead to delayed detection and poorer outcomes.

Symptoms and Causes

What are the signs and symptoms of skin cancer?

Early signs can be subtle:

  • A growth or sore that doesn't heal.

  • A mole changing in size, shape, or color.

  • A flat, scaly patch that crusts or bleeds.

  • A firm, reddened bump or pearly growth.

What does skin cancer look like?

  • BCC: Appears as a pearly or waxy bump, or a flat lesion matching skin tone.

  • SCC: Shows as a red, firm nodule or a scaly, crusted flat lesion.

  • Melanoma: Typically presents as a large brownish spot with darker speckles, or a changing mole. In people of African descent, melanoma may present as a dark streak or spot on palms, soles, or under nails.

What causes the condition?

UV-induced DNA damage is the main driver. Other contributors include toxic chemical exposures, prior radiation therapy, and genetic predispositions.

What are the risk factors for skin cancer?

Risk factors include:

  • Fair complexion, light eyes, and hair.

  • Excessive sun exposure or tanning bed use.

  • History of sunburns.

  • Living near the equator or at high altitude.

  • Family or prior personal history of skin cancer.

  • A weakened immune system or genetic disorders like xeroderma pigmentosum.

Even pigmented skin doesn't eliminate risk—melanin offers some protection but not immunity.

Diagnosis and Tests

How is skin cancer diagnosed?

Diagnosis typically involves a visual exam and biopsy of suspicious lesions.

What tests will be done to diagnose skin cancer?

  • Dermatoscopy (magnified visual inspection) helps guide decisions.

  • Biopsy remains the gold standard.

  • Lymph node sampling or imaging may be required for melanoma staging.

What are skin cancer stages?

  • Stage 0 (in situ): Cancer confined to the outer skin layer.

  • Stage I & II: Localized growth.

  • Stage III: Spread to nearby lymph nodes.

  • Stage IV: Spread to distant organs.
    Early detection is vital—melanoma outcomes decline sharply when it advances.

Management and Treatment

How is skin cancer treated?

Treatment depends on type, size, location, and stage:

  • Surgical removal is common.

  • Mohs surgery is tissue-sparing for facial tumors.

  • Cryotherapy can be used for certain early lesions.

  • Topical treatments suitable for superficial disease.

  • Radiation, immunotherapy, and targeted treatments are options for advanced cases.
    In resource-limited African settings, early detection and simple surgical excision often offer the best chance for cure.

Complications/side effects of the treatment

Treatment may cause:

  • Scars or changes in pigmentation.

  • Infection or bleeding at the treatment site.

  • Fatigue after radiation therapy.

  • Immune-related side effects with immunotherapy.

Outlook / Prognosis

What is the outlook for people with skin cancer?

  • BCC and SCC: Excellent prognosis when caught early cure rates are 95–99%.

  • Melanoma: Over 90% five-year survival when detected early, but outcomes worsen significantly in later stages.

When should I see my healthcare provider?

Consult promptly if you notice any changing or non-healing spot, especially in less-obvious areas like the soles or under nails.

What questions should I ask my healthcare provider?

  • What type of skin cancer is it?

  • What stage is it in?

  • What are my available treatment options?

  • What side effects should I anticipate?

  • Do I need regular follow-up or screening?

Prevention

Can cancer of the skin be prevented?

Yes many cases are preventable through proactive measures.

How can I lower my risk?

  • Use broad-spectrum sunscreen daily, even with darker skin.

  • Avoid intense midday sun and tanning appliances.

  • Wear protective clothing and wide-brimmed hats.

  • Examine your skin regularly and see a doctor annually if possible.

Additional Common Questions

How does  Cancer of the skin become a life-threatening cancer?

When left untreated, skin cancer especially melanoma can invade deeper tissues, lymph nodes, and distant organs like the lungs, liver, or brain. At this stage, treatment becomes more complex, and outcomes are often poor.

Why does Cancer of the skin occur in more non-sun-exposed body areas in people of color?

Melanin provides some protection against UV rays, so skin cancers in people of African descent often appear in areas not typically exposed to the sun. This includes the soles of the feet, palms, and mucous membranes areas not checked frequently.

Are all moles cancerous?

No. Most moles are harmless. However, any mole that changes in size, shape, or color or starts to itch or bleed should be checked by a doctor. Using the ABCDE rule (Asymmetry, Border, Color, Diameter, Evolving) is a helpful guideline.

Published 10th August 2025

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