Skin cancer is the most common cancer in the United States. It affects millions of people each year, across all skin tones and age groups.
This article draws on the clinical expertise of Dr. Alicia Atkins. She is a board-certified dermatologist at DermOnDemand.
It covers the main types of skin cancer. It explains what each type looks like and how doctors diagnose and treat each type.
Key Takeaways
- Skin cancer is the most common cancer in the United States. It falls into two broad categories: non-melanoma (basal cell and squamous cell carcinoma) and melanoma, which is rarer but far more dangerous.
- Basal cell carcinoma makes up about 80% of all cases and rarely spreads, while squamous cell carcinoma accounts for nearly 20% and carries a small but real risk of spreading to other parts of the body.
- Melanoma represents fewer than 3% of skin cancer cases but causes more deaths than all other types combined, making early detection through the ABCDE method critical.
- UV exposure from the sun and tanning beds is the leading cause of all major types of skin cancer, and daily use of broad-spectrum SPF 30 or higher is one of the most effective ways to reduce your risk.
- All skin tones can develop skin cancer, and most early-stage cases are painless, so any spot that changes, bleeds, or does not heal within a few weeks should be evaluated by a dermatologist.
Understanding the Different Types of Skin Cancer
Skin cancer is not one disease. Various types of skin cancer differ in where they start, how they look, and how serious they are.
The most common types of skin cancer share one cause: UV damage to skin cells over time. The four most common types are basal cell carcinoma, squamous cell carcinoma, melanoma, and actinic keratosis. Each starts in a different skin cell and behaves differently in the body.
The outer skin layer has three main cell types. Squamous cells are on the surface. Basal cells are beneath them. Melanocytes are deepest within.
UV rays from the sun or tanning beds damage these cells over time. That damage builds up and can eventually cause cells to grow out of control.
Basal Cell Carcinoma: the Most Common Type
Basal cell carcinoma BCC makes up about 80% of all skin cancers in the United States. It is the least aggressive of the main types of skin carcinoma. It grows slowly, rarely spreads to other parts of the body, and responds well to treatment when caught early.
BCC often appears as a small, shiny bump or a pink patch on sun-exposed areas such as the face, neck, and arms. It can also appear as a sore that heals and then comes back. Without treatment, it can grow deeper into the skin and reach nerves and bone, causing damage that is hard to repair.
Squamous Cell Carcinoma: Appearance, Location, and Risk
Squamous cell carcinoma SCC accounts for nearly 20% of all skin cancers. Squamous cell skin cancers are more likely to spread than BCCs, but they are still very treatable when caught early. SCC often appears as a red, rough bump or a scaly patch on sun-exposed skin. It tends to form on the face, ears, neck, arms, and lower lip.
Most cases are caught before they spread. Tumors on the ear or lip carry a higher risk of spreading than those elsewhere. Basal cell and squamous cell carcinomas are both non-melanoma skin cancers. The key difference is that BCC rarely spreads to other organs, while SCC carries a small but real chance of doing so.
Melanoma: the Most Serious Kind of Skin Cancer
Melanoma makes up fewer than 3% of all skin cancers but causes more deaths than basal cell and squamous cell carcinoma combined. It can spread quickly to the lymph nodes and organs, including the brain and liver. It is the most dangerous form of skin cancer, and how it compares to other carcinoma skin types comes down to one word: speed.
The ABCDE Warning Signs of Melanoma
Dermatologists use the ABCDE method to identify suspicious lesions. If you notice any of the following, see a dermatologist:
- A – Asymmetry: One half does not match the other
- B – Border: Edges are uneven, ragged, or blurred
- C – Color: Multiple shades of brown, black, red, white, or blue in one spot
- D – Diameter: Larger than 6 mm, about the size of a pencil eraser
- E – Evolution: Any change in size, shape, color, or new symptoms like itching or bleeding
Melanoma treated before it spreads has a much higher survival rate. Regular skin checks are the most reliable way to catch it early.
Skin Cancer Spots and Moles: What to Look For
Most skin cancers start as visible changes on the skin. Normal moles are round, evenly colored, and stable over time. A mole that grows, changes color, bleeds, or itches needs attention.
Shiny or pink patches often point to BCC. Red, rough, or scaly areas suggest SCC. Spots with many colors, uneven edges, or rapid growth are more often associated with melanoma.
A suspicious spot is not an emergency, but there are clear reasons to see a dermatologist within a few weeks of noticing a change. Waiting too long is how simple cases become complex ones.
Types of Skin Cancer on the Face
The face is one of the most common places for skin cancer to develop. That is because it gets more sun exposure over a lifetime than most other parts of the body. The most common types found on the face are basal cell carcinoma and squamous cell carcinoma.
BCC often appears as a small, shiny bump near the nose or the inner corner of the eye. It can also look like a pink or flesh-colored patch that does not go away. SCC typically shows up as a rough, scaly patch on the lip, cheek, or ear. Both types can also appear as a sore that heals and then reopens in the same spot.
The nose, forehead, cheeks, ears, and lower lip are the highest-risk areas. Melanoma can also develop on the face. It may form within an existing mole.
It can also appear as a new dark spot. The spot may have uneven edges or multiple colors. Any spot on the face that does not heal within three to four weeks, bleeds with minor contact, or slowly grows larger should be evaluated by a dermatologist.
Actinic Keratosis: a Precancerous Growth You Should Not Ignore
Actinic keratosis is a rough, dry, scaly patch caused by years of sun exposure. If you are still understanding skin cancer risk at this stage, precancerous conditions like this one are a key part of the picture.
It is not cancer, but it can turn into squamous cell carcinoma if left alone. These patches most often appear on the head, neck, hands, and forearms.
Every confirmed case should be treated. A dermatologist can remove it with cryotherapy, topical creams, or other simple outpatient procedures.
Less Common Skin Cancer Varieties
These three skin cancer varieties are rare but worth knowing:
- Merkel cell carcinoma: A rare, fast-moving cancer that appears as a flesh-colored or bluish-red lump, usually on the face, head, or neck. It spreads faster than most other types and needs prompt specialist care.
- Sebaceous carcinoma: Starts in the skin’s oil glands, most often on the eyelid. It is frequently mistaken for a stye, which can delay diagnosis.
- Dermatofibrosarcoma protuberans (DFSP): A slow-growing cancer in the deeper layers of the skin, most common on the trunk or upper limbs. It rarely spreads but tends to come back after removal.
Risk Factors for Skin Cancer
Most skin cancers are caused by too much UV exposure from the sun or tanning beds. Over the years, UV damage alters DNA in skin cells and increases the risk of skin cancer. People with fair skin, light eyes, or many moles face an increased risk of developing skin cancer across all major types.
A family history of skin cancer also increases personal risk. People with darker skin tones can still develop skin cancer, though diagnoses often come later because the signs can look different.
Some medications also increase risk, including immunosuppressants and biologics used to treat Crohn’s disease or rheumatoid arthritis. If you take any of these, ask your doctor about regular skin monitoring.
How Skin Cancer Is Diagnosed and Treated
See a dermatologist if you notice a new or changing spot, a mole that bleeds or itches, a sore that will not heal, or any growth that looks different from others on your skin.
You do not need a referral in most cases. If your doctor finds a suspicious lesion, they will take a small tissue sample for lab testing. Results usually come back in one to two weeks.
Surgery is the most common treatment across all types. Small BCC and SCC lesions are often removed during a routine office visit. Mohs surgery is used for high-risk or recurring cases, removing thin layers of tissue until no cancer cells remain.
Advanced melanoma may require immunotherapy, targeted therapy, or chemotherapy. Radiation is used in select cases of aggressive SCC.
Can You Prevent Skin Cancer?
Wear broad-spectrum SPF 30 or higher every day. Cover your skin when outdoors and seek shade between 10 a.m. and 4 p.m. Avoid tanning beds.
Check your skin once a month for new or changing spots. Annual skin checks with a dermatologist are recommended for anyone at higher risk. At DermOnDemand, board-certified dermatologists can evaluate skin concerns and help set up a monitoring plan based on your personal risk profile.
Common Misconceptions About Skin Cancer
- “Only fair-skinned people get skin cancer.” All skin tones can develop skin cancer. In people with darker skin, it is often found later because it looks different from standard clinical examples.
- “A tan means healthy skin.” A tan is a sign of UV damage, not good health.
- “Skin cancer only appears on sun-exposed areas.” Melanoma can develop between the toes, under a nail, or inside an ear canal.
- “If it doesn’t hurt, it’s not serious.” Most early-stage skin cancers are painless. If something looks wrong, get it checked.
