What You Should Know About Skin Cancer

Did you know that more people are diagnosed with skin cancer each year in the U.S. than all other cancers combined? The Skin Cancer Foundation also tells us that at least one in five Americans will develop skin cancer by the age of 70. Every year, during the month of May we raise awareness about all things skin cancer. Fellowship-Trained Mohs Surgeon and Board-Certified Dermatologist, Dr. Mariah Johnson, sat down with us for an expert Q&A about skin cancer.

Q: Tell us about skin cancer – what is it exactly?

A: Skin cancer is made up of genetically mutated cells that continuously divide and replicate out of control. There are many different types of skin cancers. Each type of skin cancer is derived by a single cell-type. For instance, basal cell carcinomas and squamous cell carcinomas are derived from keratinocytes and melanomas are derived by melanocytes.


Q: What does skin cancer look like?  

A: The appearance depends on the type of skin cancer. 

  • Basal cell and squamous cell carcinomas usually appear as pink, shiny, or scaly bumps. A scab often forms in the center of the bump. Patients often assume these cancers are acne lesions or bug bites at first, but the cancers hang around for longer than a month (unlike acne and bug bites).
  • Melanomas can sneakily resemble moles. However, they usually look different than the rest of the moles on a person’s body. We call this the ugly duckling sign. The ABCDEs of melanoma are also helpful for remembering the signs of melanoma: Asymmetry, irregular Borders, multiple Colors, Diameter >6mm (the size of a pencil eraser), Evolution. Of these features, evolution is the most important. Moles should not change significantly over the course of several months or several years.


Q: What should I be looking for to help detect skin cancer? 

A: Look at your skin in the mirror at least once a month. Have a partner look at your scalp and your back (or any other areas you have trouble visualizing). Keep track of your current lesions to ensure they are stable in appearance. If you notice any new lesions or changing lesions, you should schedule an appointment to have these lesions evaluated by a Dermatology Physician or Physician Assistant. 


Q: How is skin cancer treated? 

A: The treatment depends on the type of skin cancer, how aggressive the skin cancer is, and where the skin cancer is located on the body. These factors will dictate whether the cancer is treated with topical chemotherapy or immunomodulating creams, electrodesiccation and curettage, excision, Mohs Micrographic Surgery, radiation, or systemic immunotherapies. 


Q: What types of skin cancer are there?

A:  There are a multitude of skin cancer types. However, the three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. 


Q: Who is more at risk for skin cancer?

A: Risk factors for skin cancer include: fair complexion (light skin, red or blonde hair, green or blue eyes), dense freckles, more than 40 moles, severely sun damaged skin (leathered and speckled in appearance), history of previous skin cancers or pre-cancerous lesions, history of a compromised immune system, history of indoor tanning, history of blistering or peeling sunburns, and/or a family history of skin cancer. 


Q: Are there any medical conditions that can increase our risk for skin cancer? 

A: Yes, medical conditions that compromise the immune system or require treatments that suppress the immune system will increase the risk of skin cancer. An example would be organ transplant patients who are on life-long immunosuppressive medications to prevent the immune system from rejecting the organ. 


Q: What constitutes sun damage? 

A: An acute sign of cellular damage is a sunburn. Long-term signs of sun damage look like permanently tanned skin or a reddish-brown discoloration, brown and white speckles, premature wrinkles, leathery or cobblestone skin texture, and pre-cancerous lesions called actinic keratoses. 


Q: How does sun damage affect the health of our skin beyond skin cancer? 

A: Sun damage significantly ages the skin by causing pigmentary changes, wrinkles, and textural irregularities. 


Q: How dangerous is a sunburn? 

A: Sunlight (Ultraviolet radiation) is a known carcinogen. Each sunburn increases the risk of developing skin cancer. 

Dr. Johnson sees patients at our East Bend Mohs & DermaSpa, East Bend, Redmond, and Klamath Falls locations. Get to know her and schedule your annual Full Skin Exam with her here