Skin cancer occurs when skin cells start to grow out of control. This damage usually happens because of sun exposure. Everyone is at risk of developing skin cancer, regardless of skin color. Skin cancer can be more difficult to detect on darker skin.

People who have fair skin, spend a lot of time outdoors, or have weak immune systems have the highest risk of developing skin cancers.

Wear sunscreen and cover up to protect your skin from the sun’s harmful rays.

Skin cancer typically appears as a new spot or as mole that changes shape, color, bleeds, or oozes. Tell your primary care team or a dermatologist if you notice these signs.

Skin cancer can occur on any part of your skin, including around your nails and the bottom of your feet. 

Basal cell carcinoma

Basal cell carcinoma (BCC) is the most common type of skin cancer. These cancers are most common in sun exposed parts of the body like the face, head, neck, and arms. They look like pink bumps on the skin.

BCC tends to grow slowly and rarely spreads. If left untreated, BCC can damage the surrounding skin and destroy the underlying structures. 

Squamous cell carcinoma

Squamous cell carcinoma (SCC) is another common type of skin cancer. They often look like crusted, warty growths on the skin. 

These cancers are most common on chronically sun exposed body sites like the face, lips, ears, neck, arms, and backs of the hands. 

Melanoma

Melanoma starts in the color-making cells in the skin. It’s the most aggressive but less common than BCC or SCC. Melanoma’s usually have a bluish or black color and can sometimes develop from moles. Melanoma can occur in unusual places, including the nails, eyes, and even inside the body.

Melanoma has a reputation for its ability to spread quickly. But even so, melanoma is curable about 90% of the time, especially when caught early.

Skin cancer is very common and often very treatable. Treatment depends on the type of cancer, genetics, and patient’s overall health.

For many skin cancers, treatment starts with surgery. For most basal or squamous skin cancers, surgery is usually the only treatment needed.  

Depending on the aggressiveness of your cancer, you may need other types of treatment, like radiation, chemotherapy, immune therapy, and targeted treatments. Some early skin cancers can be treated with a cream or an injection. Your care team will decide which treatment is best for you.

Cancer surgery

The most common surgery for skin cancer is Mohs surgery. During Mohs surgery, the surgeon removes the cancer in thin layers, checking for cancer cells under the microscope after each layer. They continue removing thin layers until they no longer see any cancer cells under the microscope.

With this technique, the surgeon ensures all the skin cancer cells are removed while saving as much healthy tissue as possible. This allows for high cure rates and small scars.

Other types of surgery for skin cancer may include:

• Excision: This surgery cuts out the tumor and some of the normal tissue around it
• Shave excision: Shaves the cancer off with a small blade
• Electrosurgery: Uses electricity to destroy cancer
• Cryosurgery: Cancer cells are destroyed by freezing 

After the surgeon removes the tumor, there may be a visible scar or indentation. At Carilion, our physicians do everything possible to make those scars as imperceptible as possible.

Radiation therapy

Radiation is often used to treat many types of skin cancers. Radiation can be used after surgery to decrease the chances of aggressive cancers returning. Sophisticated machinery, scanners, and molding devices ensure the cancer is the target, not the surrounding healthy cells.

Cancer medicines

In some cases, you may need cancer medicines to treat your skin cancer. Cancer medicines travel through the body. They can kill or control the growth of skin cancer cells that have spread. 

Systemic cancer medicines that we may use for skin cancer include:

• Immunotherapy: Medicines that boost your immune system to attack cancer cells
• Targeted therapy: These medicines target specific genetic mutations found in some cancers