Skin Cancer

Understanding Skin Cancer: Symptoms, Diagnosis, Treatment, and Living Well After Diagnosis

Skin cancer is one of the most common cancers in the world, but many people are unsure what it really means or which warning signs deserve attention. If you are worried about a new spot, a changing mole, or a recent biopsy result, it helps to know that many skin cancers are highly treatable, especially when found early. This guide explains what skin cancer is, what causes it, how doctors diagnose it, which treatments are used today, and when specialist advice can make a real difference.

What is skin cancer?

Skin cancer happens when skin cells begin growing out of control. The main types are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell and squamous cell cancers are often grouped as nonmelanoma skin cancers. Melanoma is less common, but it is more likely to spread if it is not diagnosed early.

These cancers behave differently because they start in different cells. Basal cell carcinoma usually grows slowly and often stays local, though it can damage nearby tissue if ignored. Squamous cell carcinoma can be more aggressive and may spread to lymph nodes in some cases. Melanoma starts in pigment making cells called melanocytes and needs careful attention because it can spread earlier than the other major skin cancers (AAD, 2024a; NCI, 2025).

In simple terms, most skin cancer begins after repeated DNA damage inside skin cells. Ultraviolet light is a major reason this happens. Over time, damaged cells stop following the usual rules for growth and repair. That is why skin cancers often appear on sun exposed areas such as the face, scalp, ears, neck, chest, shoulders, arms, and hands, although they can also develop on less exposed parts of the body (WHO, 2022; NCI, 2025).

How common is skin cancer?

Skin cancer is extremely common. Nonmelanoma skin cancers are the largest group, while melanoma makes up a smaller share of cases but causes far more skin cancer deaths.

The World Health Organization reports that more than 1.5 million skin cancers and more than 120,000 skin cancer related deaths occurred globally in 2020. The National Cancer Institute notes that nonmelanoma skin cancer is the most common cancer in the United States and that millions of people are treated for it, although exact numbers are difficult to measure because these cancers are not consistently reported to registries. For melanoma, the American Cancer Society estimates that about 112,000 new cases and 8,510 deaths will occur in the United States in 2026 (WHO, 2022; NCI, 2025; ACS, 2026a).

Risk varies by age, skin type, geography, and exposure history. Many nonmelanoma skin cancers appear after years of accumulated sun exposure. Melanoma is also strongly linked to ultraviolet exposure, and a 2025 IARC report estimated that more than 80 percent of cutaneous melanoma cases worldwide in 2022 were attributable to ultraviolet radiation. Lighter skinned populations carry the highest burden overall, but skin cancer can affect every skin tone (IARC, 2025; Long et al., 2023).

What causes skin cancer?

The main cause of most skin cancer is ultraviolet radiation from sunlight or tanning devices. Risk also increases with fair skin, repeated sunburns, older age, many or unusual moles, family history, past skin cancer, and a weakened immune system.

WHO states that skin cancers are caused primarily by ultraviolet radiation from the sun or from artificial sources such as sunbeds. NCI also identifies tanning beds, sunburn history, and light complexion as major risk factors for nonmelanoma skin cancers. That does not mean people with darker skin are protected. They can still develop skin cancer, and delayed diagnosis can happen when suspicious lesions are overlooked (WHO, 2022; NCI, 2025).

Some risks are inherited or partly inherited. Family history, genetic syndromes, and skin that burns easily can all matter. For melanoma, recent reviews list ultraviolet exposure, indoor tanning, dysplastic nevi, older age, and personal or family history among the key risks. For basal cell carcinoma, NCI also points to immunosuppression, ionizing radiation, and chronic arsenic exposure as contributing factors in some patients (NCI, 2025; Lauters et al., 2024; Long et al., 2023).

Indoor tanning is an avoidable risk worth taking seriously. A systematic review and meta analysis found that indoor tanning was associated with increased risk of melanoma and nonmelanoma skin cancer, with especially concerning results for earlier onset disease. People with weakened immune systems also deserve closer follow up because cutaneous squamous cell carcinoma can occur more often and behave more aggressively in this setting (An et al., 2021; NCI, 2025).

What are the symptoms of skin cancer?

Skin cancer often appears as a new spot, a changing mole, a sore that does not heal, a shiny bump, a scaly patch, or a lesion that bleeds, crusts, or keeps coming back. Melanoma often follows the ABCDE warning signs: asymmetry, border change, color variation, diameter growth, and evolving appearance.

Basal cell carcinoma commonly looks like a flesh colored or pearly bump or a pink patch. Squamous cell carcinoma may look like a firm red bump, a scaly patch, or a sore that heals and then reopens. Melanoma may appear as a new dark spot or a mole that changes in size, shape, color, or sensation. Some melanomas are not dark and can look pink, red, or skin colored, which is one reason self diagnosis can be unreliable (AAD, 2024a; Long et al., 2023).

Red flags to watch for include a spot that looks unlike your other moles, a lesion with more than one color, itching, pain, bleeding, crusting, ulceration, or a sore that does not settle within a few weeks. The ABCDE rule remains useful: asymmetry, border irregularity, color variation, diameter, and evolving. Dermatologists also talk about the ugly duckling sign, meaning a mole that looks different from the rest. If a spot is changing, bleeding, or persistently irritated, it should be examined rather than watched indefinitely (AAD, 2024b; Lauters et al., 2024).

How is skin cancer diagnosed?

Skin cancer is usually diagnosed with a skin examination followed by a biopsy. The biopsy allows the tissue to be studied under a microscope, confirms the cancer type, and shows how deep or aggressive it appears. Some people also need imaging or lymph node testing to determine the stage.

Diagnosis often begins with a careful clinical skin exam and, in many clinics, dermoscopy. If a lesion looks suspicious, the next step is usually a biopsy. For nonmelanoma lesions, doctors may use shave, punch, incisional, or excisional biopsy depending on the size, shape, and location. For suspected melanoma, the goal is to remove enough tissue to measure Breslow depth because that depth helps guide staging, treatment, and prognosis (NCI, 2025; Lauters et al., 2024).

The pathology report is central because it tells the team what type of skin cancer is present and whether it shows higher risk features such as greater thickness, ulceration, nerve involvement, or aggressive growth patterns. In melanoma, sentinel lymph node biopsy may be considered when the primary tumor is at least 0.8 millimeters thick. Scans such as CT, PET CT, MRI, or ultrasound are more likely when the cancer seems deeper, recurrent, or suspicious for spread (Lauters et al., 2024; Long et al., 2023; NCI, 2025).

How is skin cancer treated?

Skin cancer treatment depends on the cancer type, the size and depth of the lesion, where it is located, whether it has spread, and your overall health. Surgery is the most common treatment for early disease. More advanced cases may need radiation therapy, immunotherapy, targeted therapy, or other systemic treatment.

Surgery

Surgery is the main treatment for most basal cell, squamous cell, and early melanoma lesions. Common approaches for basal cell and squamous cell cancers include simple excision, curettage and electrodesiccation, cryosurgery, and Mohs micrographic surgery. Mohs surgery is especially valuable for high risk tumors or cancers in cosmetically sensitive areas because it checks margins during the procedure while preserving as much healthy tissue as possible. Melanoma is usually treated with wide excision, and some patients also need sentinel lymph node biopsy (NCI, 2025; Long et al., 2023).

Radiation therapy

Radiation therapy may be used when surgery would be difficult, when a patient is not fit for an operation, or when there is a need to reduce the risk of local recurrence in selected situations. It can also help with symptom relief in advanced disease. For melanoma, radiation is not usually the main treatment for an early primary lesion, but it may be used for brain metastases, nodal disease, or symptom control (NCI, 2025; Long et al., 2023).

Medicines, including immunotherapy and targeted therapy

Drug treatment has changed the outlook for advanced skin cancer, especially melanoma. For unresectable or metastatic melanoma, immune checkpoint inhibitors such as pembrolizumab, nivolumab, ipilimumab, and nivolumab with relatlimab are widely used. Targeted therapy can be useful when the tumor carries certain mutations, especially BRAF V600. Some patients may also be candidates for tumor infiltrating lymphocyte therapy or intralesional treatment. Advanced basal cell carcinoma can sometimes be treated with hedgehog pathway inhibitors such as vismodegib or sonidegib. Advanced cutaneous squamous cell carcinoma may be treated with PD 1 inhibitors such as cemiplimab or pembrolizumab when curative surgery or radiation is not possible (NCI, 2025; Long et al., 2023).

Traditional chemotherapy is used much less often than it once was for melanoma because immunotherapy and targeted therapy are often more effective. Still, symptom control remains a major part of good care. Surgery, wound care, pain relief, nutrition support, and emotional support all matter, especially in advanced disease (NCI, 2025).

What is the outlook for people with skin cancer?

The outlook for skin cancer is often very good when it is found early. Most basal cell carcinomas and many squamous cell carcinomas are cured with local treatment. Melanoma can also have an excellent outlook when diagnosed before it spreads, but survival drops as stage advances.

For basal cell and squamous cell skin cancers, early treatment is usually highly successful. NCI notes that nonmelanoma skin cancer causes less than 0.1 percent of cancer deaths even though it is extremely common. Even so, some squamous cell cancers can spread, particularly high risk tumors or cancers that arise in scars, chronically inflamed skin, or immunosuppressed patients (NCI, 2025; Long et al., 2023).

For melanoma, stage at diagnosis strongly shapes prognosis. The American Cancer Society reports 5 year relative survival rates above 99 percent for localized melanoma, 76 percent for regional disease, and 35 percent for distant disease. Those numbers describe large groups, not any one person. Your own outlook depends on tumor thickness, ulceration, lymph node status, mutation profile, response to treatment, age, other illnesses, and access to experienced care. Modern immunotherapy has improved long term survival for some patients with advanced melanoma, which is one reason expert review matters so much (ACS, 2026b; Lauters et al., 2024; Long et al., 2023).

If you are newly diagnosed, statistics can feel frightening. It helps to remember that they are population numbers, not personal predictions. Many people do very well after treatment, and asking What does this mean in my specific case? is usually more helpful than reading a percentage without context (Long et al., 2023).

Living with skin cancer: Practical tips for patients and families

Living with skin cancer usually means more than finishing treatment. It often involves follow up visits, skin checks, sun protection, and learning how to manage the emotional strain that can come with uncertainty.

Regular follow up matters, and your schedule will depend on the type of cancer you had and whether it was low or high risk. Skin self examination also matters. Learn what your usual moles and marks look like, and pay attention to the scalp, back, nails, palms, soles, and other easy to miss areas. If you are unsure whether a lesion is changing, it is reasonable to take a clear photo and ask your clinician rather than waiting for months (AAD, 2024b).

Daily sun protection is not about blame. It is about lowering future risk. Practical steps include seeking shade, wearing protective clothing, protecting the scalp and lips, using broad spectrum sunscreen correctly, and avoiding tanning beds. People on immune suppressing medicines, outdoor workers, and families with strong sun exposure habits may need extra counseling and prevention planning (WHO, 2022; NCI, 2025; Lauters et al., 2024).

The emotional side matters too. Even a small skin cancer can bring fear about scarring, recurrence, or future spread. Melanoma can bring even more uncertainty because scans, lymph node testing, and systemic treatments may be involved. Many patients feel more grounded when they bring a relative or friend to appointments, keep written questions, and ask for plain language explanations. Support groups, counseling, survivorship services, and specialist nurses can all help. You do not have to manage the worry on your own.

When should you talk to a cancer specialist about skin cancer?

You should speak with a specialist if you have a suspicious lesion, a confirmed melanoma diagnosis, recurrent skin cancer, cancer in a sensitive area such as the face or eye region, possible spread to lymph nodes, or if you have been told you may need immunotherapy, targeted therapy, or complex surgery.

Some straightforward low risk basal cell cancers can be managed by a dermatologist or surgeon without a full oncology team. But specialist input becomes especially valuable when the diagnosis is melanoma, when pathology shows high risk features, or when there is any concern about spread or reconstruction. A cancer specialist can explain staging, whether more tests are needed, and whether treatment should stay local or involve systemic therapy. For patients who live far from a major center, an online consultation can also be a practical way to review pathology, confirm a treatment plan, or obtain a second opinion without delaying care (Long et al., 2023; NCI, 2025).

Frequently Asked Questions about Skin Cancer

Is skin cancer always deadly?

No. Most skin cancers, especially basal cell carcinoma and many squamous cell carcinomas, are highly treatable when found early. Melanoma can be more dangerous, but localized melanoma also has an excellent survival rate, which is why early diagnosis is so important (NCI, 2025; ACS, 2026b).

Can people with darker skin get skin cancer?

Yes. Skin cancer can affect people of every skin tone. It may be less common in people with darker skin, but delayed diagnosis can happen because warning signs are sometimes overlooked (WHO, 2022; AAD, 2024a).

Does every changing mole mean melanoma?

No, but every clearly changing mole should be checked. Many changing spots turn out to be benign, yet melanoma often presents as a mole or spot that evolves in size, shape, color, or symptoms such as itching or bleeding (AAD, 2024b; Lauters et al., 2024).

What happens during a skin biopsy?

A biopsy removes all or part of the suspicious lesion so it can be examined under a microscope. Depending on the lesion, the clinician may use a shave, punch, saucerization, incisional, or excisional technique. The pathology report then helps guide staging and treatment (NCI, 2025; Lauters et al., 2024).

Can skin cancer come back after treatment?

Yes. Skin cancer can come back after treatment, which is why follow up visits, self examination, and long term sun protection remain important even after successful treatment (NCI, 2025).

References

• American Academy of Dermatology. 2024a. Types of skin cancer.

• American Academy of Dermatology. 2024b. What to look for: ABCDEs of melanoma.

• American Cancer Society. 2026a. Melanoma skin cancer statistics.

• American Cancer Society. 2026b. Survival rates for melanoma skin cancer.

• An S, Kim K, Moon S, Ko KP. 2021. Indoor tanning and the risk of overall and early onset melanoma and nonmelanoma skin cancer: systematic review and meta analysis. Cancers (Basel). 13(23):5940.

• International Agency for Research on Cancer. 2025. Global burden of cutaneous melanoma incidence attributable to ultraviolet radiation in 2022. IARC News. 28 May 2025.

• Lauters R, Brown AD, Harrington KCA. 2024. Melanoma: diagnosis and treatment. American Family Physician. 110(4):367 to 377.

• Long GV, Swetter SM, Menzies AM, Gershenwald JE, Scolyer RA. 2023. Cutaneous melanoma. Lancet. 402(10400):485 to 502.

• National Cancer Institute. 2025. Skin cancer PDQ resources, including skin cancer treatment, melanoma treatment, and genetics of skin cancer.

• World Health Organization. 2022. Ultraviolet radiation.