Welcome to the Patient Education Library of Texas Medical Institute
Skin cancer is the most common form of cancer in the United States. There are many types of skin cancers. They are classified as melanomas or non-melanomas. Melanomas begin in the melanocytes, the cells in skin that produce color. Melanoma can spread quickly to other parts of the body. It is the deadliest form of skin cancer. Non-melanomas originate in skin cells other than melanocytes. Non-melanomas are less aggressive and rarely spread.
Exposure to the ultraviolet (UV) rays in the sun and a history of childhood sunburns are the main causes of most skin cancers. In some cases, skin cancer may be prevented. Skin cancer that is detected and treated early is very curable. It is important to have regular skin and mole checks by a skin specialist. Untreated skin cancer can cause disfigurement, spread to other parts of the body, and cause death.
The dermis is your second layer of skin. It is made up of connective tissue and provides structure. It is composed of collagen and various elements that give your skin strength and elasticity. The dermis contains hair cells, sweat glands, and sebaceous glands that secrete oils to hydrate the skin.
Subcutaneous tissue composes your inner most layer of skin. Subcutaneous tissue contains fat cells. The fat cells insulate your body and make your skin appear plump and full. Below the subcutaneous tissue are fat tissues, your muscles, and bones.
Basal cell carcinoma and squamous cell carcinoma are common non-melanomas that result from changes in the basal cells and squamous cells, respectively, in the epidermis layer of the skin. Non-melanomas are slower growing and tend to spread less aggressively than melanomas. However, if untreated, nonmelanoma skin cancers can grow quite large and cause disfigurement.
A- Asymmetry: One half of the abnormal area does not match the other half.
B- Border Irregularity: The growth or mole has uneven, notched, ragged, or irregular edges.
C- Color: The abnormal area or mole contains different colors instead of one solid color.
There may be different shades of tan, brown, black, red, blue, or white.
D- Diameter: The mole or abnormal growth is larger than ¼ inch across. However, some melanomas may be smaller.
There are risk factors that you can and cannot control for skin cancer. You should try to reduce the risk factors that you can control. You should perform a full body skin and mole inspection monthly. It may be helpful to use a mirror or have someone else look at areas of your skin that are difficult for you to see. Promptly report any suspicious moles or areas of skin to your doctor.
The American Cancer Society recommends a yearly skin inspection by a qualified professional every year after the age of 40, and every three years for people ages 20-40. If you experience skin cancer your doctor may recommend more frequent skin inspections. You should make and attend all of your appointments.
You may be able to prevent skin cancer by limiting the amount of time that you are exposed to the sun. Anyone that is exposed to the sun should wear a sunblock that blocks both UV A and B sunrays. A sunscreen is a different product. Sunscreens allow you to spend a longer amount of time in the sun without burning than you could if you were not wearing sunscreen. Sunscreens may reduce your risk of getting skin cancer, but it is not a guarantee. If you are in the sun for a long time, even with sunscreen, you are at risk for developing skin cancer.
Most doctors recommend a sunblock that blocks both UV A and B rays and a sunscreen with a sun protection factor (SPF) of at least 15. A SPF of 15 provides protection from burning for 150 minutes. Sunscreen should be reapplied every 1 ½ hours or so depending on your activity level.
It is important to discard old sunblock and sunscreen. Their effectiveness is reduced over time. You should apply sunblock and sunscreen even in the winter. Remember to apply it to all of your skin that is exposed including your hands, ears, lips, lower legs, the backs of your knees, and the tops of your feet.
It is beneficial to avoid being in the sun between the hours of 10 AM and 4 PM, when the sun’s rays are the strongest. A good way to remember this is that if your shadow is shorter than you are tall, it is not a good time to be out in the sun. You can still be outside, but seek shade.
If you must spend time in the sun, it is smart to wear hats with a broad rim and tightly woven fabrics that are especially made to block the sun. Some clothing is rated for its SPF factor. Your doctor is happy to refer you to such clothing suppliers.
Wear sunglasses that block UVA and B sunrays. Wrap-around styled sunglasses protect your eyes and your eye area. Sun-related cancers can occur on the iris or inside of the eye. Wear sunglasses and make sure that your eye doctor checks for cancer at each of your eye exams.
You should avoid sun tanning outside and sun tanning lamps or booths. Artificial suntan lights give off harmful UV rays and can cause sunburns. An alternative is to use self-tanning products or spray on coloring cosmetics.
You should stop smoking and avoid cancer causing chemicals. If your job requires exposure to cancer causing agents, follow all of the safety instructions associated with the chemical’s use. Wear protective masks and gear as instructed.
Teach your children about protecting their skin in the sun. This is important because many skin cancers result from sunburns that occur before age 18. Make sure that your children learn to apply and reapply sunblock and sunscreen when they are playing outdoors.
Am I at Risk
Risk factors may increase your likelihood of skin cancer, although some people that experience skin cancer may not have any risk factors. People with all of the risk factors may never develop skin cancer; however, the likelihood increases with the more risk factors you have. You should tell your doctor about your risk factors and discuss your concerns.
Risk factors for skin cancer:
_____ People with light colored skin (Caucasians), blue eyes, green eyes, gray eyes, blond hair, or red hair have an increased risk for developing skin cancer. However, people with darker complexions and dark hair may get skin cancer as well, but they have a lower risk.
_____ People that spend a lot of time in the sun, such as construction workers, farmers, fishermen, lifeguards, sunbathers, and outdoor sport enthusiasts have an increased risk for skin cancer.
_____ Receiving multiple severe sunburns in childhood or as a teenager is a big risk factor for developing skin cancer.
_____ People that have had skin cancer before are at risk for developing skin cancer again.
_____ Cigarette smoking can contribute to skin cancer. The tar in cigarettes is a known cancer causing agent.
_____ Exposure to cancer causing chemical agents, such as oils, tars, and arsenic (found in some herbicides) is associated with an increased risk for skin cancer.
_____ Chronically injured skin is a risk factor for skin cancer. Friction burns and injury can cause chronic skin injury.
_____ People with suppressed immune systems, such as organ transplant recipients or people that have AIDS, have an increased risk for skin cancer.
_____ Not wearing a sunblock for UVA and B rays while in the sun increases the risk of skin cancer.
_____ Your risk for skin cancer increases with age. Most cases develop in people that are middle aged or elderly, but it certainly can develop in younger people.
_____ People that sunburn easily are at a higher risk for developing skin cancer.
_____ People with multiple moles have a higher risk of developing skin cancer.
_____ People with dysplastic or atypical moles have an increased risk for developing melanoma.
_____ People with freckled skin have a higher risk of developing skin cancer.
_____ Artificial tanning lights used in tanning booths, beds, and lamps have harmful UV rays and increase the risk of skin cancer.
_____ Some people have a genetic predisposition to skin cancer. Skin cancer can run in families. If your close relatives have skin cancer, you have an increased risk for developing it.
_____ Overexposure to X-rays or other forms of radiation increases the risk of skin cancer.
_____ People with rare genetic disorders, such as nevoid carcinoma syndrome, basal cell nevus syndrome, xeroderma pigmentosum, or Bazex syndrome, have an increased risk for developing skin cancer.
_____ People with the human papilloma virus (HPV) carry an increased potential for developing squamous cell carcinoma.
_____ People that received X-ray treatment for acne in the 1950s have a higher risk of developing squamous cell carcinoma.
_____ Actinic keratosis is a skin condition that can develop into skin cancer. Actinic keratosis results from overexposure to the sun. It looks like rough dry patches on the skin. Your doctor should remove actinic keratosis.
_____ People treated with Psoralen and ultraviolet light for chronic psoriasis have an increased chance of developing squamous cell carcinoma and other types of skin cancer.
Researchers have discovered a link between some types of HPV and squamous cell carcinoma. If you have HPV, you should ask your doctor about your risk and preventative screenings.
Researchers have a good understanding of how the sun’s UV rays damage certain genes and cause skin cancer. Scientists have found changes in genetic material that are both inherited and not inherited but caused by sunlight. It appears that some people can repair damage caused by the sun better than others can, and they are less likely to develop melanoma. Researchers hope to use this information to develop gene therapies to prevent and cure skin cancer.
Researchers hope to use gene therapy in several ways. Researchers anticipate replacing the damaged genes in cells with healthy genes. This has had limited success because usually there is more than one type of damaged gene in a melanoma cell.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.