Skin cancer

Skin cancer is the uncontrolled growth of abnormal cells in the skin. 

The 3 main types are: 

• basal cell carcinoma (BCC) – about 2 out of 3 skin cancers 
• squamous cell carcinoma (SCC) – about 1 in 3 skin cancers 
• melanoma – about 1 in 100 skin cancers. 

BCC and SCC – These are also called non-melanoma skin cancer or keratinocyte cancer. They are far more common than melanoma and make up about 99% of skin cancers. 

Melanoma – This starts in the melanocytes and makes up 1–2% of all skin cancers. It is the most serious form of skin cancer because it is more likely to spread to other parts of the body, especially if not found and treated early. 

This information is only about non-melanoma (keratinocyte) skin cancers. 

▶ For more information about melanoma, download our booklet 'Understanding Melanoma'. 

Rare types of skin cancer – These include Merkel cell carcinoma and angiosarcoma. They are treated differently from BCC and SCC. Call Cancer Council 13 11 20 for more information.

Basal cell carcinoma (BCC)

The most common signs – a pink, pearl-like, flat or raised lump; shiny, pale/bright/dark pink scaly area.

What it may feel like – can be itchy, inflamed, ulcerate, weep, ooze, scab or bleed; may “heal” then inflame/bleed/itch again.

Where it is most often found – sun-exposed areas, such as head, face, neck, shoulders, arms and legs, but may be anywhere.

How it usually grows – slowly over months or years; very rarely spreads to other parts of the body; may grow deeper, invade nerves and tissue, making treatment more difficult.

The risk factors – having had a BCC increases the risk of developing another BCC.

Squamous cell carcinoma (SCC)

The most common signs – a thick scaly lesion; a fast-growing pink lump; a red, scaly or crusted spot.

What it may feel like – can become inflamed and often feel tender to the touch; may occasionally bleed.

Where it is most often found – sun-exposed areas, such as head, neck, hands, forearms and lower legs, but can start anywhere.

How it usually grows – quickly over weeks or months; called invasive SCC if it invades past skin’s top layer; untreated, may spread to other parts of the body (metastatic SCC).

The risk factors – SCCs on head, neck, lips, ears and in people with weakened immune systems are more likely to spread.

Refer to page 9 of our 'Understanding Skin Cancer' book for images of BCCs and SCCs.

Some spots that appear on the skin are not cancerous. We have given examples of the most common ones here, but these skin spots can vary in how they look. If you are concerned about any mark or growth on your skin, see a general practitioner (GP) or a dermatologist to have it checked.

Types of non-cancerous skin spots

Sunspot (actinic or solar keratosis) 

• flat, scaly spot that feels rough; often the colour of your skin or red 
• usually appears on skin that is most exposed to the sun, such as the head, neck, hands, forearms and legs 
• a sign of too much sun exposure and a marker of sun damage; a risk factor for skin cancer 
• may on rare occasions develop into SCC skin cancer
• more common in people over 40, but anyone of any age can develop them

Age spot (seborrhoeic keratosis) 

• raised area on the skin that feels rough; may look and feel a bit like a wart 
• may be itchy or bleed if scratched
• may range in colour from light to very dark brown 
• found anywhere on the body apart from the palms of the hands and soles of the feet 
• may look similar to a skin cancer or sunspot 
• very common but harmless

Mole (naevus) 

• brown, black or the same colour as your skin; usually round or oval 
• a normal skin growth that develops when melanocytes grow in groups 
• some people have lots of moles – this can run in families 
• too much sun exposure, especially as a child, may increase the number of moles 
• very common 
• a risk factor for melanoma; people with lot of moles may have a higher risk of developing melanoma

Irregular mole (dysplastic naevus) -

• a larger mole with an irregular shape and uneven colour 
• just as with moles, people with lots of irregular moles may have a higher risk of developing melanoma

Refer to pages 10 and 11 of our 'Understanding Skin Cancer' book for images of these other types of skin spots.

"I have lots of age spots and moles. I find it hard, but I try to keep track of what they look like, and any changes. But I make sure to get a skin check by a doctor every year too. Last check they found an SCC, but luckily it was treated early.” GWEN

More than 95% of skin cancers are caused by exposure to UV radiation. When unprotected skin is exposed to UV radiation, how the cells look and behave can change. 

Australia has one of the highest UV levels in the world. The UV peaks during summer, but can damage unprotected skin most of the year. Even moderate UV levels can still do damage. UV radiation can’t be seen or felt. It isn’t related to the temperature and can still be high on cloudy days. UV radiation can cause sunburn; premature skin ageing; and damage to skin cells, which can lead to skin cancer. 

You can’t always see sun damage that’s happened to the skin – and it can happen long before you get sunburnt or develop a tan. The damage also adds up over time and can’t be reversed.

You can check the UV levels in your local area on the SunSmart Global UV app.

See information on how to properly protect your skin from the sun and prevent skin cancer.

Australia has one of the highest rates of skin cancer in the world. About 2 out of 3 Australians will be diagnosed with some form of skin cancer before the age of 70.

Non-melanoma (keratinocyte) skin cancer is the most common cancer diagnosed in Australia. Over 1 million treatments are given each year in Australia for non-melanoma skin cancers. BCC can develop in young people, but it is more common in people over 40. SCC occurs mostly in people over 50.

Anyone of any age can develop skin cancer but it becomes more common as you get older. Many factors can increase your risk of skin cancer, including having: 

• pale or freckled skin, especially if it burns easily and doesn’t tan 
• red or fair hair and light-coloured eyes (blue or green) 
• unprotected exposure to UV radiation, particularly a pattern of short, intense periods of sun exposure and sunburn, such as on weekends and holidays 
• actively tanned, sunbaked or used solariums 
• worked outdoors or spent a lot of time outside (e.g. gardening or golfing) 
• been exposed to arsenic 
• a weakened immune system – this may be from having leukaemia or lymphoma or using medicines that suppress the immune system (e.g. for rheumatoid arthritis, another autoimmune disease or for an organ transplant) 
• lots of moles, or lots of moles with an irregular shape and uneven colour
• a previous skin cancer or family members with a history of skin cancer 
• certain skin conditions such as sunspots because it shows that you have had a lot of skin damage from exposure to the sun. 

People with brown, black, olive or very dark skin often have more protection against UV radiation, because their skin produces more melanin than fair skin does. However, people with darker skin can still develop skin cancer, sometimes in less sun-exposed areas of the body.

In a room with good light, undress completely and use a full-length mirror to check your whole body. To check areas that are difficult to see, use a handheld mirror or ask someone to help you.

If there any changes to your skin, if you notice something new, or you are worried about a spot you see, make an appointment with your doctor straightaway. You will have a better outcome if the skin cancer is found and treated early. For more information on checking your skin, visit SunSmart.

Most skin cancers are self-detected. If you know what changes to watch for, you’ll be more likely to find a skin cancer early. 

Skin cancers don’t all look the same, but there are some signs to look out for, including: 

• a spot that looks and feels different from other spots on your skin 
• a spot that has changed size, shape, colour or texture 
• a spot that is tender or sore to touch 
• a sore that doesn’t heal within a few weeks 
• a sore that is itchy or bleeds. 

Getting to know your skin will help you notice any new or changing spots. Make a time to regularly check your skin. You could try having a calendar reminder for the first day of the month, or you may want to do a check at the change of each season. 

There is no set guideline on how often to check for skin cancer, but if you have had a skin cancer or are at greater risk of developing skin cancer, your doctor will do regular check-ups and will tell you how often you need to check your own skin.

Some smartphone apps let you photograph your skin at regular intervals and compare the photos to check for changes. These apps may be a way to record any spot you are worried about or remind you to check your skin. However, research shows that apps cannot reliably detect skin cancer. If you notice a spot that worries you, make an appointment with your doctor straightaway

You may see one or more of the following doctors:

GP – Many GPs diagnose and treat people with BCC and SCC skin cancers. They may perform surgery, cryotherapy or prescribe topical treatments. Some GPs have extra training related to skin cancer. Before choosing a GP, you can ask what experience or qualifications they have with skin cancer. You may see a GP at a general practice, medical centre or skin cancer clinic. Skin cancer clinics are run by GPs with an interest in skin cancer. A GP may refer you to a dermatologist, surgeon, or radiation or medical oncologist for larger areas or cancers that are hard to remove. If there’s a waiting list and spot of concern, your GP can ask for an earlier appointment.

Dermatologist – A doctor who diagnoses, treats and manages skin conditions and skin cancer. They perform surgery, cryotherapy and prescribe topical treatments.

Radiation or medical oncologist – A radiation oncologist prescribes and oversees a course of radiation therapy, which may be used to treat some skin cancers. A medical oncologist prescribes cancer drug therapies, which may be used for a small number of (usually) advanced skin cancers.

Surgeon – Some skin cancers are treated by surgeons: 

• Surgical oncologists specialise in treating cancer with surgery; they manage complex skin cancers, including those that have spread to the lymph nodes. 
• Reconstructive (plastic) surgeons are trained in surgical oncology and in complex reconstructive techniques for more difficult to treat areas (e.g. the nose, lips, eyelids and ears).

Surgery to remove the cancer (surgical excision) is the most common treatment for invasive BCC and SCC. Most small skin cancers are removed by a GP or a dermatologist in their consulting rooms. A surgeon may treat more complex cases. 

The doctor will use a local anaesthetic to numb the affected area, then cut out the skin cancer and some nearby normal-looking tissue (margin). This margin may be very small or around 1 cm depending on the type of skin cancer and where it is on your body.

A pathologist checks the margin for cancer cells to make sure the cancer has been completely removed. The results usually take about a week. If cancer cells are found at the margin, you may need further surgery, radiation therapy or other treatment options.

Mohs micrographic surgery 

Mohs micrographic surgery is usually done under local anaesthetic by a Mohs trained dermatologist or Mohs specialist. It is used to treat skin cancers that have poorly defined edges; cancers in areas that are hard to treat, such as near the eye or on the nose, lips and ears; and BCCs that have come back. 

This procedure is done in stages. The doctor removes the cancer little by little and checks each section of tissue under a microscope. They keep removing tissue until they see only healthy tissue under the microscope. Mohs surgery aims to reduce the amount of healthy skin that is removed along with the cancer. 

Having Mohs surgery depends on where the skin cancer is and how aggressive or advanced it is. This technique costs more than other types of surgery. Special equipment and training are needed, so it’s available only at some hospitals or clinics.

Repairing the wound after surgery 

Most people will be able to have the wound closed with stitches. You will have a scar. This should be less noticeable over time. The area around the excision may feel tight and tender for a few days. 

If you have a large skin cancer removed, your doctor will explain the most suitable type of reconstruction for your wound. This may be a: 

• skin flap – when nearby loose skin and underlying fatty tissue is moved over the wound and stitched 
• skin graft – when a thin piece of skin is removed from another part of the body (the donor site) and stitched over the wound. The donor site may be stitched, or it may be dressed and allowed to heal by itself. 

Skin flaps and grafts are often done as day surgery in hospital under a local or general anaesthetic, but may be done in a doctor’s rooms. The affected area will heal over a few weeks. Whether you have an excision or Mohs surgery, sometimes you may need more complex reconstructive surgery. This can involve more than one reconstruction technique, surgery that is done in stages, and a longer stay in hospital.

Curettage and electrodesiccation (cautery) is used to treat some BCCs, small SCCs and areas of SCC in situ (Bowen’s disease).

The doctor will give you a local anaesthetic and then scoop out the cancer using a small, sharp, spoon-shaped instrument called a curette. Low-level heat will be applied to stop the bleeding and destroy any remaining cancer. The wound should heal within a few weeks, leaving a small, flat, round, white scar. Some people may have cryotherapy after curettage to destroy any remaining cancer cells.

Cryotherapy, or cryosurgery (freezing), uses extreme cold to treat sunspots, some small superficial BCCs and SCC in situ (Bowen’s disease). It is not suitable for some SCCs that have come back. 

The GP or dermatologist sprays liquid nitrogen onto the sunspot or skin cancer and a small area of skin around it. You may feel a burning or stinging sensation, which lasts a few minutes. The liquid nitrogen freezes and kills the abnormal skin cells and creates a wound. 

The treated area will be sore and red. A blister may form soon after. A few days later, a crust will form on the wound. The dead tissue will start to fall off 1–6 weeks later, depending on the area treated. New, healthy skin cells will grow and a scar may develop. The healed skin may look paler than the surrounding skin. 

Your doctor will tell you about follow-ups to check if the skin cancer has come back. In some cases, the procedure may need to be repeated.

Some spots and superficial skin cancers can be treated with creams or gels called topical treatments. They may contain immunotherapy or chemotherapy drugs, and are prescribed by a doctor. Only use them on the specific areas that your doctor has asked you to treat. Don’t use leftover cream on spots that have not been checked by your doctor.

Immunotherapy cream

Imiquimod cream is a type of immunotherapy that causes the body’s immune system to destroy cancer cells. It’s used to treat sunspots and superficial BCCs. You may need a biopsy (if you haven’t had one) before using this cream. Your doctor will explain how and when to apply the cream. For superficial BCCs, the cream is often applied at night, usually 5 days a week for 6 weeks. Within days, the treated skin may get red, sore or tender. It may peel and scab over before it gets better. Some people experience pain or itching in the affected area, fever, achy joints, headache and a rash. If you notice any of these more serious side effects, stop using the cream and see your doctor immediately.

Chemotherapy cream

A cream called 5-fluorouracil (5-FU) is a type of chemotherapy drug used to treat sunspots and sometimes SCC in situ (Bowen’s disease). 5-FU works best on the face and scalp. Your doctor will explain how to apply the cream and how often. Many people use it once or twice a day for 2–4 weeks. It may need to be used for longer for some skin cancers. 

While using the cream, your skin will be more sensitive to UV radiation and you will need to stay out of the sun. The treated skin may become red, blister, peel and crack, and feel uncomfortable. These effects will usually settle within a few weeks of finishing treatment.

Other treatments 

As at October 2025, there are no Australian guidelines or recommendations on the use of topical radiation creams such as Rhenium-188. Information on its effectiveness and side effects is needed before it may be considered a standard treatment.

Photodynamic therapy (PDT) uses a cream that kills cancer cells when a special light is applied. It is used to treat sunspots, superficial BCCs and SCC in situ (Bowen’s disease). This treatment may have a high cost.

After gently scraping the area to remove any dry skin or crusting, the doctor applies a cream to the skin. After 3 hours, light is used to activate the cream, either using an LED light or by indirect sun exposure (daylight PDT). An LED light is usually used on the area for about 8 minutes. The area is then covered with a bandage. For skin cancers, LED PDT is usually repeated 1–2 weeks later. Daylight PDT works in a similar way – your doctor will give you instructions for how long to expose only the area with the cream to sunlight. 

Side effects can include redness and swelling, which usually ease after a few days. PDT commonly causes a burning, stinging or tender feeling in the treatment area, particularly on the face. Your doctor may treat these side effects with a cold water spray or pack, or give you a local anaesthetic to help ease any discomfort.

Radiation therapy (or radiotherapy) uses radiation to kill or damage cancer cells so they can’t grow, multiply or spread. It’s used as the main treatment for BCCs or SCCs that can’t be removed surgically, for large areas, or for people not fit enough for surgery. 

You may have radiation therapy after surgery to reduce the risk of cancer returning. It should be started within 6 weeks after surgery. 

Radiation therapy to treat skin cancer is given from outside the body (externally). It may use low-energy x-rays from a superficial x-ray machine or high-energy x-rays from a machine called a linear accelerator or LINAC. Different techniques and types of radiation may be used. You will have a separate planning session so the radiation therapy team can work out the best position for your body during treatment.

Treatment will usually start a couple of weeks after a planning session. During each treatment session, you will lie on a table under the radiation machine. Once you are in the correct position, the machine will rotate around you to deliver radiation to the area with the cancer. The process can take 10–20 minutes, but the treatment itself takes only a few minutes. 

The number of treatments varies and may take 2–7 weeks to complete. Your treatment team will consider things such as the type and position of the skin cancer and your preferences and circumstances to tailor the best treatment course. Some people have 5 sessions a week for several weeks, while others may have a much shorter course of treatment. 

Skin in the treatment area may become red, dry or moist, and sore 7–10 days after treatment starts, depending on how long you have treatment. This soreness may get worse after treatment has finished but it usually improves within 6 weeks. The treatment team will suggest creams or coverings to make you more comfortable.

Download our booklet ‘Understanding Radiation Therapy’

A very small number of SCCs and even fewer BCCs spread to lymph nodes or other areas of the body. To work out if the skin cancer has spread, your doctor will feel nearby lymph nodes and may recommend a biopsy, imaging scans or other tests. You may be referred to a cancer specialist called a medical oncologist. Your doctor or medical oncologist will explain your treatment options, which may include surgery, radiation therapy or drug therapies such as immunotherapy, targeted therapy or chemotherapy. Drug therapies such as immunotherapy may be used before or after surgery for some cancers, or used instead of surgery or radiation therapy for some people.

If you’ve had skin cancer, you have a higher risk of getting more. You’ll need regular checks-ups to see if the cancer has come back and check for new ones. It’s common to have check-ups every 3–6 months if you had a high-risk cancer, and every year for low-risk cancers. People who have a weakened immune system may have more frequent check-ups. Your doctor will tell you how often they need to examine you. 

It’s very important to avoid more skin damage, check your skin often, and see your doctor if you notice a change.

After a skin cancer diagnosis, you need to take special care to protect your skin from the sun’s UV radiation. UV radiation is not the same as sunshine – UV levels can be high on a cloudy day or at the snowfields.

The UV index shows the intensity of the sun’s UV radiation. It can help you work out when to use sun protection. An index of 3 or above means that UV levels are high enough to damage unprotected skin. Using a sunscreen daily when the UV level is forecast to be 3 or above has been shown to reduce the risk of skin cancer. But when UV levels are 3 or more, you need to use more than one type of sun protection, including protective clothing, a hat, sunscreen, sunglasses and seeking shade. 

The recommended daily sun protection times are the times of day the UV levels are expected to be 3 or higher. The daily sun protection times will vary according to where you live and the time of year.

Some medicines and health conditions may make the skin more sensitive to UV radiation, causing it to burn or be damaged by the sun more quickly or easily. Ask your doctor if this applies to you and if there are any extra things you should do to protect your skin. You may need to use sun protection all the time, whatever the UV level is.

UV radiation from the sun causes skin cancer, but it is also the best source of vitamin D. People need vitamin D to develop and maintain strong, healthy bones. The body can absorb only a set amount of vitamin D at a time. Most people can get enough vitamin D through incidental exposure to the sun, while using sun protection. When the UV index is 3 or above, this may mean spending just a few minutes outdoors on most days of the week, depending on where in Australia you live and the time of year. However, people with naturally very dark skin tones, who do not burn, may need longer sun exposure to get enough vitamin D. 

After a diagnosis of skin cancer, talk to your doctor about the best ways to get enough vitamin D while reducing your risk of getting more skin cancers. Your doctor may advise you to limit your sun exposure as much as possible when the UV index is 3 or above. In some cases, this may mean you don’t get enough sun exposure to maintain your vitamin D levels. Your doctor may advise you to take a supplement. Overexposure to UV is never recommended.

Most skin cancers are caused by exposure to the sun’s UV radiation. When UV levels are 3 or above, use all or as many of the following ways to protect your skin as possible. After a diagnosis of skin cancer, it is especially important to check your skin regularly and follow SunSmart behaviour.

Slip on clothing – Wear clothing that covers your shoulders, neck, arms, legs and body. Choose closely woven fabric or fabric with a high ultraviolet protection factor (UPF) rating, and darker fabrics where possible.

Slop on sunscreen – Use SPF 50 or SPF 50+ broad-spectrum, water-resistant sunscreen and apply every morning. Apply 20 minutes before going outside and reapply every 2 hours, or after swimming, sweating or activity that rubs it off. For an adult, use about 7 teaspoons of sunscreen to cover the full body. If you’re wearing protective clothing, use 1 teaspoon for each exposed arm, leg, or face, neck and ears.

Slap on a hat – Wear a hat that shades your face, neck and ears, such as a legionnaire, broad brimmed or bucket hat. Check that the hat meets the Australian Standard. Choose fabric with a close weave that doesn’t let light through. Baseball caps and sun visors don’t offer full protection.

Seek shade – Use shade from trees, umbrellas, buildings or any type of canopy. UV radiation is reflective and bounces off surfaces, such as concrete, water, sand and snow, so shade should never be the only form of sun protection you use. If you can see the sky through the shade, even if the direct sun is blocked, the shade will not completely protect you from UV radiation.

Slide on sunglasses – Protect your eyes with sunglasses that meet the Australian Standard (with a lens category of 2, 3 or 4). Wraparound styles are best. Sunglasses should be worn all year round to protect both the eyes and the delicate skin around the eyes.

Don’t use solariums – It is not safe to use solariums. Also known as tanning beds or sun lamps, solariums give off artificial UV radiation and are banned for commercial use in Australia.

Check daily sun protection times – Each day, use the free SunSmart Global UV app to check the recommended sun protection times in your local area. and use sun protection when the UV is 3 or above. For more information, visit SunSmart. You can also find sun protection times at the Bureau of Meteorology or the BOM Weather app, or in the weather section of daily newspapers.

Skin cancer treatments such as surgery, curettage and electrodesiccation, and cryotherapy often leave a scar. In most cases, your doctor will do everything they can to make the scar less noticeable. Most scars will fade with time. Skin treated with radiation therapy may change in colour, and appear lighter or darker depending on your skin tone. Talk to your radiation therapy team about the best options for skincare. 

Talk to your doctor or nurse about treatments that can help improve the appearance of scars, such as silicone gels and tapes and non-perfumed creams (e.g. sorbolene). Steroid injections to flatten out lumpy scars may also be an option for some people. 

You may worry about how scars look, especially on the face. Cosmetics, your hairstyle or clothing may help. You can talk to a counsellor, friend or family member about how the changes make you feel.

Download our booklet ‘Emotions and Cancer’

Look Good Feel Better

Look Good Feel Better is a national program that helps people manage the appearance-related effects of cancer treatment. Workshops are run for men, women and teenagers. For information about services in your area, visit Look Good Feel Better or call 1800 650 960.

"I had skin cancer removed from my arm followed by a skin graft from the same arm. I have a large ‘indent’ from the removal of the cancer and a large scar at the donor site. I didn’t expect the amount of pain and appearance changes.” DAVID