What is skin cancer?
Skin cancer is the uncontrolled growth of abnormal cells in the skin.
The three main types of skin cancer are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. BCC and SCC are also called non-melanoma skin cancer or keratinocyte cancer. They are far more common than melanoma.
Basal cell carcinoma (BCC) – the most common type (about 66% of skin cancers), starts in the basal cells of the skin. BCC usually grows slowly over months or years and only rarely spreads to other parts of the body. If left untreated, some BCCs can grow deeper into the skin, invade nerves and damage nearby tissue,
making treatment more difficult. Having one BCC increases the risk of getting another. There can be more than one BCC at the same time on different parts of the body.
Squamous cell carcinoma (SCC) – the second most common type (about 33% of skin cancers), starts in the squamous cells of the skin. SCCs can grow quickly over several weeks or months. Some are found only in the top layer of the skin. These are called SCC in situ, intra-epidermal carcinoma or Bowen’s disease. If SCC invades through the basement membrane it is called invasive SCC. If left untreated, this can spread to other parts of the body (metastatic SCC). SCC on the lips and ears is more likely to spread.
Melanoma – Melanoma starts in the melanocyte cells 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.
Rare types of non-melanoma skin cancer include Merkel cell carcinoma and angiosarcoma. They are treated differently from BCC and SCC. Call Cancer Council 13 11 20 for more information.
Answers to some common questions about skin cancer are below.
Basal cell carcinoma (BCC)
- develops on areas that get more sun exposure, such as the head, face, neck, shoulders, lower arms and legs, but can occur anywhere on the body
- may appear as a pearl-coloured lump or slightly scaly area that is shiny and pale or bright pink; some appear darker
- the skin may break down (ulcerate), bleed and become inflamed; may appear to heal then become inflamed again
Squamous cell carcinoma (SCC)
- usually appears on parts of the body most often exposed to the sun, such as the head, neck, hands, forearms and lower legs, but can start anywhere
- often appears as a thickened, red, scaly or crusted spot or rapidly growing lump
- may bleed and become inflamed, and is often tender to touch
Some spots that appear on the skin are not cancerous. If you are concerned about any mark or growth on your skin, see your general practitioner (GP).
Sunspots (actinic or solar keratoses) – Sunspots occur more often in people over 40, but anyone can develop them. They usually appear on skin that’s frequently exposed to the sun, such as the head, neck, hands, forearms and legs. Sunspots are a warning sign that the skin has had too much sun exposure. Very rarely sunspots may develop into SCC.
What are the signs?
- flat, scaly spot that feels rough; often the colour of your skin or red
- can be easily scratched off but will return in a few days
- may develop into skin cancer
Moles (naevi) – A mole (naevus) is a normal skin growth that develops when melanocytes grow in groups. Moles are very common. Some people have many moles on their body – this can run in families. Overexposure to the sun, especially in childhood, can also increase the number of moles. People with large numbers of normal moles can have a higher risk of melanoma.
What are the signs?
- brown, black or the same colour as your skin; usually round or oval
Dysplastic naevi – People with many irregular moles (dysplastic naevi) have a greater risk of developing melanoma. This risk increases with the number of moles that a person has.
What are the signs?
- mole with an irregular shape and uneven colour
- may develop into skin cancer
Age spots (seborrhoeic keratoses) – These very common skin growths can occur anywhere except the palms and soles. They may look similar to a skin cancer or sunspot. They may be itchy and may bleed if scratched.
What are the signs?
- raised warty area on the skin that feels rough
- light to very dark brown in colour
Over 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.
UV radiation most often comes from the sun, but it can also come from artificial sources, such as arc welders, glue curing lights (e.g. for artificial nails) and solariums (also known as tanning beds or sun lamps). Solariums are now banned for commercial use in Australia because research shows that people who use solariums have a much greater risk of developing skin cancer.
Most parts of Australia have high levels of UV radiation from the sun all year round. UV radiation cannot be seen or felt and it is not related to temperature. It can cause sunburn; premature skin ageing; and damage to skin cells, which can lead to skin cancer.
You can’t always see sun damage to the skin – it can start long before you get sunburnt or develop a tan, and the damage adds up over time.
Anyone can develop skin cancer but it’s more common as you age. 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 or used solariums
- worked outdoors or been exposed to arsenic
- a weakened immune system – this may be from having leukaemia or lymphoma or using immunosuppressive medicines (e.g. for rheumatoid arthritis, another autoimmune disease or for an organ transplant)
- lots of moles, or moles with an irregular shape and uneven colour
- a previous skin cancer or a family history of skin cancer
- certain skin conditions such as sunspots.
People with olive or very dark skin have more protection against UV radiation because their skin produces more melanin than fair skin does. However, they can still develop skin cancer.
Australia has one of the highest rates of skin cancer in the world. About two in three Australians will be diagnosed with some form of skin cancer before the age of 70.
Non-melanoma skin cancer is the most common cancer diagnosed in Australia. Over one 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.
Skin cancers don’t all look the same, but there are 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 sore that doesn’t heal within a few weeks
- a sore that is itchy or bleeds.
Check your skin for changes regularly. There is no set guideline on how often to check for skin cancer, but getting to know your own skin will help you notice any new or changing spots. If you have previously had a skin cancer or are at greater risk of developing skin cancer, ask your doctor how often you should check your skin.
How to check your skin
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 you notice any changes to your skin, make an appointment with your GP or dermatologist straightaway. You will have a better outcome if the skin cancer is found and treated early. For more information on checking your skin see ‘Finding skin cancer early‘.
If you notice any changes to your skin, you may see one or more of the following doctors:
General practitioner (GP) – GPs treat most people with BCCs and SCCs. Treatment may include surgery and/or creams or gels (topical treatments. You may be referred to a dermatologist, surgeon or radiation oncologist for larger areas of abnormal tissue or cancers that are hard to remove.
Dermatologist – A specialist doctor who diagnoses and treats skin conditions, including skin cancer. They can perform general and cosmetic surgery and prescribe topical treatments.
Radiation oncologist – A specialist doctor who treats some skin cancers by prescribing and overseeing a course of radiation therapy.
Surgeon – Some skin cancers are treated by specialised surgeons:
- surgical oncologists specialise in treating cancer with surgery; they manage complex skin cancers, including those that have spread to the lymph nodes
- plastic surgeons are trained in complex reconstructive techniques for more difficult to treat areas, e.g. the nose, lips, eyelids and ears.
When you make an appointment to see a specialist, ask what you will have to pay and how much will be refunded by Medicare. If there is a waiting list and there is a spot on your skin you are worried about, your GP can ask for an earlier appointment.
Many public hospitals have specialist outpatient clinics that provide free skin cancer treatment. Your GP can refer you. In areas without a permanent clinic, you may be able to see a visiting specialist.
Skin cancer clinics offer a variety of services and fee arrangements. They are usually run by GPs who have an interest in skin cancer.
Research shows that clinics may not offer a higher level of skill than your GP. In deciding whether to attend a skin clinic, consider:
- the qualifications and experience of the medical staff – this includes whether they are members of a professional association related to treating skin cancer
- what you will have to pay and whether it is covered by Medicare – some clinics bulk-bill the first consultation but require up-front payment for other appointments or surgery; others require up-front payment for all services
- the range of services offered
- the follow-up provided.
Cancer Council does not operate or recommend any skin cancer clinics, and does not recommend any individual specialists.
This information is reviewed by
This information was last reviewed in December 2021 by the following expert content reviewers: A/Prof Stephen Shumack, Dermatologist, Royal North Shore Hospital and The University of Sydney, NSW; Dr Margaret Chua, Radiation Oncologist, Head of Radiation Oncology, Skin and Melanoma, Peter MacCallum Cancer Centre, VIC; John Clements, Consumer; Aoife Conway, Skin Lead and Radiation Oncology Nurse, GenesisCare, Mater Hospital, NSW; Sandra Donaldson, 13 11 20 Consultant, Cancer Council WA; Kath Lockier, Consumer; Dr Isabel Gonzalez Matheus, Plastic and Reconstructive Surgery, Principal House Officer, Princess Alexandra Hospital, QLD; A/Prof Andrew Miller, Dermatologist, Canberra Hospital, ACT; Dr Helena Rosengren, Chair Research Committee, Skin Cancer College of Australasia, and Medical Director, Skin Repair Skin Cancer Clinic, QLD; Dr Michael Wagels, Staff Specialist Plastic and Reconstructive Surgeon, Princess Alexandra Hospital and Surgical Treatment and Rehabilitation Service, and Senior Lecturer, The University of Queensland, QLD; David Woods,