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Design by Ruth Basagoitia

Skin cancer refers to any cancer that begins in your skin. It may develop on any part of your skin and can spread to nearby tissues and organs if the disease advances.

There are two main types of skin cancer:

  • Keratinocyte cancer develops in skin cells called keratinocytes. It has two main subtypes, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
  • Melanoma develops in skin melanocyte cells. Melanocytes are skin cells that generate skin’s brown pigment.

Other types of skin cancer include:

  • Merkel cell carcinoma
  • Kaposi’s sarcoma
  • cutaneous (skin) lymphoma
  • skin adnexal tumors
  • other types of sarcomas

These types account for less than 1 percent of all skin cancers.

What are the types of skin cancer?

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Skin cancer is the most common form of cancer in the United States. More people receive skin cancer diagnoses each year in the United States than all other cancers combined, including breast, prostate, lung, and colon cancer.

Each case of skin cancer is considered unique if a doctor believes it’s a separate cancer. A person may have multiple different types — and cases — of skin cancer.

Each year, more than 3 million Americans are affected by BCC or SCC, estimates the American Academy of Dermatology. Having one skin cancer diagnosis puts you at a higher risk for having another, too, but there are preventive measures you can take.

Here are the main types of skin cancer:

Basal cell carcinoma (BCC)

BCC is the most common type of skin cancer. More than 4 million cases of BCC are diagnosed in the United States each year, estimates the Skin Cancer Foundation. This makes it the most common form of all cancers in the United States.

However, death from BCC isn’t common. About 3,000 people die from BCC each year.

BCC most frequently develops on areas often exposed to the sun. This includes the:

  • neck
  • back
  • face
  • scalp
  • hands
  • arms

However, BCC can also develop in skin areas that don’t get a lot of sun exposure.

Squamous cell carcinoma (SCC)

More than 1 million cases of SCC are diagnosed in the United States each year, notes the Skin Cancer Foundation. SCC is responsible for about 15,000 deaths each year.

SCC most commonly appears on areas of the body that are frequently exposed to the sun. SCC, like BCC, may also develop in places that don’t get a lot of sun exposure. For example, SCC can develop on the genitals, inside the mouth, and on the lip.

Melanoma

Melanoma is the most serious type of skin cancer. It develops in the same skin cells that create moles. Because of this, melanoma is particularly dangerous. It can look like a harmless mole when it first develops.

Fewer people develop melanoma than BCC or SCC. It accounts for only 1 percent of all skin cancer cases, estimates the American Cancer Society. It is, however, responsible for the majority of deaths.

In 2018, melanoma will account for more than 91,000 new cases of skin cancer in the United States, notes the National Cancer Institute. More than 1 million Americans live with melanoma.

Actinic keratosis (AK)

AK is a less common type of skin cancer. It’s more accurately considered a precancer.

Most people associate skin cancer with big, red bumps or brown spots. AK, on the other hand, presents as rough, dry, scaly patches that develop on skin that’s had frequent exposure to sun or artificial UV light, like tanning beds.

The sun’s ultraviolet (UV) rays can destroy delicate skin. Over time, AK can form. More than 58 million Americans have AK, estimates the Skin Cancer Foundation.

How common is skin cancer?

You may think places with sunnier, hotter weather have more cases of skin cancer. This isn’t necessarily the case. In fact, the Centers for Disease Control and Prevention notes California and Florida had fewer cases per 100,000 people than states with cooler climates, like Wyoming, Montana, and Idaho, in 2015.

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The states with the fewest cases of skin cancer are:

  • Alaska
  • Arizona
  • District of Columbia
  • Florida
  • Illinois
  • Louisiana
  • Mississippi
  • Missouri
  • Nebraska
  • Nevada
  • New York
  • Oklahoma
  • Texas
  • Virginia

States with the most cases of skin cancer include:

  • Connecticut
  • Delaware
  • Idaho
  • Iowa
  • Kentucky
  • Montana
  • New Hampshire
  • Oregon
  • Utah
  • Vermont
  • Washington
  • Wyoming

What age does skin cancer commonly develop?

The older you get, the higher your chance for developing skin cancer. About half of all Americans will develop either BCC or SCC at least once by the time they’re 65. The average age of a melanoma diagnosis is 63, notes the American Cancer Society.

But melanoma is also one of the most frequently occurring cancers in young adults, especially women. Overall, melanoma occurs more frequently in women than in men before age 50. By age 65, twice as many men than women have melanoma. Rates triple by age 80.

Long-term exposure to the sun’s UV rays increases a person’s chances of developing skin cancer. Artificial UV light, as found in indoor tanning beds, is also a culprit. It accounts for approximately 419,000 cases of skin cancer each year in the United States, estimates a 2014 review and meta-analysis.

The Skin Cancer Foundation goes on to report that indoor tanning beds account for:

  • 245,000 cases of BCC
  • 168,000 cases of SCC
  • 6,200 cases of melanoma

Any history of tanning bed use increases the risk of BCC before age 40 by 69 percent.

Although we’re more educated and aware of skin cancer risks, the number of new cases has been climbing for 30 years — even among younger Americans. In the United States, cases of BCC and SCC among men and women under age 40 are increasing. New cases in children are also on the rise.

Is ethnicity a factor?

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The American Cancer Society estimates Caucasians are 20 times more likely to develop skin cancer than people of African descent. In fact, they note lifetime risk of getting melanoma is significantly higher for non-Hispanic Caucasians:

  • 2.6 percent for Caucasians
  • 0.58 percent for Hispanics
  • 0.10 percent for African-Americans

In their lifetime, 1 in 27 white men and 1 in 42 white women will develop melanoma, says the Skin Cancer Foundation.

While skin cancer is more common in white people, this population also has the best rate of survival. People of Hispanic, Asian, Native American, Pacific Islander, and African descent follow.

The five-year survival rate of melanoma for white people with skin cancer is 94 percent, compared to only 69 percent survival in black people, notes the American Cancer Society.

A 2006 investigation found this is due, in part, to people of African descent being four times more likely to receive a diagnosis of melanoma after the cancer has progressed to an advanced stage or spread to other parts of the body.

Other reasons for the discrepancy include that nearly half of dermatologists say they weren’t trained on diagnosing cancer on black skin.

Generally, skin cancers in people of color may be harder to diagnose because it often develops in areas of the skin that aren’t directly exposed to sun. In these populations, skin cancer can develop on the:

  • soles of feet
  • palms of hands
  • mucous membranes
  • nail beds
 Basal cell carcinoma is the most common cancer in:
  • Caucasians
  • Hispanics
  • Chinese
  • Japanese


Squamous cell carcinoma is most common in:
  • African-Americans
  • Asian-Indians

Does a person’s sex play a role?

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Until they’re 49, women have a higher risk for developing melanoma than men. In fact, the Skin Cancer Foundation reports that up until age 49, women have a higher probability of developing melanoma than every other cancer except breast cancer.

The foundation notes, however, after the age of 50, men are more likely to develop melanoma than women. Over an entire lifetime, 1 in 34 men will develop melanoma. Only 1 in 53 women will be.

Moreover, men are two times more likely to develop melanoma than women after the age of 60. After age 80, men are three times more likely to develop melanoma. Before 60, though, the statistic is reversed. Women are nearly twice as likely to develop melanoma before their 60th birthday.

The older a man gets, the higher his risk becomes. The single largest group of people who receive melanoma diagnoses is elderly white men. In the United States in 2011, the occurrence of melanoma was 168 cases per 100,000 for older white men, outpacing the 21 cases per 100,000 for the general population, notes the Skin Cancer Foundation.

But melanoma doesn’t discriminate by age. Young men aged 15 to 39 are 55 percent more likely to die from the disease than women of the same age.

What are the risk factors for skin cancer?

Some risk factors for skin cancer are controllable, meaning you can change them to protect yourself. Others aren’t controllable. This means you can’t change them — but you can practice proper preventive measures.

Complexion

Your skin color impacts your risk for developing skin cancer. Non-Latino Caucasians have the highest risk of developing skin cancer. People who have a greater number of moles are more likely to get skin cancer, too.

The risk is even higher if you’re of non-Latino Caucasian descent and have moles, fair skin with either blonde or red hair, and either blue, green, or gray eyes.

People with freckles are also more likely to have fair skin that burns easily. This increases their skin cancer risk.

History of sunburn

Too much UV exposure can burn your skin. A history of sunburns — especially burns that lead to blisters — will increase your risk of skin cancer, including melanoma.

One blistering sunburn as a child or teen can double a person’s risk of melanoma, while five or more blistering sunburns before age 20 increases the risk for melanoma by 80 percent.

Family history

Having a family member with skin cancer, specifically BCC, means you’re at a higher risk for skin cancer. The risk is especially strong if a close relative, such as a parent, sibling, or child, has skin cancer.

Health history

Certain events can increase your risk for developing skin cancer. These include an exposure to certain chemicals, such as arsenic, industrial pollution, or coal.

Having an autoimmune disease, such as lupus, increases your risk. Likewise, having had an organ transplant increases your risk of SCC 100 times.

Tobacco use

People who smoke or use chewing tobacco have a higher chance of developing SCC in the mouth or throat.

Tanning beds

People are more likely to develop skin cancer from using tanning beds than developing lung cancer from smoking.

Tanning beds have been classified as “carcinogenic to humans” by the World Health Organization and the International Agency for Research on Cancer. They note there’s a 75 percent increase in melanoma risk when indoor tanning beds have been used before age 30.

History of skin cancer

Once you’ve had one skin cancer, your risks for developing another increases. This is especially true if you had nonmelanoma skin cancer.

Geography

Where you live — specifically the elevation of where you live — can affect your risk of skin cancer. People who live or vacation at high altitudes or tropical climates are more likely to develop skin cancer. This is because UV rays are more powerful at higher altitudes.

Medication

Certain medications, like immunosuppressants, can increase your risk for skin cancer if you take them long term.

What are the symptoms of skin cancer?

Symptoms of skin cancer can be easily confused — and are often overlooked — if you have a history of noncancerous moles, freckles, or growths.

However, any change on your skin could be a potential cancer. Knowing the additional symptoms of skin cancer will help you know whether you’re in the clear or need to book an appointment with your doctor.

What does skin cancer look like?

  • scaliness
  • bleeding or oozing from a skin spot
  • a sore that doesn’t heal in a normal time frame
  • spreading pigment
  • a mole with irregular borders
  • sudden tenderness, itchiness, or pain
  • a noticeable, fast-growing spot

Treatment options for skin cancer

The goal of any skin cancer treatment is to remove the cancer before it has a chance to spread. If the skin cancer has spread to nearby tissues or organs, treating the cancer becomes more difficult. If it hasn’t spread, though, treating skin cancer is often very successful.

Treatment options include:

  • Surgery. Surgically removing the cancerous spot is a common option. In some cases, the spot can be removed easily in a doctor’s office. More advanced cases may require in-depth surgery.
  • Cryosurgery. This type of surgery freezes the affected skin, killing the cancerous cells. Over time, the dead skin cells fall off.
  • Immunotherapy. Immunotherapy uses a person’s immune system to target and destroy cancer. In the case of skin cancer, a medicated cream is applied to the cancerous area. The immune system then works to destroy the cancer.
  • Chemotherapy. If skin cancer has progressed beyond the skin, chemotherapy can help target and kill any cancer cells surgery can’t remove. Chemotherapy comes in several forms, including oral medication, injected shots, and IV infusions. It can even be applied to the skin.
  • Radiation therapy. Radiation seeks out and destroys cancer cells. Radiation is used to treat a larger area, or an area that’s too difficult to treat with surgery.
  • Photodynamic therapy. In this type of therapy, a chemical is applied to the skin cancer. After staying on the skin for many hours, the skin is exposed to a special light, destroying the cancer cells.

Ways to prevent skin cancer

You don’t have to avoid the sun completely to avoid skin cancer. Here are some tips to protect yourself:

  • Avoid the sun at its peak. Keep out of the sun when the UVA and UVB rays are strongest. This happens between 10 a.m. and 4 p.m.
  • Seek shade. If you have to be outside during the sun’s strongest hours, try to stay in the shade.
  • Slather on sunscreen. No matter the time of day, apply sunscreen to all exposed areas of skin. Use a sunscreen with a sun protection factor (SPF) of at least 30. Don’t put it on while you’re outside, either. Your skin needs time to absorb the sunscreen, so it’s best to apply it at least 30 minutes before you head out the door.
  • Don’t forget to reapply. Add another layer of sunscreen to your skin every two hours. If you’re sweating heavily or swimming, you may need to reapply more frequently.
  • Wear a hat. Sunscreen on your scalp, face, and neck is more likely to wear off if you’re sweating. Add an extra layer of sun protection with a hat. Wide-brimmed hats are preferable, but a baseball cap is fine if you apply extra sunscreen to your ears and neck.
  • Protect your eyes. Even your eyes need sun protection. Make sure your sunglasses block 100 percent of UVA and UVB light. This protects your sensitive eyes and the delicate skin around them.
  • Don’t prolong your stay. These sun-protective measures aren’t license to stay in the sun longer. Do what you need to do and have your fun, then return indoors until the sun has fallen in the sky.
  • Avoid artificial UV lights. The sun isn’t your only skin cancer foe. Tanning beds and sun lamps are linked to skin cancer, too. This makes cancer from these sources completely preventable. Avoid using these artificial UV light sources.
  • Get checked. Regular skin exams can help you and your doctor identify suspicious spots. They can be removed as soon as you find them, or your doctor may suggest watching for changes.

Worldwide facts

Despite doctors’ efforts, cases of skin cancer are still on the rise. According to the World Health Organization, 2 to 3 million cases nonmelanoma skin cancer are diagnosed each year across the globe. More than 132,000 cases of melanoma are diagnosed.

Change in global climate is affecting skin cancer rates, too. Changes in the ozone layer mean more solar UV radiation is reaching Earth’s surface. Some experts estimate a 10 percent decrease in ozone levels could potentially lead to an additional 300,000 cases of nonmelanoma and 4,500 cases of melanoma.

Costs of treating skin cancer in the United States

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Treating skin cancer is very costly. In the United States, treating skin cancer costs more than $8 billion annually, according to recent estimates. Nearly $5 billion goes toward nonmelanoma skin cancers like BCC and SCC. More than $3 billion goes toward melanoma.

Skin cancers developed due to tanning bed use carry a financial burden all their own. They account for $343 million in direct costs each year, with a total lifetime cost of $127.3 billion.