What Does Skin Cancer Look Like?

Skin cancer may first appear as a sore that won’t heal, a new spot on the skin, or a mole that is changing. Even early skin cancers can look different from person to person, so it's a good idea to bring any change in your skin to the attention of your healthcare provider.

Most skin cancer begins in the epidermis, the outermost layer of skin. It occurs when cells in the epidermis grow at an out-of-control rate. These abnormal cells are usually caused by exposure to the sun. It is estimated that 1 in 5 Americans will develop skin cancer by age 70.

This article discusses what skin cancer looks like. It also provides photos of the early signs of the most common types of skin cancer. 

Actinic Keratosis

Actinic keratosis is a precancerous growth that is caused by damage to the skin. This damage usually comes from the sun or tanning beds. Actinic keratosis is very common, affecting more than 58 million Americans.

Actinic keratosis is not cancerous but can become dangerous over time. About 40% to 60% of squamous cell cancer cases begin as actinic keratosis. Anywhere between 2% and 10% of these growths will develop into squamous cell carcinoma, sometimes in as little as a couple of years. 

Being able to recognize the early signs of actinic keratosis is important because these precancers can be treated and removed before they turn into cancer.

Actinic keratosis usually appears as a patch of dry, scaly skin. The color of actinic keratosis will depend on your skin tone and may look pink, red, dark tan, white, or the color of your skin.

It is often found in areas of the body that receive the most sunlight, which includes the face, scalp, ears, shoulders, neck, and hands. 

Squamous Cell Cancers

Squamous cell carcinoma (SCC) is the second most common type of skin cancer after basal cell carcinoma. It is caused by the out-of-control growth of the squamous cells in the epidermis. About 1 million Americans are diagnosed with SCC each year.

Squamous cell carcinomas are curable and can usually be removed completely when caught early.

Squamous cell carcinomas most often form on areas of the skin that receive the most sunlight. These growths can also occur in scars or sores and look like open sores, red patches, warts, or thickened skin.

SCC growths look like thick patches of rough, scaly skin. These cancers may also look like warts or sores that never heal. The skin around an SCC growth may show signs of sun damage like wrinkling and darker pigment. They can bleed or itch as well. 

The risk of SCC goes up with the amount of time you have spent in the sun or tanning bed. Other risk factors include a history of skin cancer, a weakened immune system, older age, male gender, and a history of skin infections. 

Some of the most common types of squamous cell carcinoma are:

• Intraepidermal squamous cell carcinoma
• Large cell keratinizing squamous cell carcinoma
• Large cell non-keratinizing squamous cell carcinoma
• Lymphoepithelial carcinoma
• Papillary squamous cell carcinoma 
• Small cell keratinizing squamous cell carcinoma 
• Spindle cell squamous cell carcinoma 

Basal Cell Cancers

Basal cell carcinoma (BCC) is the most common type of skin cancer and the most common of all cancers in the United States, with about 4 million diagnoses each year. 

Basal cell carcinoma usually looks like a small open sore. It can be red or pink in fair-skinned people and brown in people with dark skin. It may present as a red patch or bump on the skin.

BCC often has a raised or rolled border around the sore and may bleed or crust over. BCC may also look like a shiny, pearl-like growth or waxy scar with undefined borders. The area may itch, be painful, or have no symptoms at all. 

Fortunately, BCC typically grows slowly and is very treatable. When caught early, the treatments are effective.

The most common types of basal cell carcinoma are:

• Nodular basal cell carcinoma
• Superficial spreading basal cell carcinoma
• Sclerosing basal cell carcinoma
• Pigmented basal cell carcinoma
  

Melanomas

Melanoma is considered the most serious skin cancer because of its ability to spread beyond the skin. An estimated 186,680 diagnoses of melanoma were predicted in the U.S. for 2023.

Melanoma growths usually look like moles that are brown or black. They can sometimes grow out of a previously benign (noncancerous) mole. About 20%–30% of melanomas grow out of existing moles, and about 70%–80% occur on normal-looking skin.

Melanoma growths are related to sun exposure but can grow in areas that don’t receive much sunlight. The most common site for women is the legs, and for men, it's the trunk of the body. 

The best way to spot melanoma is by keeping an eye on any skin growths that are new or changing. When checking yourself for melanoma, remember the ABCDEs: 

• Asymmetry: A sign is when a mole or growth has two halves that do not match each other.
• Border: A border that is jagged or undefined means your mole should be evaluated.
• Color: Multiple colors are a warning sign of melanoma.
• Diameter: If you notice a mole or growth that is larger than the size of a pea, it needs to be seen.
• Evolving: Any new or changing moles should be evaluated for melanoma.

There are four types of melanoma:

1. Superficial spreading melanoma is the most common form and looks like an asymmetrical, discolored patch of skin with uneven borders.
2. Lentigo maligna melanoma most often develops in older individuals and looks like a slightly raised blotchy patch of blue-black skin.
3. Acral lentiginous melanoma is the most common type of melanoma in people with dark skin, and commonly appears as a black or brown area under the nail or on the soles of the feet. 
4. Nodular melanoma is the most aggressive form and usually presents as a black or blue bump on the skin; it can also be red or pink in color.

Less Common Cancers

Less common skin cancers include Kaposi sarcoma, Merkel cell carcinoma, and sebaceous carcinoma.

Kaposi Sarcoma

Kaposi sarcoma is a rare cancer that is caused by an infection with human herpesvirus-8 (HHV-8). It causes abnormal tissue growths under the skin that look like red and purple lesions.

Risk factors for Kaposi sarcoma include a weakened immune system, Jewish or Mediterranean heritage, and young men living in Africa. 

Merkel Cell Carcinoma

Merkel cell cancer is a rare, aggressive form of skin cancer. Each year about 3,000 Americans are diagnosed with Merkel cell cancer, and it causes 700 deaths annually. It is 40 times rarer than melanoma and is more likely to spread and return once treated. 

Merkel cell cancers usually look like firm, painless bumps or sores. They are found on sun-exposed areas of the body, especially the head, neck, and eyelids. The growths look like pearly pimple-like lumps and may be difficult to recognize. They can be pink, red, or purplish-blue. 

Unlike other forms of skin cancer, Merkel cell cancer is associated with a virus called the Merkel cell polyomavirus. It’s unclear how much having the virus raises your risk. This is because the virus is very common, while Merkel cell cancer is quite rare. 

Sebaceous Gland Carcinoma

Sebaceous carcinoma is a rare, aggressive cancer that usually affects the skin on or around the eyelid. This cancer looks like a small, round, painless tumor on the upper or lower eyelid. Sometimes the tumor is only visible when you pull the bottom of your eyelid down. 

Summary

Skin cancers can look different from each other depending on the type of cancer and its stage. If caught early, most skin cancers are treatable.

Squamous cell carcinoma, basal cell carcinoma, and melanomas are the main type of skin cancers.

It's important to examine your skin for any changes and take precautions to prevent skin cancer, such as limiting sun exposure and wearing sunscreen when outside.