What is Skin Cancer?

There are 2 main categories of skin cancer: they are Melanoma and Non-Melanoma skin cancer. 

Melanoma is a cancer that usually starts in the skin. It can start in a mole or in normal-looking skin. Melanoma is an uncontrolled growth of melanocytes (pigment cells). Melanocytes are found in the outer layer of the skin called the epidermis; they produce melanin which protects cells by absorbing UV radiation. Non-cancerous growth of melanocytes results in moles, whereas the cancerous growth of melanocytes results in Melanoma. 

Non melanoma skin cancer (NMSC) consists of two main categories: Basal cell carcinoma (BCC) and Squamous cell carcinoma (SCC). NMSC accounts for 28.1% of all cancers and 90% of all skin cancers.

BCCs are the most common type of skin cancer and sometimes referred to as “rodent ulcers” They develop from basal cells and these are found in the deepest part of the outer layer of the skin (the epidermis). They develop mostly in areas of skin exposed to the sun, including parts of the face such as the nose, forehead and cheeks. Also, on your back or lower legs.

SCC is the second most common type of skin cancer in the UK. It is generally faster growing than basal cell cancers. They begin in cells called keratinocytes, which are found in the epidermis. Most SCCs develop on areas of skin exposed to the sun. These areas include parts of the head, neck, and on the back of your hands and forearms.

Have a question about the signs and symptoms of skin cancer?
A new or changing mole:

  • Increase in size
  • Change in Shape
  • Change in Colour
  • Itch
  • Stinging/tingling
  • Bleeding
  • Becoming more elevated/raised

  • A non-healing skin lesion that has been present longer than 4 weeks.

  • A slow growing red/pink/brown or shiny nodule or lesion or
  • A fast-growing changing lesion with crusting or pain
  • Usually found on sun exposed areas of skin
  • Bleeding episodes or ulceration
  • Can look like it improves but never completely goes away
  • Can also present as a reddish patch or irritated scaling skin
  • Check your skin for changes once a month. A friend or family member can help you particularly with checking areas that you cannot easily inspect, such as your back. Check your skin from head to toe. Including fingernails, toenails and between toes Use of a mirror can help check the soles of your feet.
    Skin should be examined monthly for moles that are growing, or changing:

  • in size (getting bigger)
  • shape (becoming asymmetrical with an irregular ragged edge)
  • colour (an uneven colour with different shades of black, brown or pink)
  • If a mole is very different from the other moles on the skin
  • Also, if it has a tendency to bleed, ooze or scab
  • Ask a family member or a friend to examine your back and taking a photograph is helpful to monitor any change to a mole. Use of a ruler can help measure for change in size
  • Family history of skin cancer or personal history of skin cancer
  • Skin type – people with paler skin, which burns easier and those with green or blue eyes.
  • History of sunburning (in childhood) or prolonged sun exposure.
  • Use of sunbeds especially, before the age of 35
  • Working outdoors (e.g.) outdoor sports, gardeners, farmers and builders
  • History of breast cancer or inflammatory bowel disease
  • Immunosuppression from organ transplant or other medications
  • A large number of moles, and moles, which are large and irregular in colour and shape (‘atypical” moles).
  • Sun Advice, Prevention, Let’s Dispel the Myths!
    Yes! The Department of Health figures have shown that sunbed use under the age of 35 years increases your risk of skin cancer by 75%. However, if you stop using sunbeds and avoid sunburning and tanning you can help reduce your risk of skin cancer.
    Yes! You are at risk if you sit in direct sunlight even with a high factor sun cream as there is no such thing as a total block. Therefore, it is important that you wear a broad brimmed hat, sunglasses, protective clothing and seek the shade.
  • Protect your skin with clothing, and don’t forget to wear a broad brimmed hat that protects your face, neck and ears, and a pair of UV protective sunglasses.
  • Seek the shade and do not sit in direct sunlight.
  • When choosing a sunscreen look for a high protection SPF (SPF 30 or more) to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA. Apply plenty of sunscreen 30 minutes prior to going outdoors and reapply every two hours and straight after swimming and towel-drying.
  • Keep babies and young children out of direct sunlight.
  • Sunscreens should not be used as an alternative to clothing and shade, rather, they offer additional protection. No sunscreen will provide 100% protection.
  • If I spend longer in the sun will that increase my Vitamin D? The body can only absorb a limited amount of Vitamin D at any one time, therefore, increasing time in the sun may not increase your Vitamin D but increased sun exposure will increase your risk of skin cancer.

    Individuals concerned about their Vitamin D levels should consider having it measured. If levels are reduced a supplementary Vitamin D3 may be prescribed. Foods that may enhance Vitamin D levels are oily fish, eggs, meat, fortified margarines and cereals.
    This is radiation from the sun and sunbeds – UV radiation can burn, tan age your skin which ultimately increases your risk of skin cancer.
    Tan is DAMAGE, therefore each time you tan you increase your risk of skin cancer! A safe tan does not exist.
    It is a myth that UV damage only occurs on hot sunny days, therefore, it is advisable to protect the skin when UV levels are higher – In Norther Ireland this will be from early March until late October.
    Those with outdoor hobbies (cycling, running, sailing, golfing and gardening)
    Outdoor workers (farmers, council workers, professional sports people and construction workers).
    The answer is yes. You reduce your risk at any time by using good sun protection, wearing protective clothing, a hat, sunglasses and staying in the shade out of direct sunlight
    SPF 30 plus, broad spectrum and water resistant. Look for 4 – 5 Star rating with UVA & UVB protection.

    Sun cream must protect against UVA which protects against ageing of the skin and the risk of skin cancer. UVB which will help against sunburning and increased skin cancer risk.
    Sun cream needs to be applied 30 minutes prior to going out – this will give it time to activate to protect the skin You should reapply after swimming and always reapply every 2 hours.

    Remember there is no safe tan, avoid burning and tanning to reduce your risk of skin cancer and prematurely ageing your skin.
    Points to remember!

    Don’t forget to stay in the shade, apply broad spectrum with a minimum SPF 30, wear clothing with UV protection or closely woven knit, wear a brimmed hat and sunglasses with UV protection.

    Further patient information is available on following links: