Skin cancer

General information about skin cancer

Skin cancer, including white skin cancer, occurs more frequently in Germany and the spread is also increasing faster than all other types of cancer. The most common cause is exposure to the sun’s ultraviolet rays. Repeated sunburn can cause the cells in the skin to divide uncontrollably or grow into another layer of the skin. If you have light skin and burn yourself more often or expose yourself to strong sunlight for a long time, the risk of illness increases.

In exceptional cases, uncontrolled cell division without any exposure to the sun can lead to skin cancer.

Malignant melanoma, black skin cancer, is perhaps the most well-known type of skin cancer. Around 22,000 people in Germany contract this disease every year. Skin cancers that are non-melanotic, on the other hand, are much more common. Around 99,000 people are affected by squamous cell carcinoma each year, and around 159,200 people develop basal cell carcinoma, a so-called basal cell carcinoma.

Such a diagnosis is most common in people over the age of 40, often much later. Skin cancer in children and adolescents is very rare.

WHO advises against sunbathing

The World Health Organization (WHO) classifies all types of UV radiation as carcinogenic in the highest risk category. She points to experts who believe that four out of five cases of skin cancer could be avoided because UV radiation could be avoided to a large extent. Therefore, the WHO advises against sunbathing. In the case of vitamin D deficiency , dietary supplements are recommended instead.

Skin cancer symptoms

Skin cancer can look very different. Old birthmarks or moles, or moles that grow or change appearance can be a sign of cancer. But more often it’s an entirely new change in your skin that looks like a spot, lump, or pimple. Eczema-like, rough, and scaly skin that doesn’t heal — or heals and comes back — can also be a sign of skin cancer.

The skin lesions can be anywhere on the body, but mostly occur in areas of the skin that have been particularly exposed to the sun.

Common skin changes in skin cancer:

• rough, red, scaly, or sore skin that won’t heal
• skin-colored or pale red pimples or bumps that may be flaky, itchy, or tender
• new moles, moles, or birthmarks with irregular edges or changing color (sometimes with shades of white, red, or blue)
• older moles, moles, or birthmarks that change color or shape, grow, or bleed.

Other possible explanations

Skin reactions can have many causes, such as a temporary rash from a virus or sunburn. Sunburn can also cause skin changes that are permanent but not dangerous, such as sunspots (hyperpigmentation).

Dry skin , eczema , and psoriasis can produce skin reactions similar to skin cancer. This also applies to scab, rosacea , warts, athlete’s foot and nail fungus . Growing nodules in the skin, especially in older people, can be harmless skin changes that are not cancerous.

In rarer cases, skin lesions can be one of several symptoms of underlying serious medical conditions. For example, cancers such as lymph node cancer and lymphocytic leukemia can have symptoms such as skin lesions and skin tumors.

causes of skin cancer

Skin cancer occurs when skin cells divide in an uncontrolled manner and form cancerous cells. This can be caused, for example, by sunburn, which the cells cannot repair.

If you get sunburned frequently, you are more likely to develop serious skin changes that lead to skin cancer. But the skin can also develop tumors without you having been sunburned. This is often the total exposure to the sun throughout life. People with fair skin or large moles are more prone to cancer than others. The risk of being affected by skin cancer increases with age.

The sun’s ultraviolet rays are the most common cause of cell changes and skin cancer. But there are exceptions – certain types of skin cancer can develop in skin that hasn’t been exposed to the sun.

Factors that increase the risk of skin cancer:

• excessive exposure to UV radiation, which also applies to artificial radiation in the solarium
• thin ozone layer
• light skin
• many or large birthmarks
• high age
• heritability
• previous sunburn and burn injuries
• chronic wounds
• various disease states, including other types of cancer
• certain treatments for diseases, including radiation therapy and medicines that weaken the immune system

Different forms of skin cancer

Basal cell carcinoma – Basal cell carcinoma

Basal cell carcinoma, the “white skin cancer”, belongs to the non-melanotic group and is the most common type of skin cancer in this subgroup. In most cases, a basalioma consists of a superficial skin change that grows slowly and very rarely spreads to other parts of the body. The lesion usually resembles a skin-colored pimple or shiny lump. It can also present as an eczema-like sore that doesn’t heal — or heals and recurs.

The symptoms are often caused by prolonged exposure to the sun, but also by genetic factors, for example. White skin cancer most commonly affects people with fair skin. The skin reaction most often occurs on skin that is exposed to the sun, such as the face, neck, chest, stomach or back.

• superficial basal cell carcinoma – looks like an eczema-like patch that is flaky.
• nodular or nodular basal cell carcinoma – looks like a shiny pimple or lump at first and then grows into a wart-like lump, sometimes with a raised ridge that has a sore or small blood vessels in the center
• aggressive basal cell carcinoma – grows deeper into the skin and may appear as a scar or small plaque. A white or yellow-pink lesion that is sometimes sore. Aggressive basal cell carcinoma can occur in different forms and is sometimes referred to as infiltrative basal cell carcinoma.

squamous cell carcinoma

Squamous cell carcinoma is the second most common type of skin cancer and also belongs to non-melanotic groups. It often grows deeper than the basal cell carcinoma and can sometimes spread to nearby lymph nodes, for example.

The lesion may look like eczema that doesn’t heal or a wart-like, skin-colored or pale red lump. The spots and lumps can be tender, scaly, and sore.

The condition is often caused by prolonged exposure to the sun and is most common in white-skinned people. The skin lesion occurs most commonly on the face, crown, neck, neck, or hands.

In more than half of the cases, squamous cell carcinoma develops after a so-called actinic keratosis, a superficial sunburn, which can be a very early stage of cancer. Bowen’s disease, also known as squamous cell carcinoma in situ, can develop into squamous cell carcinoma without a clear connection to long-term sun exposure.

• actinic keratosis – a superficial sunburn on sun-exposed skin that can sometimes be a very early stage of squamous cell carcinoma; often looks like eczema that does not heal
• Squamous cell carcinoma in situ or Bowen’s disease – superficial squamous cell carcinoma that has not fully developed; also often looks like eczema that does not heal but has no connection to prolonged sun exposure
• Squamous cell carcinoma – developed squamous cell carcinoma that grows deep into the skin and resembles a wart or lump; is often formed from an eczema-like skin change, but can also occur in scars or wounds that have not healed.

Malignant melanoma

A malignant melanoma is the rarest and usually the most dangerous type of skin cancer, which in certain cases can spread in the body. It is therefore important to treat malignant melanoma at an early stage, before it has metastasized.

A melanoma usually forms in moles, birthmarks or moles. It is often brown or black, but can also take on shades of white, red or blue, for example. The most common form is an entirely new mole or a small lump in the skin, but it can also be an old mole or pigmented mole that is changing appearance, growing, or bleeding. Melanomas can have an irregular shape with no smooth edge. The skin change is often located on sun-exposed skin areas such as the chest, stomach, back, arms or legs.

A malignant melanoma is caused in most cases by UV radiation and can be a result of frequent sunburn, for example. But melanoma can sometimes form in skin that hasn’t been exposed to the sun, for example on the soles of the feet, palms of hands, inside the mouth, eyes or abdomen. That’s because melanoma occurs in the skin’s pigment cells, called melanocytes, which are present in all skin and also in the mucous membranes.

• malignant melanoma in situ – a precursor to malignant melanoma that only grows in the outermost layer of the skin; each year around 3,000 patients are diagnosed with malignant melanoma in situ, while 4,000 are affected by a developed malignant melanoma.
• superficial melanoma – the most common form of malignant melanoma; often looks like a brown or black, flat or slightly raised patch that can sometimes grow into the outermost layers of the skin for months or years before it begins to grow into the skin.
• nodular or nodular melanoma – the second most common form of malignant melanoma; often looks like a blue or black nodule that quickly grows deeper into the skin and can quickly generate metastases.
• Lentigo maligna – a rarer form of black skin cancer; usually begins as a preliminary stage, lentige maligna, in the form of a light brown spot that grows and, after a few years, develops into a melanoma in the form of a darker nodule with various shades of color
• acrolentiginous melanoma – an exceptional form of malignant melanoma not caused by UV radiation; For example, it can be under a nail, on the sole of the foot, on the toes, fingers or in the palm of the hand and can be confused with athlete’s foot or nail fungus.

examination and treatment

Temporary skin injuries or skin changes caused by the sun are usually not signs of skin cancer and usually do not require treatment. However, permanent skin changes must be examined by a doctor. In many cases, looking and touching the skin is enough to make the correct diagnosis. Sometimes, however, a so-called skin biopsy is required to determine whether the skin changes are dangerous or malignant. If skin cancer is suspected, the lymph nodes are usually also checked. X-rays may sometimes be needed to see if the cancer has spread through the body.

In certain cases, precursors to skin cancer can be treated with a prescription cream that strengthens the immune system. Freezing and laser treatment are other common alternatives. For skin lesions that may be signs of cancer, the entire lesion or mole is usually removed and analyzed. Once the diagnosis is established, further treatment, often with the help of surgery, may be required. To be on the safe side, a little more tissue is often removed around the skin lesion.

Most people who get treatment early get rid of skin cancer. However, it is important to have surgery as early as possible, otherwise there is a risk that the cancer will spread. This is particularly true for squamous cell carcinoma and malignant melanoma.

Squamous cell carcinoma or malignant melanoma, which has already caused metastases in other parts of the body, requires further operations and often further treatment in the form of immunotherapy or cytostatics, for example.

In the case of widespread cancer, it is recommended that the treatment is also accompanied by supportive talks for you, because a cancer finding generates many thoughts and feelings. Outside you need to talk about possible side effects of medical treatment. You can also get support from various patient groups and organizations.

How to protect yourself

Because skin cancer is often caused by sunburn, you can reduce the risk by protecting your skin in a variety of ways, such as using sunscreen or clothing.

Check skin all over your body regularly , including your scalp, soles of your feet, and other areas that aren’t exposed to the sun. In this way, you can detect skin or pigment changes at an early stage. Pay special attention to skin lesions that look odd. For example, it could be an eczema-like patch that doesn’t heal, a lump in the skin, or a growing or bleeding mole that’s irregular in shape or color. A raised mole or pigmented mole that is hard should also be examined more closely.

Protect yourself against the sun:

• limit time in the sun – avoid spending too much time in strong sun, especially if you have fair skin, large birthmarks, or a family history of malignant melanoma
• adjust your time in the sun to where you are – the reflection off snow, water and bright beaches make it easier for you to get sunburned. And the sun is stronger the closer you are to the equator
• Protect your skin and head – smear yourself with a high factor sunscreen that protects against UVA and UVB rays, wear sunglasses, a sun hat or cap and protect your skin with clothing if the sun is particularly strong
• stay in the shade – midday, when the sun’s rays are at their strongest, may be a good time to avoid the sun altogether to reduce the risk of damaging sunburn.

Recognize skin changes with the ABCDE method:

• Asymmetry – does the skin lesion have an irregular shape?
• Boundary – is the boundary to normal skin indistinct?
• Colorit (color) – does the skin change have a different color or several different color nuances?
• Diameter – is the skin lesion larger than 5 millimeters?
• Development – ​​does the mole change or does it always look the same?

Also look out for skin lesions that have a different appearance compared to your other moles – a so-called “ugly duckling”.

When to seek medical help

Birthmarks, moles or moles that are larger than five millimeters in diameter should be examined by a doctor. Skin lesions that are growing or have an irregular color or shape should also be examined. This applies to moles as well as lumps, pimples and other abnormalities in the skin.

See a doctor if you have moles, moles, or moles that are itchy, sore, or bleeding. Likewise, you should seek medical advice if you have eczema-like skin changes that won’t heal.

Here’s how Med-Healths can help you

You can contact us if you need advice and information about unusual skin changes. Use the app to make an appointment for a video consultation and, if necessary, upload a photo of the affected area of ​​skin. A doctor makes an individual assessment based on your symptoms, your photo and the findings of the examination. You can then be referred to a specialist practice if necessary. However, a physical examination is required to make a definitive diagnosis.