What Does Skin Cancer Look Like?

Skin cancer is the atypical growth of skin cells. The most common cause is prolonged exposure to the sun, but it can also develop in areas where no sunlight exposure has occurred. There are four types of skin cancer: basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma.

In the United States, skin cancer is the most common form of cancer. Skin cancer affects upwards of 300 million Americans each year, which equates to a combined treatment cost of just over $8 billion per year.  Skin cancer, and specifically melanoma, affects all skin types equally, although people with darker skin tones are more at risk of missing early detection and thus experience a lower survival rate.

Survival rates for skin cancer vary by type. With basal cell carcinoma and squamous cell carcinoma, the survival rate is 92% if detected early. Prevention and early diagnosis are of the utmost importance. Knowing the signs and symptoms of skin cancer can help you determine if you need to get any suspicious-looking moles or skin spots checked out.

When Is a Mole a Problem?

If a new or existing mole begins to change shape, color, size, or becomes flaky, crusty, or begins to bleed, it's time to make an appointment with your dermatologist to get it checked out. A mole can turn into melanoma on rare occasions. In early melanoma, the shape of a mole becomes asymmetrical and uneven.

Female dermatologist (30s) examining male patient's skin with dermascope, carefully looking at a mole for signs of skin cancer.

kali9 / Getty Images

Nodular Basal Cell Carcinoma

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Skin cancer, close-up - stock photo

Science Photo Library - DR. P. MARAZZI / Getty Images

Nodular basal cell carcinoma is a type of skin cancer that is most often found on the head. This type of cancer starts in basal cells, which are tasked with making new skin cells to push the old ones toward the surface of the skin. Nodular basal cell carcinoma is responsible for 60%-80% of all basal cell carcinomas. In the United States, it’s estimated that 4.3 million cases of basal cell carcinoma are diagnosed every year, with 2.5 to 3.4 million of those cases being nodular basal cell carcinoma.

This type of cancer appears as a pearl-like papule that is round and surrounded by threadlike red lines on the skin made up of tiny blood vessels. The risk of developing nodular basal cell carcinoma can be increased by spending a lot of time out in the sun, living in high-altitude and sunny locations, and radiation therapy.

Other risk factors include:

  • Having fair skin
  • Getting older
  • Family or personal history of skin cancer
  • Taking immunosuppressive drugs
  • Prolonged exposure to arsenic
  • Certain rare genetic disorders such as basal cell nevus syndrome

Although this type of cancer is common, it is highly treatable, and the five-year relative survival rate is 100%. 

Infiltrative Basal Cell Carcinoma

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Basal cell carcinoma affecting the face

DermNet NZ

Infiltrative basal cell carcinoma occurs when a tumor makes its way into the dermis (the inner layer of the two main layers of skin) via thin strands between collagen fibers. This aggressive type of skin cancer is harder to diagnose and treat because of its location. Typically, infiltrative basal cell carcinoma appears as scar tissue or thickening of the skin and requires a biopsy to properly diagnose.

To remove this type of basal cell carcinoma, a specific form of surgery, called Mohs, is used. During a Mohs surgery, also called Mohs micrographic surgery, thin layers of skin are removed until there is no cancer tissue left.

Superficial Basal Cell Carcinoma

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Superficial basal cell carcinoma, face

DermNet NZ

Superficial basal cell carcinoma, also known as in situ basal-cell carcinoma, tends to occur on the shoulders or the upper part of the torso, but it can also be found on the legs and arms. This type of cancer isn’t generally invasive because it has a slow rate of growth and is fairly easy to spot and diagnose. It appears reddish or pinkish in color and may crust over or ooze. Superficial basal cell carcinoma accounts for roughly 15%-26% of all basal cell carcinoma cases.

Squamous Cell Carcinoma (Early Stage)

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Squamous cell carcinoma of limbs

DermNet NZ

When squamous cells that make up the middle and outer layers of the skin become cancerous, it is referred to as squamous cell carcinoma. This type of cancer has an extremely high survival rate, though it can be aggressive in nature. If it is left untreated, it can spread to other areas of the body and cause serious complications.

Squamous cell carcinoma is mostly found on areas of the body that experience the most exposure to the sun, such as the face, lips, ears, scalp, shoulders, neck, back of the hands, and forearms. They can also develop on skin that has been damaged in some way, typically within scars or skin sores. In the early stages of squamous cell carcinoma, a nodule will form, which resembles an opalescent wart. The wart-like nodule may also have a dip in the middle that looks like a crater.

Squamous Cell Carcinoma (Central Hyperkeratosis)

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Squamous Cell Carcinoma (Central Hyperkeratosis

DermNet NZ

Later-stage squamous cell carcinoma is more distinguishable from basal cell carcinoma because of its distinct appearance. The wart-like nodule changes into patches that can be scaly and red (called hyperkeratosis). It can also present as an open sore. When this happens, the crusted skin can bleed on and off and become itchy. At or before this stage, it is important to seek treatment, because squamous cell carcinoma can infiltrate the body and lead to more serious health concerns.

Squamous cell cancers can affect roughly 1 million Americans every year. Men are more likely to develop this type of cancer, as are people over 50. People with light skin, hair, and eyes are at increased risk for this type of skin cancer. Having a weakened immune system, chronic infection, blood or bone marrow cancer, an organ transplant, or skin injury or damage can also increase the risk for this disease. Those with xeroderma pigmentosum, a rare genetic condition that reduces the body’s ability to repair the skin's DNA after damage from the sun, are also at an increased risk.

Squamous Cell Carcinoma (Ulceration)

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Squamous cell carcinoma of the lip: shallow ulcer with infiltrated border and covered with scales and crusts. Borderline ulcerated lesion (ulcerated actinic cheilitis, histologically) 

Research Gate

When squamous cell carcinoma develops into an ulcer or becomes affected by one, this is known as a Marjolin ulcer. Although Marjolin ulcers can be considered an infiltrative type of basal cell carcinoma, they are most typically squamous cell carcinoma. Marjolin ulcers are formed in the skin that has been damaged in some way, but most notably in skin that has been badly burned. They can also occur because of bone infections, pressure sores, frostbite, skin grafts, and radiation.

Marjolin ulcers can take anywhere from 11 to 75 years to turn into cancer, though the average length is 30 to 35 years. This type of cancer is quite aggressive, even if it grows slowly, and has the ability to infiltrate other areas of the body. In the early stages of this disease, the damaged skin where the ulcer formed will begin to itch and burn, and a new sore will show up shortly after. This sore is generally flat with hard, raised edges, and it could come with other symptoms, such as severe pain, bleeding, crusting, or foul-smelling pus.

Squamous Cell Carcinoma In Situ

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Ungual squamous cell carcinoma in situ

DermNet NZ

Squamous cell carcinoma in situ, also known as Bowen’s disease, is a precancerous condition that appears as a red or brownish patch or plaque on the skin that grows slowly over time. The patches are often found on the legs and lower parts of the body, as well as the head and neck. In rare cases, it has been found on the hands and feet, in the genital area, and in the area around the anus.

Bowen’s disease is uncommon: only 15 out of every 100,000 people will develop this condition every year. The condition typically affects the Caucasian population, but women are more likely to develop Bowen’s disease than men. The majority of cases are in adults over 60. As with other skin cancers, Bowen’s disease can develop after long-term exposure to the sun. It can also develop following radiotherapy treatment. Other causes include immune suppression, skin injury, inflammatory skin conditions, and a human papillomavirus infection.

Bowen’s disease is generally treatable and doesn’t develop into squamous cell carcinoma. Up to 16% of cases develop into cancer.

What's the Difference Between Basal Cell Carcinoma and Squamous Cell Carcinoma?

Both basal cell and squamous cell carcinoma aren't usually life-threatening, but squamous cell carcinoma is more likely to infiltrate the deeper layers of the skin.

Melanoma (Early Signs)

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Melanoma in situ

DermNet NZ

Melanoma is the most serious form of skin cancer. Risk factors include sun exposure, fair skin, and a family history of melanoma. Some research suggests that genetic factors play a role in 72% of cases. Use the ABCDE method to check for this form of cancer:

  • Asymmetry—Benign moles tend to be symmetrical in shape. If a mole is asymmetrical, it could be a sign of melanoma.
  • Border—Harmless moles will have regular edges, whereas those that could be melanoma often have an irregularly shaped border.
  • Color—The color of a mole can be a good indicator of whether it requires further inspection. Melanoma moles will have a more pronounced coloring that will vary. They could be red, black, dark brown, or flesh-colored.
  • Diameter—The size of the mole matters. If a mole is larger than the eraser end of a pencil, it should be inspected further.
  • Evolving—Moles that change over time may require evaluation. Changes in color, size, shape, or elevation should always be examined by your healthcare provider.

Using the ABCDE method will help you keep track of your moles and any changes that require a visit to the dermatologist.

Melanoma (Ugly Duckling Sign)

The ugly duckling sign of melanoma is an observation method to help people identify a mole that could be a sign of melanoma.  

Melanoma (Nodular)

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Nodular Melanoma

DermNet NZ

Nodular melanoma occurs most often on the legs, torso, arms, and head, but can develop on any part of the body. It looks like a mole, bug bite, or pimple. It is typically solid in color, most notably black, but it can also be pink, tan, blue, gray, red, or white. Men are more likely to develop nodular melanoma than women, and the condition is often found in adults over 50.

The EFG method can be used to detect this type of melanoma:

  • Elevation—If the mole in question is elevated off the skin, it could be a cause for concern. The elevation could be even or uneven.
  • Firm—Nodular melanomas are typically very firm to the touch.
  • Growth—Mole growth is a significant cause for concern, and requires further inspection.

Nodular melanomas are fast-growing. A way to tell the difference between a new mole growing normally and a nodular melanoma is that melanoma will continue to grow past the typical two to three weeks growth of a normal mole.

Melanoma (Amelanotic)

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Amelanotic nodular melanoma

DermNet NZ

Amelanotic melanoma often has little to no pigmentation, giving it a pinkish or whitish appearance. It accounts for the majority of melanoma cases that occur in children. It may be difficult to examine using the ABDCE method, since this type of melanoma doesn’t display the typical features of other types of melanoma.

Melanoma (Acral Lentiginous)

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Acral lentiginous melanoma

DermNet NZ

Acral lentiginous melanoma occurs on the palms of the hands, soles of the feet, or beneath the nails. It can develop on its own or within an existing mole. It first appears as a flat patch that is discolored, but can infiltrate the skin when it passes through the basement membrane, the part of the skin that is between the outermost layer (epidermis) of the skin and the dermis. This type of melanoma typically looks like a large mole with a smooth surface, and it thickens over time. Its color varies from a mixture of brown, blue, and grey to black and red colors.

It occurs in all skin types and colors, but it is the most common form of skin cancer found in people with darker skin tones, accounting for 29%-72% of all melanoma cases in people with dark skin. Both men and women are equally affected by acral lentiginous melanoma, and the majority of cases occur in adults over the age of 40.

Merkel Cell Carcinoma

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Merkel Cell Carcinoma

DermNet NZ

This type of rare skin cancer grows rapidly and presents as a nodule that is either flesh-colored or bluish-red. It can be found most commonly on the face, head, or neck. Older adults are more likely to develop Merkel cell carcinoma, and risk factors include sun exposure, immunosuppression, light skin, and a history of other skin cancers. It is highly aggressive and can spread easily throughout the body. Its risk for returning is also high. It is estimated that one in 130,000 people in the United States will develop Merkel cell carcinoma at some point in their lives.

Merkel Cell Carcinoma

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Merkel Cell Carcinoma

DermNet NZ

Clinical features of Merkel cell carcinoma led to the development of the AEIOU method to help people with early detection:

  • Asymptomatic—If there is a lack of tenderness in the nodule, Merkel cell carcinoma may be suspected.
  • Expanding rapidly—If the nodule grows rapidly in less than three months, it could mean that it is a case of Merkel cell carcinoma.
  • Immunosuppression—A weakened immune system can mean a person is more at risk for developing Merkel cell carcinoma.
  • Older age—Adults over 50 are more susceptible to this type of cancer.
  • UV exposure—Because exposure to the sun can increase the risk of developing this type of skin cancer, monitoring how much sun a person gets is a good way to determine their risk level when growth appears.

Merkel Cell Carcinoma (Collision Tumor)

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CSL of a basal cell carcinoma and an angioma in a 67-year-old male on his back

Europe PMC

A collision tumor occurs when there is more than one type of skin cancer present directly adjacent to one another. This is most often the case when someone has both Merkel cell and squamous cell cancers, but it can also happen with Merkel cell and Bowen’s disease or basal cell carcinoma. Collision tumors are more likely to occur in adults over 60 following a lifetime of sun exposure.

A Word From Verywell 

A majority of skin cancers are easily treatable if caught early. It’s important to know the signs and how to self-examine moles and nodules on the body to determine whether a new mole or other skin changes is normal or cancerous. It's generally good practice to have a dermatologist check out any new growths, even if they seem to look normal.

Taking precautions to prevent skin cancer, such as avoiding too much sun exposure, getting sunburns, and tanning, can significantly decrease your risk of developing this disease. Always wear sunscreen with a broad-spectrum SPF of at least 15 and cover up your body as much as possible while outdoors.

Frequently Asked Questions

  • What does skin cancer look like?

    Skin cancer can appear as moles, nodules, rashes, scaly patches, or sores that won't heal. The most important things to look for are skin growths or patches that are different from other areas of the skin and change over time. Itching and bleeding are other common signs.

  • What types of skin cancer are deadliest?

    Melanoma causes the majority of skin cancer deaths. These cancers are usually asymmetrical with ragged borders, and unevenly colored. Melanomas look different than other moles and change in size and shape over time.

  • What does skin cancer on the lip look like?

    Squamous cell carcinoma is the most common type of lip cancer. It starts as a raised, wart-like bump that may or may not have a dimple in the middle. A scab-like crust may form, but the area won’t heal and may occasionally bleed.

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17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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