Detecting non-melanoma skin cancer

Photo of a man looking at his forehead in the mirror

In order to detect non-melanoma skin cancer, you can either check your skin for unusual areas or spots yourself, or have a doctor examine it. Skin cancer can be treated more effectively if it is discovered early, before it spreads.

It can be worrying if an area of your skin changes in size, shape, color or looks abnormal. Many people know that changes like this could be a sign of skin cancer. Skin cancer can also develop on skin that is naturally dark to very dark. But most unusual-looking areas of skin are harmless.

The older you get, the more your skin changes, and new moles or age spots (also known as liver spots or solar lentigines) may develop. This is a normal part of aging. So some people decide to wait and keep an eye on any skin changes.

Carefully checking your skin on a regular basis is a good way to notice any changes, or any wounds that don't heal as quickly as usual. If they don't go away within about four weeks, it's best to have a doctor take a closer look – for instance, your family doctor or a skin specialist (dermatologist). In Germany, statutory health insurers cover the costs of skin cancer screening every two years in people aged 35 and over.

The appearance of non-melanoma skin cancer can vary greatly. There are two types of non-melanoma skin cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

What does basal cell carcinoma look like and where might it arise?

At first, basal cell carcinoma (basal cell cancer) typically looks like a shiny, slightly see-through lump with a surface similar to candle wax. There may be smaller shiny bumps around the edge of it. On lighter skin, you can sometimes see blood vessels beneath the uppermost layer. But basal cell carcinoma can also be dark (pigmented), or it might look like a pale scar. Then it’s more difficult to recognize that it's cancer. In people with dark or very dark skin, the bumps are often brown or dark in color, and it might be harder to see the bumpy, raised edges.

If there is a sunken area in the center of it and the area is moist and sore, an or wound has developed. This is a sign that the cancer is growing. Then the wound typically doesn't heal – not even after a few weeks – or it keeps healing and then starts bleeding again.

Non-melanoma skin cancer might look like this on light skin:

Illustration: Non-melanoma skin cancer might look like this on the ear (light skin)
Illustration: Non-melanoma skin cancer might look like this on the temples (light skin)
Illustration: Non-melanoma skin cancer might look like this on the shoulder (light skin)

Non-melanoma skin cancer might look like this on dark skin:

Illustration: Non-melanoma skin cancer might look like this on dark skin
Illustration: Non-melanoma skin cancer might look like this on dark skin

Other forms of basal cell carcinoma lead to a clearly defined, shiny, reddish or pink scaly area of skin.

Basal cell carcinoma usually arises on areas of skin that have been exposed to a lot of sun, such as the face and back of the neck. Much more rarely, it is also found on the torso or legs, or even on the soles of your feet, palms of your hands, chest, in your armpits or genital area.

What does squamous cell carcinoma look like?

It is not easy to identify squamous cell carcinoma or tell it apart from basal cell carcinoma. It may look like a scaly, red or brownish-yellow patch of skin – or a scabby or crusted sore that bleeds from time to time. The affected area is usually very sensitive to touch and often has hard, thick skin on it as well. In people with very dark skin, squamous cell carcinoma is often darker in color, while the skin around it looks a lot lighter or blotchy.

Squamous cell carcinoma can develop inside a scar or chronic wound, but also in healthy skin. It is often found on the edge of the ears or on the face, including the lips.

In people with light skin, it mainly develops on areas of the body that are frequently exposed to sunlight, like the head and neck area. In people with dark or very dark skin, it more commonly affects areas that are usually covered by clothing, such as the legs and genital area.

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Deutsche Krebsgesellschaft (DKG), Deutsche Krebshilfe (DKH). S3-Leitlinie Prävention von Hautkrebs. AWMF-Registernr.: 032-052OL. 2021.

Bendick C. Besonderheiten der nichtweißen Haut. In: Braun-Falco's Dermatologie, Venerologie und Allergologie. Berlin: Springer; 2017.

Dadzie OE, Petit A, Alexis AF. Ethnic Dermatology: Principles and Practice. Hoboken: Wiley-Blackwell; 2013.

Gloster HM, Neal K. Skin cancer in skin of color. J Am Acad Dermatol 2006; 55(5): 741-760; quiz 761-744.

Hogue L, Harvey VM. Basal Cell Carcinoma, Squamous Cell Carcinoma, and Cutaneous Melanoma in Skin of Color Patients. Dermatol Clin 2019; 37(4): 519-526.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on February 19, 2024

Next planned update: 2027

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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