Detecting non-melanoma skin cancer

Photo of a man
PantherMedia / Fabrice Michaudeau

In order to detect non-melanoma skin cancer, you can either check your skin for abnormalities yourself or have a doctor examine it. Skin cancer can be treated more effectively if it is discovered before it spreads to other parts of the body.

It can be worrying if an area of your skin changes in size, shape, color or looks abnormal. A lot of people know that changes like this could be a sign of skin cancer. 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 abnormalities.

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.

In Germany, statutory health insurers cover the costs of skin cancer screening every two years in people aged 35 and over.

Where can basal cell carcinoma arise and what does it look like?

Basal cell carcinoma (basal cell cancer) typically looks like a shiny, see-through or waxy bump at first. There may be smaller bumps around the edge of it. You can sometimes see blood vessels beneath the uppermost layer.

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 tumor is growing. The wound typically doesn't heal – not even after a few weeks – or it keeps healing and then starts bleeding again.

Photo: Non-melanoma skin cancer might look like this

Non-melanoma skin cancer might look like this (Photographer: Kelly Nelson, M.D.; Source: visuals.nci.nih.gov)

Other forms of basal cell carcinoma are characterized by a clearly defined, shiny, reddish or pink scaly area of skin. But basal cell carcinoma can also be dark (strong pigmentation), or it might look like a pale scar. This makes it harder to identify it as cancer.

Basal cell carcinoma usually arises on areas of skin that have been exposed to a lot of sun, such as the face and neck. But it is also sometimes 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's not always easy to identify squamous cell carcinoma or tell it apart from basal cell carcinoma. It may look like a scaly, reddish or yellow-brown area of skin, or a crusty, scabby wound that bleeds from time to time. The affected area is usually quite sensitive and often has scaly parts as well.

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

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Deutsche Krebsgesellschaft (DKG), Deutsche Krebshilfe (DKH). S3-Leitlinie Prävention von Hautkrebs. AWMF-Registernr.: 032-052OL. April 2014. (Leitlinienprogramm Onkologie).

Bath-Hextall F, Jenkinson C, Kumar A, Leonardi-Bee J, Perkins W, Cox K et al. Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year. BMC Dermatol 2013; 13: 13.

Baxter JM, Patel AN, Varma S. Facial basal cell carcinoma. BMJ 2012; 345: e5342.

Deutsche Krebsgesellschaft (DKG), Deutsche Dermatologische Gesellschaft (DDG). Aktinische Keratose und Plattenepithelkarzinom der Haut (S3-Leitlinie). AWMF-Registernr.: 032-022. June 2019.

Gemeinsamer Bundesausschuss (G-BA). Hautkrebsscreening. Zusammenfassende Dokumentation des Unterausschusses „Prävention“ des Gemeinsamen Bundesausschusses. March 31, 2008.

Rubin AI, Chen EH, Ratner D. Basal-cell carcinoma. N Engl J Med 2005; 353(21): 2262-2269.

Stratigos A, Garbe C, Lebbe C, Malvehy J, del Marmol V, Pehamberger H et al. Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline. Eur J Cancer 2015; 51(14): 1989-2007.

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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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Updated on November 29, 2018
Next planned update: 2021

Authors/Publishers:

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

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