Non-melanoma skin cancer

At a glance

  • There are two different kinds of non-melanoma skin cancer: basal cell carcinoma and squamous cell carcinoma.
  • Non-melanoma skin cancer is more common than melanoma, but it's less dangerous.
  • The main risk factors are too much UV light, a light skin color and older age.
  • The best way to prevent non-melanoma skin cancer is not to spend too much time in the sun without protection.
  • In Germany, statutory health insurers cover the costs of skin cancer screening every two years in people aged 35 and over.
  • If doctors think you may have non-melanoma skin cancer or if it is diagnosed, they will remove the unusual area of skin.


Photo of a mother and daughter at the park

Basal cell carcinoma (basal cell cancer) and squamous cell carcinoma (squamous cell cancer) are collectively referred to as non-melanoma skin cancer. This is to distinguish them from melanomas, which often look like dark moles on light skin.

Non-melanoma skin cancer is much more common than melanoma. But non-melanoma skin cancer can usually be fully removed, and it only rarely spreads to other parts of the body.


Non-melanoma cancer can take on very different forms so it can have a number of different symptoms too: The affected area of skin may become scaly, lumpy, or change color. This makes it difficult to tell the difference between non-melanoma skin cancer and other skin changes.

Basal cell carcinoma:

  • On light skin, it usually looks like a shiny, slightly see-through lump at first. The surface may look similar to candle wax.
  • On darker and very dark skin, the bumps are often dark or brown in color with a shiny, glossy appearance.
  • It mainly develops on areas of skin that are regularly exposed to sunlight, such as the scalp, neck or cleavage.

Squamous cell carcinoma:

  • This may look like a scaly, red or brownish-yellow patch of skin – or a scabby or crusted sore.
  • In people with light skin, it often develops on areas of skin that are frequently exposed to sunlight – on the face, for example.
  • In people with dark skin, it more commonly develops in areas that are usually covered by clothing, such as on the legs.
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)
Illustration: Non-melanoma skin cancer might look like this on dark skin
Illustration: Non-melanoma skin cancer might look like this on dark skin

People sometimes notice non-melanoma skin cancer because an area of skin is itchy or starts to bleed. It doesn't cause any other symptoms for a long time. But if it grows larger, enters deeper layers of tissue or spreads inside the body, it causes other symptoms – mostly pain in the affected area.

Causes and risk factors

Various factors can increase your risk of developing non-melanoma skin cancer. Too much sunlight is the main risk factor, but people with light-colored skin or certain medical conditions are more prone too.

The risk of getting non-melanoma skin cancer increases with age. The average age of people diagnosed with basal cell carcinoma is about 60, and for squamous cell carcinoma it's 70.


Basal cell carcinoma and squamous cell carcinoma are among the most common types of cancer.

In Germany in 2018, about 224 out of 100,000 women and 257 out of 100,000 men developed one of these two types of skin cancer. So men are slightly more likely to get non-melanoma skin cancer. A total of about 200,000 people were diagnosed with non-melanoma skin cancer in Germany in 2018.

The following year, 631 men and 445 women died of non-melanoma skin cancer.


Basal cell carcinoma grows slowly and usually doesn't spread to other organs (metastasis). But if it goes unnoticed for a long time, the cancer can enter deeper layers of tissue, and is then more difficult to treat. About 1 out of 1,000 people who develop basal cell carcinoma die of it.

Squamous cell carcinoma is more aggressive than basal cell carcinoma. It also grows in the area where it develops, gradually destroying tissue around it. If left untreated, there is a danger that the cancer might spread to other parts of the body. About 40 to 50 out of 1,000 people with squamous cell carcinoma die of it.


Doctors can often tell whether you have non-melanoma skin cancer just by looking at your skin. To examine it more closely, they often use an instrument called a dermatoscope as well. This is a very powerful magnifying glass with a light on it.

If doctors think you may have non-melanoma skin cancer, they will remove the unusual area of skin and some surrounding tissue. Sometimes they will first check whether it really is non-melanoma skin cancer. This involves taking a tissue sample (biopsy) and examining it under a microscope. Further examinations (like an ultrasound scan of nearby lymph nodes) are usually only needed if it's thought that the cancer may have spread.

People sometimes wrongly assume that you can’t get skin cancer if you have darker skin. It is also harder to see skin cancer on dark skin. Because of these two things, the cancer may go undetected for a longer time. This makes it even more important to look out for changes in darker skin too.


Skin cancer is aimed at large numbers of people who haven't yet been diagnosed with this disease. In Germany, skin cancer focuses on people aged 35 and over. Statutory health insurers then offer to cover the costs of this examination every two years. The idea is to detect pre-cancerous changes in the skin and discover cancer before it can invade nearby tissue or spread to other parts of the body (metastasis). The ultimate aim is to provide better treatment and increase the chances of a full recovery.

In skin cancer screening, the doctor closely inspects all of your skin, from head to toe. For the examination to be thorough, they should also look at skin folds and mucous membranes. Doctors who mainly examine people with light skin sometimes find it harder to recognize non-melanoma skin cancer on darker skin. This is because the cancer might look different and develop on other parts of the body in people with darker skin. Aside from skin cancer , it's also important to look out for changes in your skin yourself and have a doctor examine any unusual areas.


There is no surefire way to prevent non-melanoma skin cancer. It is generally sensible to avoid overexposure to ultraviolet (UV) light. This mainly means not spending too much time in the sun without protection and not using tanning beds.


Basal cell carcinoma and squamous cell carcinoma can often be fully removed in a minor operation, particularly when discovered at an early stage. If skin cancer can no longer be surgically removed, radiotherapy or medication are considered. If the cancer has entered deeper layers of tissue, more major interventions are needed.

Further information

Squamous cell carcinoma and the abnormal changes in the skin that can lead to it – known as actinic keratosis – have been acknowledged as occupational diseases since early 2015. People who spend a lot of time being exposed to UV light because they work outdoors are more likely to develop this type of non-melanoma cancer.

You can find information about using tanning beds on the website of the German Federal Office for Radiation Protection (Bundesamt für Strahlenschutz, or BfS).

When people are ill or need medical advice, they usually go to see their family doctor first. Information about health care in Germany can help you to navigate the German health care system and find a suitable doctor. You can use this list of questions to prepare for your appointment.

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Deutsche Krebsgesellschaft (DKG), Deutsche Krebshilfe (DKH). Diagnostik, Therapie und Nachsorge des Melanoms (S3-Leitlinie, in Überarbeitung). AWMF-Registernr.: 032-024OL. 2020.

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

Bundesamt für Strahlenschutz (BfS). Optical radiation: Legal regulations for sunbeds. 2022.

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

Dellavalle R. Skin cancer, moles, and actinic keratosis. In: Williams H, Bigby M, Herxheimer A et al. (Ed). Edvidence-based dermatology. London: BMJ Books; 2014. P. 223-319.

Deutsche Krebsgesellschaft (DKG), Deutsche Krebshilfe (DKH), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Aktinische Keratose und Plattenepithelkarzinom der Haut (S3-Leitlinie). AWMF-Registernr: 032-022OL. 2020.

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

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.

Jackson BA. Nonmelanoma skin cancer in persons of color. Semin Cutan Med Surg 2009; 28(2): 93-95.

Robert Koch-Institut (RKI), Gesellschaft der epidemiologischen Krebsregister in Deutschland (GEKID). Krebs in Deutschland für 2017/2018. 2021.

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. 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.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas - either via our form or by We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

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?

Über diese Seite

Updated on February 19, 2024

Next planned update: 2027


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

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.