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Skin cancer usually shows up as a new spot that will not go away or an existing spot that is changing, and the most common warning signs are a sore that scabs, heals partway, and breaks open again, a pearly or shiny bump that bleeds easily, a rough scaly patch that keeps returning, or a mole that is growing, changing shape, or turning multiple colors. It is the most common cancer in the United States, and when it is found early it is highly treatable, often with a single office procedure. The single most useful thing you can do is get any spot that behaves differently from your other spots looked at in person rather than waiting to see whether it settles down.
The spots people worry about are almost never the dramatic ones. It is the tiny place on the nose that bleeds a little every time it gets bumped shaving, blamed on a razor for eight months. It is the rough patch on the ear that a fingernail keeps finding. It is the mole on the back that a spouse says looks different and you cannot see for yourself. Many patients tell us they noticed something a year ago and kept meaning to call. That delay is the part worth changing, because early skin cancers are small problems and late ones are not.
Three types account for the vast majority. Basal cell carcinoma is the most common by far and typically grows slowly, appearing as a pearly or waxy bump, a flat scar-like area, or a sore that heals and reopens. It rarely spreads to other organs, but it grows locally and can cause real damage to nearby tissue if ignored, especially on the face. Squamous cell carcinoma often looks like a firm red bump, a rough scaly patch, or a wart-like growth that may be tender, and it carries a somewhat higher risk of spreading. Melanoma is less common but the most serious, because it can spread to other parts of the body if it is not caught early. There are also precancerous spots called actinic keratoses, which are rough sandpaper-like patches on sun-exposed skin that can develop into squamous cell carcinoma over time.
Ultraviolet radiation is the leading cause, from sunlight and from tanning beds, and the damage accumulates over decades. Blistering sunburns in childhood matter years later. Other risk factors include fair skin that burns easily, light eyes or hair, many moles or unusual-looking moles, a personal or family history of skin cancer, a suppressed immune system such as after an organ transplant, and older age. Living in North Texas adds meaningful lifetime exposure simply because of how many bright months we get.
Skin cancer occurs in people of every skin tone. In darker skin it is less common but more often found late, and it tends to appear in less expected places, including the palms, the soles of the feet, under the nails, and inside the mouth. Those areas deserve attention regardless of how much sun they see.
Think in terms of new, changing, and not healing. Any of the following is a reason to be seen:
For moles specifically, dermatologists use the ABCDE guide. A is for asymmetry, meaning one half does not match the other. B is for border, meaning edges that are ragged or blurred. C is for color, meaning more than one shade within a single spot. D is for diameter, with anything larger than a pencil eraser worth checking. E is for evolving, meaning any change over time, and that last one matters most.
A dermatologist examines the spot, often using a dermatoscope, which is a handheld magnifier with a light that reveals patterns beneath the surface that the naked eye cannot see. If a spot looks suspicious, a skin biopsy is done, meaning a small sample is numbed and removed and sent to a pathologist for examination under a microscope. Biopsies take a few minutes and usually require only a small amount of local anesthetic. A biopsy is how skin cancer is confirmed, and no one can tell you definitively by looking alone. Results generally come back within about a week.
Treatment depends on the type, the size, the depth, and the location. Small, superficial cancers are sometimes treated with prescription creams or with a scraping and cautery procedure done in the office. Surgical removal with a margin of normal skin around the tumor is the most common approach. For cancers on the face, ears, hands, and other areas where preserving tissue matters, or for tumors with unclear borders or a tendency to recur, Mohs surgery is often the preferred option. In Mohs surgery the tumor is removed in thin layers and each layer is examined under a microscope during the same visit, so removal continues only where cancer remains and healthy tissue is spared. Radiation is used for selected patients who are not good candidates for surgery. Advanced melanoma is managed with additional treatments coordinated with other specialists.
Daily sun protection does more than any product applied after the fact. Use a broad-spectrum sunscreen of SPF 30 or higher, reapply every couple of hours outdoors, and remember that a single morning application does not last through a Texas afternoon. Seek shade between midmorning and late afternoon, wear a wide-brimmed hat and sunglasses, and consider sun-protective clothing for long days outside. Never use tanning beds. Get familiar with your own skin by checking it every month or two, using a mirror or a partner for your back and scalp, so you notice changes early.
Make an appointment any time a spot is new, changing, or refusing to heal after about a month. Do not wait for it to hurt, because most skin cancers do not. You should also schedule a full skin examination if you have a history of significant sun exposure or blistering sunburns, a personal or family history of skin cancer, many or unusual moles, a suppressed immune system, or if you simply have never had your skin checked. If a spot is worrying you enough that you keep looking at it, that is a good enough reason on its own.
Blue Ribbon Dermatology cares for patients of all ages in Allen and welcomes neighbors from Plano, McKinney, Frisco, Fairview, and Wylie. Skin checks are quick, and having them nearby makes it far easier to come back on schedule once you have had one skin cancer, since a history of one raises the odds of another. Being close also means a concerning spot can be evaluated in days rather than sitting on a calendar for months.
Usually not, and that is exactly why it gets ignored. Most skin cancers are painless, though some become tender or itchy as they grow. Waiting for a spot to hurt before getting it checked is the most common reason people come in later than they should.
A full skin examination is straightforward. You change into a gown and your dermatologist looks systematically at the skin from scalp to feet, including areas the sun never reaches. It is a good time to point out anything you have been wondering about.
Yes. Skin cancer occurs in every skin tone, and although it is less common in deeper skin, it is more often diagnosed at a later stage. It also appears more frequently in areas with little sun exposure, such as the palms, soles, and under the nails, so those spots are worth checking.
Any procedure that removes tissue leaves some mark, though techniques are chosen to keep it as small and inconspicuous as possible, particularly on the face. Scars typically fade and soften over the first year. Your dermatologist can explain what to expect for your particular spot and location before anything is done.
Having one raises your chances of developing another, which is why regular follow-up matters. Many patients settle into a schedule of checks every six to twelve months. The upside is that subsequent cancers tend to be caught very early because someone is looking.
Long-standing moles are usually stable, but the important thing is whether it is changing now. A mole that has looked the same for thirty years and suddenly darkens, grows, or develops an irregular edge deserves attention regardless of how long it has been there.
If a spot has been on your mind, that instinct is worth acting on. Schedule an appointment at Blue Ribbon Dermatology in Allen for a skin check or to have a specific spot evaluated, and let us give you a straight answer.
This article is general education about skin cancer and is not medical advice. It cannot substitute for an in-person examination by a licensed physician, and no article can tell you whether a particular spot is dangerous. Please have any concerning spot evaluated by your own doctor.
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