Skin cancer

Skin cancers can vary in how they look. Always make an appointment with your GP if you have:

• a new or changing mole
• any other unusual or unexplained skin changes
• an itch or sore that will not go away.

It might help to take a photograph of anything unusual, so you can check for any changes. Remember that there are many other skin conditions that are not cancer, especially in older people.

We have more information about possible symptoms of:

• melanoma
• basal cell carcinoma and squamous cell carcinoma.

If you have symptoms, contact your GP. They will examine you and may take photos of the skin change. Sometimes, a specially trained GP may be able to remove the affected area.

If they think your symptoms could be a skin cancer, your GP can refer you to a specialist at a hospital. This is usually a doctor who specialises in treating skin diseases. They are called a dermatologist.

Your GP follows national guidelines to decide how quickly you need to see the specialist:

• If they think you might have a melanoma or a squamous cell carcinoma (SCC), they will make an urgent referral for a dermatologist appointment. This means your GP is asking for a dermatologist appointment for you within 2 weeks or as soon as the clinic can arrange it.
• If your GP suspects that you have a basal cell carcinoma (BCC), they will make a routine referral. This means they are asking for a less urgent appointment for you, usually within 18 weeks. This is because nearly all BCCs grow slowly and are unlikely to change much during this time.

The dermatologist examines the affected area of skin. They also ask you questions about how long you have had symptoms, and any changes you may have noticed. They can learn a lot from a simple examination.

They may use an instrument called a dermatoscope to look more closely and examine the skin. It looks like a magnifying glass with a light.

It is not always possible to tell whether skin changes are cancer just by looking at the skin. Your doctor may talk to you about having a biopsy. This is when a sample of tissue is taken and then tested to find out more.

A biopsy can usually be done in an outpatient clinic. The doctor numbs the area with a local anaesthetic. Then they remove all or part of the affected skin. They send this to the laboratory for tests.

Different types of biopsies are used to diagnose skin cancer:

Waiting for test results can be a difficult time. We have more information that can help.

If the biopsy shows you have a skin cancer, your doctor will usually check other areas of your skin. This is to determine whether there are other possible areas of skin cancer.

• If you have a basal cell carcinoma (BCC), you probably will not need any further tests, as long as the cancer has been completely removed. This is because BCCs almost never spread.
• If you have a melanoma, you may have tests to check the lymphoma nodes nearby. Find out more about further tests for melanoma.
• If you have a squamous cell carcinoma (SCC), your doctor may feel the lymph nodes close to the cancer to check whether any are enlarged. This is because SCCs can occasionally spread. Your doctor may recommend that you have an operation to take samples of the nearby lymph nodes. They will only do this if they think the cancer may have spread there, which is rare.

You may have some scans if your doctor thinks that the cancer has started to spread. These scans are not usually needed when you are first diagnosed. Your doctor will explain more about these tests to you.

Many people who have surgery for basal cell carcinomas (BCCs) and early-stage squamous cell carcinomas (SCCs) do not need long-term follow-up hospital appointments. But your doctor may want you to have regular check-ups for a time. This is to make sure that treatment has been successful and the cancer has not come back. You can also talk to your doctor or specialist nurse about any problems or worries you may have.

Follow-up after treatment for melanoma depends on the stage of the melanoma. You can find out more in our information about melanoma.

Once you have had a skin cancer, you have a higher risk of developing it again in the same area. This is called a recurrence. You are also more at risk of developing another one somewhere else on your skin.

Your specialist team may advise you to have regular skin checks with your GP. It is important to regularly check your skin for any new symptoms or changes that could be cancer. Using a mirror can help if there are areas you cannot see easily, such as your back. Or you can ask a family member or friend, if you feel comfortable doing so. If you have any problems, or notice any new symptoms in between check-ups, tell your doctor as soon as possible.

We have more information about follow-up care after treatment.

After you have had treatment for skin cancer it is even more important to protect yourself from the sun. Find out how you can protect your skin in our information about sun safety and cancer treatment.

It is also important to:

• Never use an indoor tanning device, such as a sunbed or sunlamp. If you want to look tanned, use fake tan.
• Check your skin regularly for any changes.

If you are not often outdoors or in the sun, ask your specialist doctor or GP to check your vitamin D levels. Vitamin D is important for general health and can become low in people who avoid the sun or are indoors most of the time. You may need to take vitamin D supplements if your levels are low.

Doctors will try to minimise the effects of skin cancer treatments on your appearance. Many people have only minor scarring after treatment. But for some, it may be more obvious.

If treatment has changed the way you look, you may feel differently about yourself and your body image. Body image is the picture in your mind of how your body looks and works. The effects will often improve with time, but you may feel more self-conscious about how you look.

Everyone’s reactions are different. You may feel more self-conscious about your body but find it manageable. Or you may find your concerns are on your mind a lot of the time, which may affect how you cope.

Talking with people you trust can help. This could be your family, friends, cancer doctor or nurse. Talking to another person who has been through something similar can also help.

There are practical things that can help you to:

• feel better about your appearance
• manage changes to your body
• improve your confidence.

You may want to consider using camouflage make-up to cover a scar. Talk to your doctor or specialist nurse about camouflage make-up or about any concerns you have. Changing Faces has more information about skin camouflage.

We have more information about body image and cancer treatment.

It is important to remember there is no right or wrong way to feel about a skin cancer diagnosis. Everyone’s reactions are different, and you might have a mixture of emotions.

Even if you were diagnosed with a skin cancer that is likely to be cured, you may feel anxious or upset for a while. Talking about your feelings can be helpful. You may find it helpful to talk with your family, friends, doctor or nurse. Sometimes it is easier to talk to someone who is not directly involved in your situation. If you are finding it difficult to cope, your cancer doctor, specialist nurse or GP may be able to refer you to a counsellor who can help.

Macmillan is here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 0000.
• Chat to our specialists online
• Visit our skin cancer forum Online Community to talk to people who have been affected by skin cancer, share your experience, and ask an expert your questions.

The following organisations also offer information and support:

• Changing Faces offers a range of advice and information services about visual differences to the face or body. Provides support and information by phone and online, through workshops and counselling services. Also offers a skin camouflage service in England and Scotland.
• Know your skin – developed by the British Skin Foundation to support people with skin conditions. Know your skin offers information about different skin conditions including skin cancer and Bowen’s disease.
• Skcin: the Karen Clifford skin cancer charity – Skcin offers information focusing on the prevention of skin cancer through education, promoting sun safety and early detection.