Paying attention to the skin, observing signs and changes in the tissue, is one of the ways to take care of health. This is because, often, skin cancer shows signs through wounds that do not heal, lesions or even spots that start to itch.
The skin covers the human body and has thousands of cells specialized in different functions. When any of these cells undergo changes in the DNA and multiply unbridled, the condition of skin cancer appears.
The main signs of manifestation of the disease are spots, bumps, changes in spots and nodules on the skin .
As the largest organ in the human body, the skin is also the most affected by cancer, reaching 25% of diagnosed cases.
It is important to know that the high incidence of the disease is mainly related to sun exposure without using a protector, in which ultraviolet radiation causes genetic changes in cells.
There are self-assessment methods, called ABCDE, that help in prevention and can make up an early diagnosis. Skin care and observation should always be associated with frequent consultations with a health professional.
Non-melanoma basal cell carcinoma – CBC
It is the least aggressive and the most frequent, reaching 70% of diagnosed cases. Areas such as the head, neck, face and shoulders are very vulnerable regions for the appearance of the disease, as soon as they are more exposed to UVA and UVB rays.
However, cancer can manifest itself in any region of the skin. Generally, its evolution is slow and can be identified from a wound that does not heal.
The incidence in people with fair skin is high due to the sensitivity of the dermis when subjected to frequent or unprotected sun exposure.
Non-melanoma squamous cell carcinoma – CPB
Less frequent than Basal Cell Carcinoma, this second type originates in the outermost layers of the skin, affecting the cells of the spinous surface.
The evolution of the disease is faster and the worsening of the spots or wounds is easily noticeable.
The skin tends to show signs of wrinkling, changes in pigmentation and loss of elasticity, caused by frequent and prolonged exposure to the sun.
The most aggressive type of the disease is called Melanoma and has the worst prognosis among skin cancer cases. Its evolution is quite aggressive and the mortality rate is high when not treated.
The melanoma originates in the melanocytes, the cells that produce melanin protein and are responsible for pigmentation of the skin.
Melanin is transported to the most superficial layers of the skin and acts as a tissue filter, reducing the incidence of ultraviolet rays.
Therefore, people who have fair skin have a lower melanin production and have a higher incidence of skin cancer.
Diagnosing the disease early on offers greater chances of cure, facilitating treatment and mitigating the consequences for the body.
Up to 90% of cases that are discovered in the early stages are completely cured and have no consequences for the body.
Although they are quite rare, there are other types of skin cancer that can manifest themselves.
Merkel cell tumor
It presents as a rare skin cancer and its origin is aggressive neuroendocrine (varied tumors that can develop from cells of the endocrine system).
The prevalence is in females, especially in women over 70 years old and with fair skin.
Although the causes are not fully known, it is indicated that there is a correlation with sun exposure. Therefore, in general, the neoplasm affects more easily the upper limbs, head and neck, which are areas most exposed to the sun.
Sarcoma de Kaposi
It is a rare type of cancer that affects the inner layers of blood vessels. The condition is prevalent in patients with the AIDS virus and can cause damage to the skin, ganglia, liver, lungs, bronchi and intestinal mucosa.
There is also the possibility of affecting the oral cavity, such as the gums, lips, tongue, in addition to the eyes and eyelids.
Cutaneous T-cell lymphoma
The condition originates in lymphocytes (white blood cells) and quickly affects the skin.
The signs can appear in any region of the tissue, but there is a greater incidence in the glutes and breasts, with red spots, which peel and itch. Some patients may also be affected by tumors and erythroderma, which is marked redness and scaling in more than 90% of the skin.
In more advanced cases, the condition can affect the internal organs, affect the blood and promote an increase in the ganglia (which are glands of the lymphatic system).
It is characterized by a malignant tumor that derives from the sebaceous glands.
As the sebaceous glands are highly concentrated in the head and neck, these are the regions most affected, especially close to the eyelashes (ocular attachment).
Most cases present skin lesions, identifying elevations, stiffness and, in some cases, irregularities, such as crusts or ulcerations, may be present.
The most severe cases may have flatter lesions with poorly defined margins.
Microcystic anexial carcinoma
It is characterized by a malignant neoplasm of the eccrine gland of the skin.
In general, the predominance is in the face and its growth is called aggressive infiltrative. This is due to the ability of the tumor to infiltrate bones, muscles and nerves. Despite affecting both sexes, the highest incidence is in women over 50 years of age.
The main causes of skin cancer refer to care with sun exposure. On average, 5% of solar radiation comes from ultraviolet rays (UVA and UVB), being highly harmful to the skin.
The disease can be related to intense and recent sun exposures or, as a result of the accumulated incidence for years.
Thus, people who live in regions most affected by the sun and the elderly are at greater risk of being affected by cancer.
About 80% of the ultraviolet radiation that we accumulate throughout life is absorbed until the age of 20. This radiation gradually damages the cells and can generate late changes in the flow of cell reproduction.
For this reason, the diagnosis in young adults may be the result of accentuated and unprotected sun exposure while still in childhood.
But it is not just external factors that imply health risks. There are also genetic issues related to melanoma , the most aggressive type of the disease.
Thus, when there are cases in the family, especially first-degree relatives (mother, father, siblings), it is essential to carry out periodic examinations and to redouble attention.
Sun exposure over the years can result in basal cell or squamous cell carcinomas, the least aggressive types of skin cancer. Age is not, in itself, a risk factor, but the incidence of ultraviolet rays accumulated without proper protection.
3 times more men with skin cancer are diagnosed than women. The fact lies in the possibility that women tend to take better care of the skin, use sunscreen more often and subject themselves less to sun exposure.
The smoking can affect all organs of the body, causing problems and immediate or future complications.
Among dermatological problems, dry skin, premature aging and the appearance of wrinkles are quite recurrent.
Cigarettes also cause the degradation of the skin’s elastic fibers, which weakens the tissue and makes it more sensitive to sun exposure, increasing the risk of cancer.
Human papilloma virus – HPV
HPV patients are at increased risk of squamous cell skin cancer, especially when there is a decrease in immunity.
If the immune system is severely weakened, there may be a cell mutation caused by the HPV virus, causing the wounds and injuries caused by the disease to develop into skin cancer.
Most of the cases in which the cell mutates, the result is the formation of an irregularity of the skin, like a mole that does not cause complications to the patient, which can only be an aesthetic discomfort.
Patients who have family members with cases of skin cancer or, at some point, have already been diagnosed with the disease are at greater risk due to genetic inheritance.
Factors that promote a decrease in immunity, such as leukemia , lymphomas, use of immunosuppressive drugs or transplant patients, constitute a risk group due to the vulnerability of the organism.
Low melanin production
Genetic and biological conditions can lead to the onset of skin cancer, such as fair skin and blond or red hair, resulting from the low production of melanin.
The skin is less protected against ultraviolet rays, damaging cells and favoring premature aging.
In summary, melanin is a polymer (large molecules) produced by the body, which determines the color of the skin and protects it from ultraviolet A (UVA) and ultraviolet B (UVB) rays.
The human body has amino acids responsible for the production of the melanin protein, called melanocytes . The amount of protein produced determines the color of the skin and is genetically defined.
After production, the melanin pigment is carried to the surface of the skin and acts as a filter, protecting the DNA against the action of UVA and UVB sunlight.
People with fair skin, blond or red hair have low melanin production, making them more susceptible to skin cancer.
In this case, even if the skin is exposed to the sun and acquires a more tanned color, the melanin levels are not altered, as they are genetically determined characteristics.
Cancerous lesions can present skin peeling, erosion, itching and even bleeding, but skin cancer does not always show noticeable symptoms.
Nodules, swollen lymph nodes, difficulty breathing, coughing and headaches can manifest, although they are less frequent.
Symptoms may or may not be associated with skin manifestations that may be more tender or itchy.
Therefore, it is necessary to be attentive to the various manifestations of the organism:
Appearance of spots or stains
Generally, skin cancer shows the first signs with red, translucent, prominent or raised spots.
These lesions do not heal or improve appearance, and are easily mistaken for common injuries.
Therefore, new spots or spots that appear suddenly, unique or clustered can be a warning.
Change of appearance
It is important to pay attention to spots and freckles that change in size or texture. The growth or appearance of black or brown spots, which itch or should not be observed.
The changes can also occur in spots or birthmarks.
Delays in healing
Sometimes, the spots or signs of skin can resemble lesions or skin changes, such as burns or peeling. However, scarring does not occur and, in some cases, the skin sign may spread.
Signs of spreading skin
Whether it is sores or spots, when the skin marks start to spread on the body, in regions close or not, it is important to see a doctor.
In cases of cancer, the spread of skin signs is due to the inflammatory reaction that occurs in the tissue. The condition is easily confused with allergies or irritations, especially the reddish and sensitive aspect of the layer.
Spots are very common signs on the skin that generally do not present health risks. They are usually raised or protruding parts of the skin, caused by alterations of a genetic nature.
When observing the spots, the most important aspects are the borders, coloring, size, growth or alteration, and symmetrical shape.
Attention to the skin helps to maintain health and, in necessary cases, indicates the need to consult a dermatologist. Professionals indicate a simple and very efficient procedure, called ABCDE observation , to do self-tracking:
The spots should be rounded and with the same sides. Check your spots and their symmetry by drawing an imaginary line and dividing them in half. Corresponding sides indicate the normality of the spot.
The edges must be smooth, regular and linear. Check if there is a change in the texture or roughness of the skin, as non-uniform spots deserve attention.
Spots or stains should show color uniformity. Generally, in cancer there is the presence of different stains in the same lesion or region of the tissue.
Size of spots and birthmarks must always be the same and not exceed 6mm. Therefore, if you notice their increase or spread, you need to see a doctor.
Keep an eye out for changes in color, size, texture or the appearance of spots and skin patches. Any changes in the skin, especially those that do not show signs of healing, should be a warning sign.
The dermatologist is responsible for the correct diagnosis and monitoring of the patient. Through detailed examinations, the professional characterizes the skin lesions and the evolution of the disease.
When showing signs or suspicions of cancer, the dermatologist uses physical examination procedures, observing the color, texture, shape and size of the lesions, in addition to the presence of bleeding or peeling.
In the case of melanoma , it is possible for the cancer to spread to other regions of the skin or other organs, therefore, the presence of lymph swelling is also verified.
After a physical examination and the suspicion of skin cancer, the doctor may request additional tests.
The results make up a broader and more complete picture of the stage of the disease.
The examination can be performed manually, when the doctor observes spots and stains, evaluating their appearance and appearance, or digitally, which gives a more potent enlargement of the lesions.
In the digital examination, aspects that are difficult to observe with the naked eye are easily observed, increasing the accuracy of the diagnosis.
The examination uses the diode laser, a kind of light source, allowing for a better visualization of the skin and the details of the lesions.
The great advantage of the method is the ability to enlarge the analyzed region, very close to that of the microscope, without the need to remove part of the tissue to perform the analysis.
A fragment of the tissue from the lesion is removed and sent for histological analysis and evaluation, which will determine the type and degree of the cancer. Despite configuring a more invasive method, the biopsy is performed with very small samples of skin.
Complementary or secondary exams
Imaging tests for skin cancer are usually requested to check for risks and complications arising from the disease, such as radiography and tomography, which allow the presence of metastasis in the lung and nodules in the organs.
Biopsies are requested to confirm and monitor melanoma , which is the most serious case of skin cancer.
Skin cancer has a cure. The rates are high, reaching 90% when diagnosed in the early stages, even in the most aggressive cases.
In the beginning, the cancer is restricted to the most superficial layers of the skin, making it easier for the affected areas to be surgically removed without major complications.
Over time, the disease deepens, increasing the risk of metastasis, which is the spread of the disease to other organs.
Thus, there is greater difficulty in obtaining a cure, requiring prolonged and complementary treatments to the surgery.
In cases where a cure is not possible, there are therapeutic and palliative resources that reduce the risks to the patient’s health, improve the quality of life and make it difficult for the disease to spread throughout the body.
The consequence is a reduction in pain and an improvement in the appearance of the skin.
The treatment of skin cancer depends on the stage of the disease, but surgery to remove the lesion is still the most recurrent.
However, there are cases where medications and radiotherapy can be combined with treatment.
Treatment with ointments and medications is usually indicated for superficial and aggressive basal cell cancer, in addition to some cases of melanoma with metastasis.
Among the options, there are creams, gels and liquid solutions that act by stimulating the immune system. The organism slows down cell growth, prevents proliferation and, in some cases, attacks cancer cells.
Through the application of ionizing radiation, cancer cells are inhibited or destroyed.
Among the options available for treatment, the most recurrent are the electromagnetic method (gamma rays) and the electron method (high energy linear accelerators).
In some cases, radiotherapy is indicated even after the need for surgical intervention, reducing the possibility of cancer affecting the patient again.
The method can be used for basal cell and squamous cell cancer in which, through the localized application of laser (photodynamic reaction), cancer cells are destroyed through cellular oxidation.
Performed on non- melanoma tumors , the procedure removes the affected part of the tissue and provides a safety margin. Anesthesia is local and can leave a small scar at the site.
Curettage and electrodissection
A scraping of the injured skin is carried out. After removal, an electric current is applied to destroy the cancer cells.
Mohs Micrographic Surgery
It is considered by the Brazilian Society of Dermatology to be one of the most effective and refined methods for the removal of skin cancer.
The professional removes a layer of skin affected by cancer, analyzes it and identifies the need to remove other layers.
If more cancer cells are identified, a new withdrawal is made, which is also analyzed by the responsible professional.
To ensure greater effectiveness of the surgery, the skin lesion is extracted with a safety margin, which is the removal of a healthy strip of skin around the cancer.
After realizing that the entire wound has been removed, the region is reconstructed, accelerating recovery.
The area is frozen at an extremely low temperature. Generally, liquid nitrogen is used, which causes cell death.
Non-invasive or non-surgical treatments have shown good results for early stage diagnoses.
In these cases, photodynamic therapy (therapy that uses light for cell destruction), chemotherapy creams, immunomodulators (drugs that act on immune responses) and radiotherapy are possible alternatives to surgery.
They act specifically on the lesions, destroying cancer cells, and cause less impact on the body, however they do not demonstrate efficacy for the more advanced stages of the disease.
Some medications have shown significant responses in improving skin cancer. Treatment represents a non-invasive method of relieving symptoms and the spread of the condition.
Fluorouracil treatment can last, on average, 6 weeks and is indicated for cases of superficial and small cancers. The product must be applied and its action inhibits tumor cells.
Currently, it is one of the most prescribed medications for topical use in cases of basal cell and squamous cell cancer.
Its use is made through the application of a layer on the wound or affected area according to the medical recommendation. The action of the ointment consists in inhibiting the superficial cancer cells.
Therefore, it is not effective for deep or severe injuries.
Side effects are less than in invasive treatments, such as radiotherapy, but burning, redness and sensitivity to sunlight may appear.
Imiquimod acts as an immune response modifier, being used for some basal cell cancers. Its action stimulates the immune action, causing the organism to attack cancer cells.
The substance is a group of immunoregulatory proteins naturally produced by human cells. The structure, which is also chemically produced and marketed as Interferon Alpha 2 , can be injected directly into the lesion and promotes an increased immune response.
The indication may be for isolated use or associated with surgical treatment.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
In cases where surgery is indicated, the statistics are very promising, pointing to up to 90% cure in the early stages, including melanomas, the severe type of the disease.
Genetic factors can predispose the organism to the appearance of cancer, but the adoption of preventive measures and habits can be decisive to avoid future problems.
Clothing and fabrics
The Brazilian society of Dermatology makes some recommendations that are simple to include in the routine and help prevention, including the use of hats, long – sleeved shirts and parasols to reduce the direct sunlight on the skin.
There are fabrics specially developed and designed to help protect the skin.
In general, fibers intertwined with titanium dioxide are used, which is a substance present in the sunscreen that acts to alleviate the sun’s incidence.
However, fabrics with sun protection usually cost up to 30% more than ordinary clothes.
Therefore, the indication is to prefer fabrics with fibers based on polyamide, opaque fabrics or dark colors are the most suitable for outdoor activities, as they reflect more quantity of rays, blocking a percentage of the solar incidence.
Daily use of sunscreen or sunscreen with adequate SPF considerably decreases the chances of developing skin cancer.
Most people use the product only when there is direct exposure to the sun, however, the Brazilian Society of Dermatology recommends that the use should be daily and at least twice a day, if there is no direct exposure to the sun.
That is, for those who work indoors or partially protected from the sun, the recommendation is to use a layer of sunscreen in the morning and another in the middle of the afternoon.
The sun protection factor (SPF) indicated should be chosen according to skin color, exposure time and situation, but in general the recommendation is:
|Sunscreen factor||Skin type|
|Above 50||White and very white skin|
|Above 30||Brown skin|
|Above 15||Black skins|
Especially on the beach or in the pool, the sun’s rays fall more directly on the skin. Therefore, in addition to sunscreen, which must be reapplied every 2 hours, it is important to associate tents, hats and T-shirts.
In general, tents and tarpaulins made of cotton are the ones that offer the best protection, being able to reduce the passage of UV rays by up to 50%.
December Orange is a movement to raise awareness about skin cancer, which has been taking place since 2014.
The idea is for the campaign to be widely disseminated, bringing information about self-care, medical follow-up and treatments.
With simple and alternative measures, the Brazilian Society of Dermatology (SBD) encourages the use of orange clothing and decorations during the month of December, reminding everyone about skin care.
In addition, it produces special content on prevention, diagnosis and treatment so that more people have access to information, preventing disease and reducing cases of late diagnosis.
Check below some images of signs and spots related to skin cancer, always remembering the importance of seeking evaluation from a dermatologist for diagnosis.
Does sunscreen affect vitamin D synthesis?
The sunscreen considerably reduces the synthesis of vitamin D. When the product has SPF 30, the decrease can reach 95%.
So that there is no lack of the vitamin, it is recommended to keep the use of the protector with high SPF on the face and neck, leaving the arms and legs exposed to the sun at mild times (between 9 am and 10 am), for a maximum of 15 minutes daily.
How to choose sunscreen?
Many people only remember to use sunscreen on the beach or when they spend long periods exposed to the sun, but daily use is essential.
In the daily routine, it is recommended to apply the protector or blocker at least twice a day. When there is direct exposure to the sun, reapplication should take place every two hours.
As for the protection factor, people with very light skin, the so-called phototypes I and II, should prefer sun protection factors 60 or above. More brunette people, of phototype III and IV can choose factor 50 when exposed directly to the sun. Black skins, phototypes V and VI, should use factor 30.
The characteristics of the product do not interfere with the protective action and must be chosen according to the oiliness of the skin or ease of application. There are products in gel, cream, spray, mousse, for example.
Factor 15 protectors or cosmetics that have an SPF below 30 are quite common in stores, but offer low skin protection. Therefore, they are not indicated for isolated use.
Find out more in our text “Guide to sunscreen”.
Is skin cancer hereditary?
In people with a first-degree family history, such as parents or siblings, the incidence of skin cancer can be up to 3 times higher.
However, most of the time, skin cancer is the result of cellular changes that occur throughout life, mainly due to sun exposure.
In which parts of the body does skin cancer develop most easily?
As skin cancer is often caused or facilitated by undue exposure to the sun, the body regions that are most exposed have a higher incidence. Among them the face, neck and upper limb.
There are always genetic and external factors that can influence the appearance of diseases, however, adopting healthy habits helps to reduce risks.
Avoiding direct and intense exposure to the sun, and the use of sunscreen daily are attitudes that reduce risks of developing the disease.
It is also important to be aware of the signals that the body gives.
So, get to know your skin, observe changes and consult a doctor regularly. Prevention is the best strategy!