Skin cancer

Skin cancer is caused by uncontrolled growth of abnormal skin cells. It occurs when damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations, or genetic defects. This can cause skin cells to multiply and form malignant tumours.

Types of skin cancer

There are three main types of skin cancer, which are divided into non-melanoma and melanoma cancers:

Non melanoma skin cancer

Non melanoma skin cancer – Basal cell carcinoma (BCC) – is a cancer that arises in cells found in the base of the outer layer of the skin (epidermis), and is sometimes referred to as a rodent ulcer. It is the most common type of skin cancer diagnosed in Northern Ireland and globally. It is most often found on areas exposed to the sun such as the head and neck

Squamous cell carcinoma (SCC) – Squamous cell carcinoma (SCC) – is a cancer of the cells (called keratinocytes) found in the outermost layer of the skin (the epidermis). It is the second most common type of skin cancer in the UK.  It is also most commonly found on areas exposed to the sun such as the head, neck, ears and hands. SCC’s have a small risk of spreading to other parts of the body (metastasise).

Melanoma skin cancer

Malignant melanoma is a cancer that usually starts in the skin, either in a mole or in normal looking skin. It accounts for 10% of all skin cancers however if not treated early is potentially the most serious. Melanoma develops when the pigment cells of the skin (melanocytes) grow in an uncontrolled way.

The first sign of a melanoma is often a change in the shape, size or colour of a previous mole, or a new darker area of skin. If you are concerned about change in an existing mole, or the appearance of a new mole, you should attend your GP who can refer you to a specialist if necessary. If a melanoma is detected early it can be removed before it spreads deeper into the skin or other parts of the body.

Rarer types

There are a number of other rare types of cancer that can occur in the skin, these account for less than 1% skin cancer in the UK:

• Merkel cell carcinoma – this is a cancer that develops in Merkel cells which are found in the top layer of the skin
• Kaposi’s sarcoma
• Cutaneous T-cell lymphoma of the skin
• Sarcoma

The Northern Trust has a specialist skin team that offers rapid advice, diagnosis and treatment to patients displaying symptoms of a skin cancer.

Our Cancer Services team is here to support you every step of the way. This skin cancer section on our website takes you through your skin cancer pathway within the Trust and provides you with the information and support you will need throughout your journey.

Who is at risk of skin cancer?

Skin cancer can affect anybody at any age. It is most common in people over 50, or people who have had prolonged exposure to the sun.

You are at higher risk if you:

• Have fair or red hair and are prone to sunburn
• Were burnt during childhood
• Have spent a lot of time in the sun (for work or leisure)
• Have periodical exposure (e.g. on holidays)
• Use sunbeds
• Have lots of moles or freckles
• Have a family history of skin cancer
• Are over the age of 50
• Have undergone an organ transplant
• Are on certain medications or have a health condition

Prevention of Skin Cancer

Preventing harmful UV exposure is the key to reducing the chances of skin cancer. Remember UV rays can damage your skin even when it doesn’t feel hot outside.  Sun damage can happen anywhere, even in Northern Ireland. It is important to remember that the sun’s rays can reflect off water and snow and penetrate glass so sun safety should also be considered.

Look after your skin by using the five S’s of sun safety:  Slip, Slop, Slap, Seek, Slide.

• Slip on protective clothing. Clothing can be one of the most effective barriers between our skin and the sun. Clothing should cover as much skin as possible and look for clothing with in-built sun protection.
• Slop on the sunscreen. Always use a sunscreen with an SPF of 30 or above and which has a UVA rating of 4 stars or above. Sunscreen should be applied 20 minutes before going out and reapplied throughout the day. Remember commonly missed areas such as ears, temples, the back and sides of the neck and feet.
• Slap on a wide brimmed hat. This will provide protection to the face, neck and ears. Baseball caps do not provide adequate shade.
• Seek shade from the sun when possible. Particularly at the hottest times of the day between 11am and 3pm when UV penetration is strongest. Keep toddlers and babies in the shade at all times. Never rely on shade alone and always combine with other protective measures.
• Slide on quality sunglasses. Wraparound sunglasses with a CE mark will protect the eyes and also around the eye area. Those labelled with a high EPF (Eye Protection Factor) will provide best protection. Remember price and darkness of the lens have no reflection on the quality of protection.

Skin cancer can be treated, and early diagnosis makes the chances of a full recovery very high. If you spot a suspicious lesion, it is vital that you have it checked by a doctor.

It is important to note that many skin lesions are benign and do not require treatment. Many early stage skin cancers can be treated very successfully. If you are concerned it is better to see your GP and have these lesions checked as early as possible.