Prepared by Aktif International Hospital Editorial Board .

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What is skin cancer and why is early detection clinically important?

Skin cancer develops when the cells that make up the skin begin to multiply uncontrollably. The most common types are basal cell carcinoma, squamous cell carcinoma, and melanoma. Contrary to the widespread belief that “a cancerous mole is always dark in colour,” the first warning sign may also be a small wound that does not heal, recurring crusting, or a dark line that appears beneath a nail. Awareness of skin cancer, which can become extremely dangerous, is essential both for recognising its symptoms and for ensuring early diagnosis.

In this article, we take a detailed look at skin cancer. You can find answers to many questions, ranging from the different types of skin cancer and the warning signals the disease may produce in the body to diagnostic procedures and current treatment methods.

Is skin cancer contagious? Can it spread through contact?

Let us begin with one of the most frequently asked questions: Is skin cancer contagious? The answer is definitely “no.” The disease cannot be transmitted from one person to another through physical contact.

While lesions detected at an early stage can usually be treated much more comfortably, the risk to life is also significantly reduced. Therefore, if you notice a new mark on your body, a spot that changes colour, or a lesion that does not heal for several weeks, the safest approach is to consult a dermatologist without delay.

What are the most common types of skin cancer?

Skin cancers are classified according to the group of cells in which the disease begins. The three main types most commonly encountered in clinical practice are basal cell carcinoma, squamous cell carcinoma, and melanoma. However, the most important point to remember is that it is impossible to determine the exact type of a lesion simply by looking at its colour or external appearance.

In other words, the same type of cancer may appear as a small, pearly bump in one person, while in another person it may present as a crusted wound or a mole that has changed shape.

So, what do these types mean clinically, and how does each one progress in the body? Let us begin with basal cell and squamous cell skin cancers.

Are basal cell and squamous cell skin cancers harmless?

Describing basal cell and squamous cell carcinomas, commonly known as non-melanoma skin cancers, as harmless or insignificant is a potentially dangerous misconception. Although treatment success rates are extremely high when they are detected early, neglected lesions may progress into deeper tissues and cause serious damage.

Basal cell carcinoma: This is the most common type of skin cancer. It usually progresses very slowly, and the risk of spreading to distant organs is extremely low. However, when it develops in sensitive areas such as the side of the nose, around the eyes, the ear, or the lips, it may extend as deeply as the cartilage and bone. Small wounds that heal and reopen or pearly, shiny bumps are among its most typical signs.
Squamous cell carcinoma: This type originates from the upper layers of the skin. It usually appears as a firm, scaly, crusted lesion that may occasionally bleed. Compared with basal cell carcinoma, it has a higher risk of spreading to the lymph nodes and surrounding tissues.

The diameter of the tumour, its location, and the patient’s immune status directly affect the level of risk. Therefore, dismissing lesions by saying, “It does not hurt anyway,” or “It is only a small lesion that has been there for years,” is a serious clinical mistake.

What is melanoma (malignant melanoma), and how quickly does it spread?

Melanoma, clinically known as malignant melanoma, develops from melanocytes, the cells that give the skin its colour. Although it is less common than other types of skin cancer, it is the most aggressive type and requires the greatest level of attention.

Early intervention can be life-saving because melanoma has a high potential to spread into the deeper layers of the skin, the lymph nodes, and distant organs. This brings us to one of the questions that concerns patients most: How quickly does skin cancer spread?

There is no single timeframe for the spread of melanoma that applies to every patient. The speed of progression varies according to the type of melanoma, the microscopic depth it has reached within the skin, and its biological characteristics. Some types may remain superficial on the skin for months, while certain subtypes may rapidly progress into deeper tissues within weeks.

The determining factor in this type of cancer is not the visible diameter of the mole but the tumour depth reported in the pathology results. A cancerous mole that appears small may already have progressed into deeper tissues, while a larger-looking lesion may still be limited to the surface.

What are the symptoms of skin cancer? Are itching and colour changes signs of cancer?

The symptoms of skin cancer may vary from person to person depending on the type of lesion, its location, and the speed at which it progresses. Contrary to common belief, skin cancer does not always appear as a dark and clearly noticeable mole. In some cases, the first warning sign may be a pink, transparent, flaky bump or a lesion that resembles an ordinary spot.

One of the concerns most frequently expressed by patients is: “I have persistent itching or a mark on my skin. Could it be cancer?”

Itching or a simple colour change alone does not directly indicate cancer. Dry skin, eczema, allergies, and insect bites are among the most common harmless explanations encountered by patients wondering whether skin cancer causes itching. However, if itching, stinging, bleeding, or crusting repeatedly occurs on a mole or lesion, it should be evaluated by a specialist.

Similarly, skin cancer marks are not always dark brown or black. Multiple colours within the same lesion, the presence of pink or red tones, or gradual darkening over time are important features that should be taken into consideration.

The main warning signs to watch for on your body generally include:

Wounds that do not heal completely despite several weeks having passed,
Areas that appear to heal but reopen in the same place or bleed easily,
Pearly, pink, or translucent bumps,
Firm, red nodules with rough or crusted surfaces,
Dark lines beneath the nail that develop without injury and gradually become wider.

Not every itchy area or mark that appears on the skin is cancer. However, if you have a lesion that changes over time, bleeds, or does not resolve on its own within a few weeks, the safest course of action is to consult a dermatologist without waiting for your routine examination.

How can a cancerous mole be recognised? What does the ABCDE rule for moles mean?

It is, of course, impossible to make a definitive diagnosis at home simply by looking at a mole. However, the ABCDE rule used in dermatology to identify skin cancer symptoms is an excellent guide for noticing suspicious moles at an early stage:

A (Asymmetry): One half of the mole does not match the other half in shape.
B (Border irregularity): The edges are uneven, notched, blurred, or poorly defined.
C (Colour variation): Different shades, such as brown, black, pink, or blue, are present within the same mole.
D (Diameter / Different from others): The mole is larger than 6 millimetres in diameter or looks noticeably different from all the other moles on your skin.
E (Evolution / Change): The mole grows, becomes raised, changes colour, or begins to bleed over time.

What causes skin cancer? Does using sunscreen reduce the risk?

When the causes of skin cancer are examined, the main factor is found to be ultraviolet damage that accumulates in the DNA of cells and leads to uncontrolled growth. The most important modifiable and therefore preventable sources of this damage are sunlight and artificial ultraviolet sources such as tanning beds.

UVA and UVB rays from the sun or tanning beds gradually damage the genetic structure of cells. Although the body can repair some of this damage, the process may eventually become uncontrolled after years of accumulated exposure. Severe sunburns experienced particularly during childhood or adolescence are a critical risk factor frequently encountered in clinical practice.

Using a broad-spectrum sunscreen with an SPF of at least 30, which provides protection against both UVA and UVB rays, significantly reduces cellular damage and sunburn by limiting the amount of radiation that reaches the skin. However, sunscreen alone is not a miraculous shield. Clinically, one of the greatest dangers is the belief that “I have applied sunscreen, so I can now remain in the sun for hours.”

Sunscreen should be used to protect exposed areas, not to extend the amount of time spent in the sun. For effective protection, an adequate amount of sunscreen should be applied before going outside and reapplied every two hours. It should also be reapplied after swimming in the sea or a pool.

How is skin cancer diagnosed? Examination, dermoscopy, and biopsy procedures

Skin cancer cannot be diagnosed solely by looking at the external appearance of a mole or wound. Determining whether a lesion is malignant or a completely harmless mole requires a step-by-step clinical evaluation.

The diagnostic process generally consists of the following main stages:

The dermatologist asks when the lesion first appeared and whether it causes itching, bleeding, or changes in size. A family history of melanoma and any previous severe sunburns are also assessed at this stage.
The entire skin is examined, including not only the area of concern but also the scalp, behind the ears, the palms, and the areas around and beneath the nails.
A dermoscope, a specialised illuminated magnifying device, is used to examine pigment patterns and blood vessel structures beneath the surface of the skin. In patients with numerous moles, digital dermoscopy may be used to create a mole map and monitor changes over time.
Physical examination and dermoscopy may increase clinical suspicion, but a definitive diagnosis can only be established after a tissue sample has been examined in a pathology laboratory.

Blood tests, computed tomography scans, or PET scans are not required for every patient. Additional tests are planned only according to the pathology result and the stage of the disease.

Can having a biopsy cause cancer to spread?

One of the concerns patients most frequently raise with our doctors during examinations, and unfortunately one of the main reasons they may avoid a biopsy, is the belief that a biopsy can cause cancer to spread. This idea is simply a myth without scientific support.

There is no evidence that a skin biopsy performed using standard medical techniques causes cancer to spread. A biopsy is a life-saving diagnostic tool that enables tissue to be examined under controlled conditions. Cancer spreads when tumour cells biologically enter the blood vessels or lymphatic vessels, and a biopsy does not trigger this process.

Critical warnings and recommendations from Aktif International Hospital dermatology specialists on skin cancer

To help protect your skin health and recognise possible risks at the appropriate time, we have summarised the most important points emphasised by the specialist dermatologists at Aktif International Hospital:

Skin cancers generally cause no pain or discomfort in their early stages. Therefore, whether a lesion is dangerous is not determined by whether it hurts, but by whether it grows, changes colour, or begins to bleed over time.
Trying to remove, squeeze, or apply caustic chemicals or herbal mixtures to a suspicious mole or lesion noticed in the mirror can be extremely dangerous. These interventions may irritate the skin and make it more difficult for the doctor to assess the original tissue during the examination.
When performing a personal skin check, examine not only visible areas such as the face and arms but also the scalp, behind the ears, the back, the palms, the soles of the feet, and the nail beds.
Taking a photograph of a suspicious lesion and noting the date can help your doctor assess changes during the examination.

Remember that although not every mark appearing on the skin is cancer, receiving an early specialist evaluation is always the safest approach whenever you notice something suspicious.

Which treatments are used for early-stage and advanced skin cancer?

Thanks to advances in medical technology, skin cancer treatment can now be planned specifically for the individual patient and the stage of the disease. The main factors affecting treatment success are the type of cancer, the depth reached by the lesion within the skin, and whether it has spread to other parts of the body.

The vast majority of skin cancers result in complete recovery and do not pose a risk to life when detected at an early stage. However, aggressive types such as malignant melanoma can become life-threatening when neglected and allowed to spread to distant organs.

Early diagnosis is the most powerful tool in treatment. Depending on the stage, type, and location of the cancer, the treatment plan may involve one or a combination of the following methods:

Surgical excision: This is the most frequently used and most effective method for lesions limited to the skin. The cancerous tissue is removed together with a safe margin of healthy surrounding tissue.
Mohs surgery: This method is particularly preferred for sensitive areas such as the nose, eyelid, lips, or ears, where tissue loss may have important cosmetic and functional consequences. During the procedure, the tissue is examined layer by layer under a microscope, allowing only the cancerous area to be removed while preserving as much healthy tissue as possible.
Superficial and non-surgical treatments: For superficial lesions located in the uppermost layer of the skin, treatments such as cryotherapy, curettage, medicated creams, or light-based therapies may be used.
Lymph node biopsy: In melanoma cases that have reached a certain depth, this specialised staging procedure is used to examine the lymph node to which the cancer is most likely to spread first.
Immunotherapy: This is frequently preferred for advanced cases that are unsuitable for surgery or have spread to distant organs. It works by strengthening the patient’s own immune system so that it can fight cancer cells.
Radiotherapy: This may be used as the primary treatment in areas where surgery is not possible or after surgery to reduce the risk of recurrence.

Will it recur?

Following successful treatment, one of the questions patients ask most frequently is whether the disease may return. People who have previously had skin cancer have a higher risk of developing a new lesion or experiencing a recurrence in the same area than the general population. However, this should not cause unnecessary fear.

After treatment has been completed, attending routine skin examinations at intervals determined by your dermatologist and checking your own skin every month can help identify possible new developments at an early stage and make prompt intervention easier.