How to identify signs of skin cancer

Written by: Dr Raj Mallipeddi
Edited by: Emily Lawrenson

Skin cancer is the most common type of cancer found worldwide, with an estimated 42 cases diagnosed every day in the UK alone. Dr Raj Mallipeddi, expert dermatologist and clinical lead for skin cancer at Guy's & Thomas' Hospital, London, explains the risks we should be aware of, and the changes in our skin we should be looking out for. 

The main types of skin cancer include melanoma, the deadliest type, and non-melanoma which accounts for about 100,000 cases of the disease each year.

How common is skin cancer in the UK?

Skin cancer rates in the United Kingdom are increasing, with more people dying from the disease here than in Australia. There are an estimated 12,000 cases of melanoma each year, and around 2,000 deaths. It has become the most common form of skin cancer among people in the age bracket of 15 to 34.

Knowing what to watch out for can greatly increase one’s chances of survival if it so happens that they develop skin cancer. For this reason, even if you do all you can to stay safe in the sun, it’s important to be on the lookout for the early signs of skin cancer. It is worth bearing in mind that around 80% of all cases of skin cancer are caused by over-exposure to dangerous UV radiation from the sun or sunbeds.

As fair-skinned people are much more susceptible to sun damage and therefore skin cancer, it is imperative they know what to look out for, especially if they have been spending a lot of time on sunbeds or in the sun.

The ABCDE skin cancer guide

It is important to watch out for changes in moles or for the formation of new moles. The earlier skin cancer is detected, the higher the likelihood of cure. The ABCDE guide is helpful, easy to remember, and stands for:

Asymmetry - if the mole is not symmetrical it’s best to get it checked out.

Border becoming irregular - benign moles have smooth borders. The borders of early melanoma are usually uneven.

Colour changes - especially uneven and abnormal colour. Most benign moles are just one colour.

Diameter greater than 6mm - benign moles are usually smaller.

Enlargement or elevation - a general sign of melanoma is if a mole changes size over time.

Other signs of skin cancer to keep an eye out for

Melanoma tends to appear as a new lesion more often than developing from a pre-existing mole. A new mole or one which is different to the rest of the surrounding moles should be scrutinised more carefully. Moles which become itchy or bleed may also need to be examined. It is also important to be aware that most skin cancers do not appear as ‘moles’. Basal cell carcinoma often appears as a pearly pink or red spot, a red scaly patch or an ulcer. Squamous cell carcinoma appears as a scaly or crusty area of skin or a lump with a red, inflamed base. They may feel sensitive to touch and bleed when rubbed. As we get older we develop scaly, rough patches predominantly in areas exposed to the sun. These are known as actinic keratoses and they become more common with advancing age, especially in fair-skinned people. These occasionally develop into squamous cell carcinoma and so can also be considered to be pre-cancerous.

Fortunately, most skin lesions are harmless and we are more likely to develop benign lesions as we grow older. However, it is difficult for an untrained eye to tell the difference, so if you are concerned about skin cancer it is best to seek your GP’s opinion and if necessary refer to a dermatologist.

As always, it’s better to be safe than sorry. If in doubt get it checked out!

By Dr Raj Mallipeddi

Dr Raj Mallipeddi is an award-winning consultant dermatological surgeon based in London who specialises in skin cancer, cosmetic dermatology and surgical dermatology alongside Mohs surgery, laser surgery and photodynamic surgery. He practices privately for HCA Sydney Street Outpatient Centre, Dermatological Surgery and Laser Unit and Bupa Cromwell Hospital. He is also works for the Guy's and St Thomas' NHS Foundation Trust.

Dr Mallipeddi is well respected in the dermatology and skin cancer field, working in lead roles at top centres in the capital. He is the lead clinician for dermatological surgery and the laser unit at St John's Institute of Dermatology at Guy's Hospital Cancer Centre and the lead consultant for skin cancer for his NHS trust, seeing referrals from all over the UK. 

After graduating with a BSc in Psychology from University College London in 1994, Dr Mallipeddi went to Imperial College London where he was awarded an MBBS in surgery. After his MBBS in 1997, he became a Doctor of Medicine in oncology and cancer biology after studying at King's College London from 2001 to 2003.

Dr Mallipeddi's has been professionally recognised as well as by patients. He has been awarded the St John's Institute of Dermatology societies registrar prize, the Wooden Curette Award from the British Society for Dermatological Society and named by Marquis (American publisher of directories) as the Who's Who in Healthcare 2009-10.       

As well as being a highly-qualified professional, Dr Mallipeddi lectures nationally and internationally. He is also heavily involved in medical education as the national curriculum lead for Mohs and Advanced Dermatological Surgery.

He is also widely published, and a pioneer in his field for being one of the only UK doctors who has completed advanced training in Mohs micrographic surgery as certified by the American College of Mohs Surgery. 

He serves on numerous boards including chair of the UK Mohs micrographic service standards committee and was the past President of the British Society for Dermatological Surgery. He is currently a member of the British Association of Dermatologists' (BAD) national guideline committees for basal cell carcinoma, squamous cell carcinoma and photodynamic therapy, alongside being an active member of the British Society for Dermatological Surgery (BSDS), the American Society for Dermatologic Surgery (ASDS) and the American Academy of Dermatology (AAD).

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