Dr Philippa Kaye on Skin Cancer

Shutterstock © A lady at beach applying sunscreen to face

Dr Philippa Kaye explains the three different types of skin cancer and when to check out moles…

Dr Philippa Kaye

Dr Philippa Kaye

Millie is 62 and had sent an e-consultation saying that her husband had noticed a mole looked different on her back. She had asked him to look as she’d been itchy in that area.

She had grown up in Southern Europe and couldn’t even remember anyone mentioning suncream until she was in her mid-20s!

Millie’s mole did have some concerning features and so I referred her to dermatology, the mole was removed and she recovered fully.

While many of us enjoy relaxing in the sun, it is important to remember it can be harmful. Around 100,000 people are diagnosed with a form of skin cancer each year in the UK.

Dr Philippa Kaye explains the 3 main types of skin cancer

There are three main types of skin cancer:

  • malignant melanoma
  • basal cell carcinoma
  • squamous cell carcinoma

The majority of cases are related to sun damage, in particular sun exposure during childhood and episodes of sunburn.

Basal cell carcinoma (BCC) is the commonest form of skin cancer in the elderly and those with fair skin, typically starting on the head or neck as a small pink/red pearly lump which can ulcerate and bleed, or look crusty. BCCs are slow growing cancers.

Squamous cell carcinoma (SCC) is more likely to spread to other parts of the body but also tends to start on the face, looking like a pink/red small, scaly patch of skin.

Skin cancer diagnoses and ABCDE rule

Checking lady's back for suspicious moles

Pic: Shutterstock

Malignant melanomas are less common than BCCs and SCCs. If diagnosed and treated early they have an excellent survival rate, but if untreated are more likely to spread to the rest of the body. A useful tool when looking at a mole or darker patch of skin is to use the ABCDE rule:

  • A – asymmetry – the two halves of a mole tend to match but a melanoma is often asymmetrical.
  • B – border – the border of a mole is regular and easily seen; in a melanoma, edges may be irregular or blurred.
  • C – colour – a mole generally is one uniform colour, while a melanoma may have two or more shades.
  • D – diameter – melanomas tend to be over 6mm diameter
  • E – evolution – melanomas change, so if you notice any change in size or shape, or new symptoms like itching or bleeding, get it checked

Wear suncream whatever the weather

In the same week I saw another patient who the previous year had noticed a scaly, rough patch on her cheek. She had a condition called actinic keratosis, which is precancerous; it is not cancer but has the potential to develop into squamous cell carcinoma if it is not treated.

On Sandy’s cheek there was a reddish scaly patch of about 5mm across. She had been offered treatment with a cream called 5-fluorouracil (5FU) cream, or cryotherapy, where liquid nitrogen is used to freeze the affected patch.

She told me she was being extremely careful wearing her sun cream, and I was glad to hear it! Everyone needs to wear sun screen, no matter your age or colour of your skin, every day, whatever the weather as you can still get sun damage even if it is cloudy.

Look for a broad protection sunscreen which protects against both UVA and UVB rays. Look for a high SPF (at least factor 30) and a high star rating (at least 4 stars out of 5); this should be on the packaging. Applying two different SPFs doesn’t mean protection increases. Mixing an SPF 20 with an SPF 30 doesn’t give SPF 50, you simply get the higher of the two, ie SPF 30. Apply regularly and generously!

What about Vitamin D and sunscreen?

A lady wearing a wide-brimmed hat

Pic: Shutterstock / STUDIO GRAND WEB

I’m often asked whether wearing sunscreen will prevent you from getting vitamin D from the sun via your skin. Vitamin D is an essential vitamin and has multiple roles in the body including being involved in bone health.

In the UK we do not get enough sunlight in winter so it’s recommended that everyone takes a 400IU vitamin D supplement from October to about April. Research has shown that wearing sun protection does not lead to low levels of vitamin D. Maybe we don’t use enough of it, or apply it regularly enough!

Advice given in this article and on the My Weekly website and magazines is not meant to replace personalised medical advice from your doctor. If you have any health concerns please see your doctor.

Article written on June 20, 2022; article reviewed and updated on July 10, 2024.

Each week we’ll ask Dr Philippa Kaye to talk about a prominent health issue, so look out for more articles in our health and wellbeing section in coming weeks. Read her advice on Allergies, Parkinson’s Disease, Shingles, Ovarian Cancer, Endometriosis, Long Covid and Ticks and Lyme Disease.