Understanding Nonmelanoma Skin Cancer

Learn About Nonmelanoma Skin Cancer

April 4, 2023

By DERMTECH EDITORIAL TEAM

Our skin is the largest organ in our bodies. It’s responsible for protecting us from infections, injuries, heat and exposure to sunlight. As the first line of defense against harmful external exposures, our skin can fall victim to the exact hazards it’s designed to protect us from.1

Skin cancer is the most common type of cancer in the United States.2 While melanoma is the deadliest form, the most common type of skin cancer is nonmelanoma skin cancer.3 Additionally, other rarer types of skin cancer include Merkel cell carcinoma, cutaneous T-cell lymphoma, dermatofibrosarcoma protuberans, sebaceous cell carcinoma, and Kaposi sarcoma.4,5

Approximately 90% of nonmelanoma skin cancers are caused by exposure to ultraviolet (UV) radiation from the sun or other sources, such as tanning devices.6,7 Basal cell carcinoma– the most common type of nonmelanoma skin cancer– typically appears as a small, shiny or pearly bump on the skin. Squamous cell carcinoma, which sometimes arises from precancerous keratosis, often appears as a firm, scaly red bump. These are the two most common types of nonmelanoma skin cancer.8,9

Actinic Keratosis (AK) is a precancerous condition that affects millions of people. AKs usually appear as dry and scaly patches on the skin and are often easier to feel than see due to their rough texture. The leading cause of AKs is chronic exposure to UV rays from the sun and/or tanning beds. AK can develop into squamous cell carcinoma.10

Common Risk Factors for Nonmelanoma Skin Cancer

While the exact cause of cancer is not always known, risk factors make it more likely for someone to develop cancer in their lifetime.

Those who have an increased chance of developing nonmelanoma skin cancer often experience the following risk factors:

  • Older Age. Although skin cancer can develop at any age, those who are older have a higher risk for nonmelanoma skin cancer.11
  • Weakened immune system. Those who have a weakened immune system are at an increased risk of skin cancer. The disease is also likely to be more serious.11
  • Smoking. People who smoke are more likely to develop skin cancer, especially on areas like the lips.11
  • Use of tanning devices. Despite the common misconception, tanning beds and sun lamps are not safe for the skin. People who use indoor tanning beds can increase the risk of developing squamous cell carcinomas by 58 percent and the risk of developing basal cell carcinoma by 24 percent.12
  • Blistering sunburns in the past. People who have a history of severe sunburns have a higher risk of getting nonmelanoma skin cancer.13
  • Light-colored skin. While anyone can get skin cancer, the skin pigment melanin has a protective effect against harmful UV rays. People with light-colored skin have a much higher risk for skin cancer than people with naturally darker skin.11

Early Detection of Nonmelanoma Skin Cancer

Nonmelanoma skin cancers are usually diagnosed by a healthcare provider in the early stages, when spots are still small and have not spread to other parts of the body.14 Though these skin cancers are generally less aggressive than melanoma skin cancer and have a lower risk of spreading to other parts of the body, these types of skin cancers can still be serious if not found and treated early.15

If you notice any significant changes in your skin, it is important to see a board-certified dermatologist or your primary care physician right away. With early diagnosis, actinic keratosis and nonmelanoma skin cancer are highly treatable.16,17,18 Regular skin exams, both with a dermatologist and at home,  may be able to save you from an advanced skin cancer diagnosis.19

There are also a number of things you can do to reduce your risk of nonmelanoma skin cancer, including avoiding excessive sun exposure and using sunscreen regularly. Additionally, quitting smoking and maintaining a healthy lifestyle can help reduce your risk.20

It is important to be aware of the risks of skin cancer and to take steps to protect yourself from the sun. If you have any concerns about skin cancer, please consult your doctor. Early detection is key to successful treatment. Bottom line: Taking steps to protect yourself from harmful UV rays can help decrease your risk of developing skin cancer.

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  10. American Academy of Dermatology. Actinic Keratosis: Overview. Accessed Nov. 16, 2022. https://www.aad.org/public/diseases/skin-cancer/actinic-keratosis-overview
  11. Basal and squamous cell skin cancer risk factors. American Cancer Society. https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/causes-risks-prevention/risk-factors.html#:~:text=in%20these%20areas.-,Smoking,factor%20for%20basal%20cell%20cancer. Accessed March 30, 2023.
  12. An S, Kim K, Moon S, et al. Indoor Tanning and the Risk of Overall and Early-Onset Melanoma and NonMelanoma Skin Cancer: Systematic Review and Meta Analysis. Cancers (Basel). 2021;13(23):5940. Published 2021 Nov 25. doi:10.3390/cancers1323594 0
  13. Wu S, Cho E, Li W-Q, Weinstock MA, Han J, Qureshi AA. History of severe sunburn and risk of skin cancer among women and men in 2 prospective cohort studies. American Journal of Epidemiology. 2016;183(9):824-833. doi:10.1093/aje/kwv282
  14. Early detection, diagnosis, and staging. American Cancer Society. https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging.html. Accessed April 03, 2023.
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  16. Guidelines of care for the management of basal cell carcinoma. Journal of the American Academy of Dermatology. https://www.jaad.org/article/S0190-9622(17)32529-X/fulltext. Published 2018. Accessed March 30, 2023.
  17. Guidelines of care for the management of cutaneous squamous cell carcinoma. Journal of the American Academy of Dermatology. https://www.jaad.org/article/S0190-9622(17)32530-6/fulltext. Published 2018. Accessed March 30, 2023.
  18. Guidelines of care for the management of actinic keratosis. Journal of the American Academy of Dermatology. https://www.jaad.org/article/S0190-9622(21)00502-8/fulltext. Published 2021. Accessed April 03, 2023.
  19. Can basal and squamous cell skin cancers be found early? American Cancer Society. https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging/detection.html. Accessed March 30, 2023.
  20. Skin cancer prevention (PDQ) – patient version. National Cancer Institute. https://www.cancer.gov/types/skin/patient/skin-prevention-pdq. Accessed March 30, 2023.