Dermatologists urge people to learn the ABCDEs of skin cancer

They want them to know when a 'mole' might pose a threat to health

By Marissa Harshman, Columbian health reporter




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How often do you perform skin self-checks (look for abnormal spots or moles)?

  • Every month. 47%
  • Couple times a year. 24%
  • Never, my doctor checks my skin. 18%
  • Why would I examine my skin? 11%

55 total votes.

Every year, millions of Americans are diagnosed with skin cancer.

While some skin cancers are easily treated, others are not. Every year, thousands of people in the U.S. die from skin cancer.

Education, prevention and early detection can be the difference makers, according to dermatologists.

Save your skin

Taking steps to protect your skin is important to prevent or reduce the risk of skin cancer, according to dermatologists. That means avoiding tanning beds and exposure to the sun during the middle of the day, from 10 a.m. to 2 p.m., if possible.

Daily sunscreen use, even on cloudy days, is also important. Apply a sunscreen of at least SPF 30 about 15 minutes before going outside. An ounce of sunscreen (the size of a shot glass) should be applied to exposed skin, and a tablespoon worth should be applied to the face to ensure an adequate coating is applied.

Wearing sunglasses and protective clothing, such as clothing with a tight weave, protects the eyes and skin.

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal cell carcinoma is the most common type of skin cancer, with 2 million to 3 million people diagnosed in the U.S. each year, said Dr. Craig Hersh, a dermatologist with Kaiser Permanente. Basal cell carcinoma very rarely spreads beyond the skin.

Squamous cell carcinoma is the next most common form of skin cancer. It tends to be more aggressive locally but has a low risk of spreading beyond the skin, Hersh said.

Both forms are very treatable, but the earlier the cancer is found, the simpler the treatment, he said.

Melanoma is the most serious form of skin cancer and can develop in areas of the body other than the skin, including the eyes and internal organs. Melanoma is treatable when detected early, Hersh said.

"Melanoma is the least common, but the most potentially dangerous," he said.

The American Cancer Society estimates 76,690 Americans — 2,350 Washingtonians — will be diagnosed with melanoma in 2013. An estimated 9,480 Americans will die as a result of the diagnosis, according to the Cancer Society.

Early detection

Basal and squamous cell carcinomas are typically found in sun-exposed areas. The most common areas are the head, neck, upper back and chest, said Dr. Benjamin Vazquez, a dermatologist with The Vancouver Clinic.

Basal cell carcinoma looks like a small bump or pimple that doesn't heal. The bumps are typically reddish or pink in color and grow slowly. They may bleed on their own or form a sore or scab that doesn't go away, according to dermatologists.

Squamous cell carcinoma usually appears as a hard, red, scaly bump or lump on the skin. The spot can also be flat and rough, especially earlier in the growth process, Vazquez said.

Melanoma is also found in sun-exposed areas but can develop in non-exposed areas, as well. Melanoma is more widely distributed on the body than the other forms of skin cancer, but most often it's detected on the backs of men and the legs of women, Hersh said.

Other risk factors for melanoma include having fair skin, a family or personal history of melanoma, a history of blistering sun burns, tanning bed use and having more than 50 moles on the body, Vazquez said. Age is also a risk factor; men over the age of 60 are at the highest risk, Hersh said.

Melanoma appears as an irregular, growing black spot. About three-quarters of melanomas start as melanoma, not as a mole, Hersh said. Melanoma may initially appear to look like a mole, but it will continue to grow and change, he said.

"Look for changing moles, but it's more likely it will show up as melanoma to begin with," Hersh said.

Dermatologists and the American Academy of Dermatology recommend people follow the ABCDEs when inspecting their skin for melanoma.

"A" stands for asymmetry. Is the mole or spot symmetrical? In other words, if you draw a line down the middle of the mole, do both sides look the same?

"B" stands for border. Does the mole have uneven, jagged borders?

"C" stands for color. Does the mole have multiple colors or shades?

"D" stands for diameter. Is the mole larger than 5 to 6 millimeters (the width of a pencil eraser)?

And "E" stands for evolving. Is the mole changing over time — becoming bigger, darker or more irregular?

Answering "yes" to any of those question doesn't necessarily mean one has skin cancer, but he or she should visit a dermatologist, Vazquez said.

Another thing to look for is a mole that doesn't look like other moles on the body. Dermatologists refer to it as the "ugly duckling" mole. People tend to form moles that look like each other, so an ugly duckling should be checked by a physician, Hersh said.

Dermatologists recommend performing a skin self-check every one to three months. If anything appears unusual or to have changed since, visit a dermatologist.

"When in doubt, see a dermatologist," Vazquez said.

Marissa Harshman: 360-735-4546;;;