Non-melanoma skin cancer

Non-melanoma skin cancer forms in the outer layers of the skin. There are 2 main types of non-melanoma skin cancer:

• basal cell carcinoma (BCC)
• squamous cell carcinoma (SCC).

These cancers are often found on sun-exposed areas of skin, such as your:

• face
• ears
• hands
• arms
• lower legs.

They are much more common than melanoma in Aotearoa New Zealand.

The main cause of skin cancer is lifetime exposure to ultraviolet (UV) light from the sun, including sunburns at any age. Aotearoa New Zealand has very high UV levels and a high rate of skin cancer. Tanning sunbeds are another strong source of UV light.

Excessive UV light damages the cells (the building blocks) in your skin. They then grow in an abnormal or uncontrolled way and become cancerous.

Most skin cancers are in people older than 50. The risk increases as you age, but younger people also get skin cancer.

The cause of most non-melanoma skin cancer is too much exposure to UV light from the sun, sunburns and from using a sunbed.

You have a higher personal risk of non-melanoma skin cancer if you:

• have a light skin colour
• have blonde, light or red hair, and blue eyes
• form freckles and sunburn easily
• spent a lot of time outdoors
• have had a skin cancer before
• have whānau who have had skin cancer
• smoke tobacco
• have lowered immunity from other health conditions or medicines.

Basal cell carcinoma

Basal cell carcinomas are usually slow-growing lumps that:

• can be skin-coloured or pink
• can be pigmented (darker than your skin)
• can bleed
• can ulcerate (be raw and not heal)
• are a few millimetres to several centimetres in diameter.

Basal cell carcinomas grow but do not spread around the body. They are rarely a cause of death.

You can see images of basal cell carcinoma on DermNet. 

Basal cell carcinoma affecting the face — DermNet (external link)

Squamous cell carcinoma

Squamous cell carcinomas are skin lumps that:

• are scaly or crusty
• can ulcerate (be raw and not heal)
• can be tender or painful
• are a few millimetres to several centimetres in diameter.

Squamous cell carcinomas can grow more quickly than basal cell carcinomas. They can spread over weeks to months. Sometimes they are life-threatening.

You can see images of squamous cell carcinoma on DermNet. 

Squamous cell carcinoma of limbs — DermNet (external link)

Your healthcare provider will examine your skin. A basal cell carcinoma or squamous cell carcinoma can sometimes be diagnosed by its appearance. Your healthcare provider may use a dermatoscope (a small skin microscope) to allow a better view.

If your healthcare provider thinks it could be a skin cancer they may recommend:

• surgically removing a small sample (a biopsy)
• removing it all by cutting it out (an excision biopsy).

You will be given a local anaesthetic to numb the skin before the biopsy is taken. The biopsy is sent to a laboratory to confirm whether it contains cancer cells and what type. You will be given a few stitches (sutures) to help your skin heal.

If you have a high risk squamous cell carcinoma, you may need extra imaging scans and tests to check if it has spread.

Basal cell carcinomas and squamous cell carcinomas are usually treated by removing them surgically. Different types of surgery may be required depending on your cancer.

Surgery often cures non-melanoma skin cancers. The chances of this are best while the cancers are small.

For some, smaller skin cancers may be treated with:

• cryotherapy (freezing with liquid nitrogen)
• topical treatment (drug-containing creams).

Other less commonly used options include:

• photodynamic (light) therapy
• radiotherapy (x-ray therapy)
• cancer medicines.

You can reduce your risk of skin cancers whatever your age. Keep yourself and your tamariki (children) safe from the sun.

Be sun safe

• Try to avoid the sun between 10am and 4pm, September to April.
• Find shade outdoors, if possible.
• Cover up by wearing long-sleeved tops and pants.
• Wear a wide-brimmed hat and UV-protective sunglasses.
• Use high-SPF sunblock on exposed skin.

Do skin checks

Check your own skin about every 3 months. This will help you spot any changes early. Skin checks are particularly important if you:

• are aged over 50
• have a family history of skin cancer
• are at higher risk of getting skin cancer
• have had skin cancer.

Treatment of non-melanoma skin cancer is very often a cure, but these cancers can return. It is important to keep checking your own skin and to attend follow-up appointments with your healthcare provider.

SunSmart has detailed information on how to do a skin check.

Check your skin – SunSmart (external link)