Information about skin cancer and the impacts surgery can have on your appearance, plus guidance on how we can other organisations can help.
“Skin cancer” refers to two main types of cancers which affect the skin in different ways:
Both types are usually caused by ultraviolet (UV) light from the sun and other sources such as sunbeds. The risk of developing both non-melanoma and melanoma skin cancers increases with age, as well as other factors which we talk about later on. The most common treatment for skin cancer is surgery.
If you receive a skin cancer diagnosis, your focus will understandably be on getting quick and effective treatment. However, it is worth being aware that surgery often leads to scarring, and as part of your preparation, you may want to consider the impacts of this on your life after your cancer has been treated.
If you’ve had treatment for skin cancer in the past, you may have come to this page because you’re struggling with the impacts of surgery on the way you look.
At Changing Faces, we focus on the impact of conditions on your appearance, so this page is not a general guide to skin cancer. The NHS and Cancer Research UK have many informative and detailed resources on skin cancer which we recommend browsing if you are looking for general information and advice on cancer – we have provided links throughout this page.
Here, we take an overview of the different types of skin cancers, as well as causes and treatments. We will also explore the impact of skin cancer surgery on your appearance, how this can affect your wellbeing, and what we can do to help you manage the challenges you may be experiencing.
Note: We have a dedicated page on scars which you may find it helpful to read alongside this page. We also have a page on moles which may also be of interest.
The main cause of skin cancer is exposure to ultraviolet (UV) light from the sun or a sunbed. UV light damages the DNA – a molecule that carries genetic information, often referred to as the “blueprint of life”. Too much damage to the DNA can cause cells to grow out of control, which is when cancer occurs. Protecting yourself from the sun can reduce your risk of skin cancer, no matter what your skin tone.
Your risk of skin cancer goes up with:
Other risk factors are linked to the specific to the type of cancer. We cover these later in the article.
Our bodies are made up of cells. Cancer occurs when cells in a particular part of the body multiply uncontrollably. This uncontrolled growth happens because of genetic changes (“mutations”). This makes skin cancer a genetic condition.
That doesn’t mean that skin cancer is always inherited. Genetic mutations can occur randomly. But in some cases, skin cancer may be inherited.
There are many different forms of non-melanoma skin cancer. The two most common forms are:
The most common form of non-melanoma skin cancer, representing 75% of cases. It is found in the deepest part of the epidermis, which is the outer layer of the skin. Basal cell carcinoma is in turn divided into different types, with nodular being the most common. It is very rare for BCC to spread or lead to a secondary cancer. Having one BCC does not increase your risk of developing another one.
23% of non-melanoma skin cancers are squamous cell carcinomas. SCC begins in the keratinocytes, a cell in the epidermis. It usually develops in areas exposed directly to the sun. Again, it does not often spread. When it does, this is usually to deeper layers of the skin. Occasionally, it may spread to nearby lymph nodes or other areas of the body.
You can find more information about Melanoma skin cancer on the Cancer Research UK website.
As we are focused on the implications of skin cancer on your appearance, this is not a comprehensive list. We recommend having a look at the NHS and Cancer Research UK pages on symptoms – we have linked to these below. If you are worried, see your GP immediately.
Non-melanoma skin cancers tend to result in growths or unusual patches on the skin, most commonly on:
Have a look at the NHS and Cancer Research UK pages for images and more detailed advice.
The risk of developing squamous cell skin cancer is higher if one of your parents has had it.
People with a family history of melanoma have a higher-than-average risk of developing basal cell skin cancer.
There is no screening for skin cancer in the UK, so see your GP if you are worried about a mark on your skin.
If your GP thinks you may have non-melanoma skin cancer, they may refer you to a skin cancer specialist, who will probably take a biopsy (a small sample of tissue). In some cases, basal cell carcinomas can be treated at your GP surgery.
Surgery is the most common treatment for non-melanoma skin cancers, unless there is a reason you cannot have it. This type of surgery is considered minor and is usually done under local anaesthetic.
In small cancers, an excisional biopsy may be sufficient to remove the cancer. This is used both to diagnose and treat the cancer. In some cases, this may entirely remove the cancer. Another type of surgery which may be considered in smaller cancers is Mohs micrographic surgery (MMS), where a specialist surgeon aims to cut out the cancer while leaving as much healthy tissue intact as possible.
In larger non-melanoma skin cancers, a wide local excision may be used. This is where the cancer is cut out along with a portion of the surrounding heathy tissue.
Have a look at Cancer Research UK’s guide for a detailed explanation of the treatment options.
Melanoma is so called because it affects the melanocytes – skin cells which make melanin, the pigment which gives skin its colour. Melanocytes produce more melanin when exposed to the sun, which is why you get a suntan. Melanoma often starts in a mole, although it can affect any patch of skin. It may also occur under the nails.
Melanoma is less common in people with black or brown skin. Where melanoma occurs in people with darker skin, it usually occurs on the palms of the hands or the soles of the feet. This is known as “acral melanoma” and is not related to sun exposure.
Your risk of melanoma is higher if you have lots of moles. Studies suggest the risk of developing melanoma is higher in people with 100 non-cancerous moles, compared to those with fewer than fewer than 15. Certain hair and eye colours are also linked to increased risk of melanoma.
You can find more information about Melanoma skin cancer on the Cancer Research UK website.
As we are focused on the implications of skin cancer on your appearance, this is not a comprehensive list. We recommend having a look at the NHS and Cancer Research UK pages on symptoms – we have linked to these below. If you are worried, see your GP immediately.
Existing moles can develop into melanoma, or you can develop a new mole which is a melanoma.
If you have moles keep an eye out for changes. Be especially vigilant if you have lots of moles, as you may be at greater risk of melanoma, and pay particular attention to moles in parts of your body regularly exposed to the sun.
Doctors use the ABCDE method to diagnose melanomas. This particularly applies to people with lighter skin:
Although melanoma is much less common in people with black or brown skin, it can still occur. If you have darker skin, your melanoma may not conform to the telltale ABCDE signs which often apply to those with lighter skin. For example, melanoma on black or brown skin may be symmetrical. Melanomas in people with darker skin may also be:
Melanomas may also occur under the fingernails or toenails. Acral melanomas occur on the palm of the hand or sole of the foot.
Have a look at the NHS and Cancer Research UK pages for images and more detailed advice.
You are considered to be at a higher risk of developing melanoma if a close relative (parent, sibling or child) has had melanoma. The risk is highest if they developed melanoma before the age of 30, or if more than one close relative has had melanoma.
If you have a family history of melanoma, you may be offered a genetic test to check whether you have a gene called p16, which increases the risk of melanoma.
There is no screening for skin cancer in the UK, so see your GP if you are worried about a mark on your skin.
If your GP thinks there is a risk that you have melanoma, they will refer you to a cancer specialist for further investigation. The specialist will probably take a biopsy and in some cases scans they will run tests on your lymph nodes.
The most common treatment option for melanoma skin cancer is surgery. We don’t go into detail on this page and we encourage you to follow the links to the Cancer Research UK pages for more information.
In the early stages of melanoma, a type of surgery known as wide local excision is the preferred treatment option. This is where a surgeon removes the melanoma along with an area of healthy issue around the cancer. The amount of tissue that needs to be removed depends on the size of the cancer. This is relatively minor surgery and is usually done under local anaesthetic.
If the cancer has spread beyond the original melanoma, it’s likely that other treatments may be needed. Chemotherapy, radiotherapy and other options will be discussed with you at this stage, depending on how far the cancer has spread.
The Cancer Research UK website has a detailed guide to the different treatment options available at each stage of melanoma.
If you have surgery to remove your skin cancer, you are likely to experience some scarring. The prominence of any scars will depend on the size and location of the wound.
For example, an excisional biopsy to remove a small non-melanoma skin cancer may not be particularly noticeable to others. A wide local excision – a common form of treatment for melanoma – may lead to larger and more visible scarring. Scars on exposed parts of the body, particularly the face, are obviously more conspicuous.
If you have a melanoma, the amount of healthy tissue removed during a wide local excision is usually linked to the stage the cancer has reached. If a larger area of skin is removed, your surgeon may carry out a skin graft or skin flap.
A skin graft is where a thin layer of skin is taken from an inconspicuous area on the body and placed on top of the wound. A skin flap is like a skin graft, but the skin is taken from the area next to the wound and remains attached to the body, meaning it still has blood flow, promoting quicker healing.
The site where the skin was taken from will look like a graze, and this should heal within a few weeks. The graft on the wound will appear different to the surrounding skin. Scars from surgery usually become less noticeable over time but they may not disappear completely. Some can be thick and raised – these are known as hypertrophic or keloid scars, and you can read them about our page on scars.
If you’ve come to this page, the chances are you have some concerns about possible scarring from skin cancer surgery or are impacted by scars from surgery you’ve already had. The impacts of scarring on your mental health are not always related to the size of your scars or where they are on your body. However big or small your scars, your feelings are real and valid.
Some people feel self-conscious when their appearance changes. You may be aware of people looking at your scars. Others may even have made comments or asked questions about them. This can be upsetting and affect your self-esteem and confidence.
We recommend you have a look at our page on scarring for more guidance. You may also find this detailed post about scarring from skin cancer surgery useful – it’s from a US organisation called the Skin Cancer Foundation.
Here at Changing Faces, we offer a number of support services if you are struggling with the impact of scars from skin cancer surgery on your appearance.
Counselling and wellbeing support helps you manage the social, emotional and psychological effects impacts of living with a visible difference. Our trained practitioners will listen and provide guidance to help you navigate the difficulties you may be experiencing. Read more about counselling and wellbeing support to see whether this might be helpful for you.
We have a series of self-help guides covering topics including self-esteem and mental health, other people’s reactions, working life and dating. We also have a section for young people as well as guidance for parents and carers.
You don’t need to hide your scars to fit in with other people, but some people choose skin camouflage to reduce the appearance of their scarring. The extent to which skin camouflage can conceal your scars depends on things like their size, location and how raised they are. However, our Skin Camouflage Service team would be very happy to talk to you about how skin camouflage might be able to help you. Read our Skin Camouflage pages for more information.
We provide a number of other services for people with scars and other visible differences:
If you’d like to learn more, contact our Support and Information Line. Our team can link you up with our services and they also offer support calls which provide a space for you to talk about the impact of scarring from skin cancer surgery on your life.
Guidance, support and advice is also available from other organisations. Please follow the links to their websites to learn more.
Cancer Research UK provides information and support, raises money for research into cancer treatments and lobbies the government for more effective policies on cancer. Their website offers a treasure trove of resources and support.
Please have a look at the NHS conditions page for official guidance on melanoma, including images of what it can look like. You will also find out what treatments are available on the NHS, the prognosis you can expect, and how to seek help.
The companion page on non-melanoma skin cancer. It includes key information about non-melanoma skin cancer and how it differs from melanoma, as well as details on treatments available on the NHS and what to do if you are worried you have skin cancer.