Non-melanoma skin cancer: symptoms and causes

Find out about non-melanoma skin cancer, including what the symptoms are, what causes it, and how it's diagnosed and treated.

What is non-melanoma skin cancer?

Non-melanoma skin cancer is a common type of cancer that starts in the top layer of skin.
The main types are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Non-melanoma skin cancer can often be easily treated.
The main cause is ultraviolet light, which comes from the sun and is used in sunbeds.
Things that increase your chances of getting non-melanoma skin cancer include your age, having pale skin and having had skin cancer in the past.
It's possible to reduce your risk of skin cancer by being careful in the sun – for example, by using sunscreen and reapplying it regularly.

There's another type of skin cancer called melanoma. It's less common and usually more serious than non-melanoma skin cancer.

Symptoms of non-melanoma skin cancer

Main symptoms of non-melanoma skin cancer

The main symptom of non-melanoma skin cancer is a growth or unusual patch on the skin.

Any part of your skin can be affected, but it's most common in areas exposed to the sun, such as the:

head, face and ears
neck and shoulders
back
hands
lower legs

The growths or patches can vary in colour, size and texture.

New mole or changes to a mole

A new mole or a change in an existing mole may be a sign of melanoma. This is a more serious type of skin cancer.

See a GP if:

you have a growth on your skin that's getting bigger or has changed colour or texture
you have a growth or area of skin that hurts, itches, bleeds, crusts or scabs for more than 4 weeks

Finding non-melanoma skin cancer early can mean it's easier to treat.

What happens at your GP appointment

The GP may ask some questions about your health and symptoms, and how much time you spend in the sun.

Tell the GP if the growth or area of affected skin has recently changed. Also tell them if you or your family have had skin cancer in the past.

The GP will look at the affected area of skin. They may ask if they can take a photograph to send to a specialist (dermatologist) to look at.

Referral to a specialist

You may get an urgent referral for more tests or to see a specialist in hospital if the GP thinks you have symptoms that could be cancer. This does not definitely mean you have cancer.

Causes of non-melanoma skin cancer

Main causes of non-melanoma skin cancer

Ultraviolet (UV) light is the most common cause of non-melanoma skin cancer. It comes from the sun and is used in sunbeds.

Non-melanoma skin cancer is more common in older people, but younger people can also get it.

You're also more likely to get non-melanoma skin cancer if you have:

pale skin that burns easily in the sun
red or fair hair
blue or green eyes
a large number of freckles or moles
had a lot of sun exposure and you've had sunburn a lot in the past
used sunbeds a lot
a history of skin cancer in your family or you've had skin cancer before

If you have brown or black skin, you have a lower chance of getting non-melanoma skin cancer, but you can still get it.

How to lower your chance of getting skin cancer

Staying safe in the sun is the best way to lower your chance of getting skin cancer.

There are some things you can do to help prevent getting skin cancer when you're outdoors.

Do

stay out of the sun during the hottest part of the day (11am to 3pm in the UK)
keep your arms and legs covered, and wear a wide-brimmed hat and sunglasses that provide protection against ultraviolet (UV) rays
use sunscreen with a sun protection factor (SPF) of at least 30 and at least 4-star UVA protection – make sure you reapply it regularly
make sure babies and children are protected from the sun – their skin is much more sensitive than adult skin

Tests and next steps for non-melanoma skin cancer

Main test for non-melanoma (excision biopsy)

If a GP refers you to a specialist because they think you could have non-melanoma skin cancer, you'll have tests to check for cancer.

The specialist will check your skin and ask you about any changes you've noticed. They may use a magnifying device that lets them look at the skin more closely.

The specialist may also recommend having a small area of affected skin cut out so it can be sent to a lab and checked for cancer. This is known as an excision biopsy.

Getting your results

You should get the results of the excision biopsy within 2 weeks. They will be sent to the GP or the hospital where you had the procedure.

Try not to worry if your results are taking longer than you expect. It does not mean anything is wrong.

You can call the hospital or GP if you're worried. They should be able to update you.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

If you're told you have non-melanoma skin cancer

Being told you have non-melanoma skin cancer can feel overwhelming. You may be feeling anxious about what will happen next.

It can help to bring someone with you to any appointments you have.

A group of specialists will look after you throughout your diagnosis.

Your team will include a clinical nurse specialist, who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Next steps

If you have been told you have non-melanoma skin cancer, you may have some more tests to see how deep the cancer is and how far it's spread (called staging).

Tests you may have include:

a CT scan or MRI scan
tests to see if the cancer has spread to your lymph glands
blood tests

You may not need these tests. It depends on the type of non-melanoma skin cancer you have.

The most common type, called basal cell carcinoma (BCC), rarely spreads to other areas of the body, so more tests are only needed if it's very large.

A less common type called squamous cell carcinoma (SCC) sometimes spreads, so tests may be needed.

The test results will help your specialist decide what treatment you need.

Treatment for non-melanoma skin cancer

Main treatments for non-melanoma skin cancer

Non-melanoma skin cancer can usually be effectively treated.

The treatment you have will depend on:

the type of skin cancer
where the cancer is
if it has spread
your general health

Surgery is the main treatment for non-melanoma skin cancer. Radiotherapy, targeted medicines, photodynamic therapy and chemotherapy are also sometimes used.

The specialist care team looking after you will:

explain the treatments, benefits and side effects
work with you to create a treatment plan that's best for you
discuss the chances of the skin cancer coming back and how it will be treated if it does

You'll have regular check-ups during and after any treatments.

Depending on the stage of your non-melanoma, you may have tests and scans.

If you have any symptoms or side effects you're worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Surgery is the main treatment for non-melanoma skin cancer, especially if it's found early.

You may also need surgery if the skin cancer has spread to other areas of your body or if it's come back again after being removed.

Several types of surgery can be used to treat non-melanoma skin cancer, including:

cutting out the cancer and some surrounding healthy skin (excisional biopsy)
freezing the affected skin, which forms a scab that drops off a few weeks later (cryosurgery)

If a large area of skin is removed, skin may need to be taken from another part of your body and used to cover the area where the skin cancer was. This is known as a skin graft.

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

It may sometimes be recommended if:

the cancer covers a large area
the location of the cancer makes surgery difficult
you're too unwell to have surgery
the cancer has spread to your lymph glands (part of the immune system)

Sometimes radiotherapy is used after surgery to help reduce the chance of the cancer coming back.

Targeted medicines and immunotherapy

Targeted medicines aim to stop the cancer growing.

Immunotherapy medicines help your immune system find and kill cancer cells.

There are different types that come as a skin cream, tablets or liquid that's given directly into a vein.

Targeted medicines or immunotherapy may be used if:

you have skin cancer in more than one place
the cancer has spread to deeper layers of skin or other parts of your body
you're unable to have other treatments, such as surgery or radiotherapy

Photodynamic therapy

Photodynamic therapy uses light-sensitive medicine and a light source to kill cancer cells.

It's carried out in hospital and is sometimes used to treat non-melanoma skin cancer if it's not too thick and has not spread deeper into the skin.

The light-sensitive medicine can be given as a cream, tablet or injection.

After the cancer cells have absorbed the medicine, a lamp or laser is shone on the affected area. The light reacts with the medicine and kills the cancer cells.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

A chemotherapy cream is sometimes used to treat skin cancers that only affect the top layer of skin.

You'll usually need to use the cream for 3 to 4 weeks. Your specialist team will be able to give you more advice about how to use it.

Chemotherapy given into a vein (intravenous chemotherapy) is rarely used to treat skin cancer.

Non-melanoma skin cancer