Hollywood star Hugh Jackman has revealed his most recent skin cancer scare and urges fans to remain vigilant.
The Wolverine star had biopsies of moles on his nose that could be basal cell carcinoma, the most common form of skin cancer with a high survival rate.
DailyMail.com spoke to dermatologists to break down the early warning signs of skin cancer to help you protect yourself.
Asymmetric moles
Dermatologists follow the ABCDEs when diagnosing melanoma; i.e. asymmetry, edge, color, diameter and evolving.
Most melanomas, the rarest but most dangerous skin cancer most likely to spread, present as moles with uneven edges. It looks different from common moles, the round, tan, or brown spots on the skin caused by growing clusters of cells in the skin called melanocytes.
Dr. Nayoung Lee, a dermatologist at New York University’s Langone Hospital, told DailyMail.com, “If you can’t find the mole in half, if the edges don’t line up,” that could be melanoma.
Irregular edges of a mole, the “B” in ABCDEs, may also indicate melanoma. The edges of a normal mole
The Skin Cancer Foundation advises people to look out for ‘ugly ducklings’ – ugly moles that stick out very clearly from the pack all over the body.
The foundation says: “This recognition strategy is based on the idea that most normal moles on your body look alike, while melanomas stand out like ugly ducklings.”
Moles of uneven colors
Color, the “C” in ABCDEs, is a strong indicator of dangerous melanoma. Healthy moles are usually a single color, from dark and light brown to pink and flesh-colored.
Some moles become cancerous and gradually change color. About 20 to 30 percent of melanoma cases develop in existing moles.
The other 70 to 80 percent of the time, cancerous moles form on otherwise healthy-looking skin.
But a suspicious birthmark often contains various shades of brown, black, or brown, as well as spots in pink, red, or purple. It becomes more colorful as the cancer progresses, so early action is crucial. In fact, 99 percent of patients who detect and treat their melanoma early survive five years or more after their diagnosis.
Dr. Zaineb Makhzoumi, a dermatologist at the University of Maryland Medical Center who specializes in a type of surgery to remove cancerous moles, said, “Once you start getting two, three, four colors fused together in one mole, that should be a warning sign.” and you should have that mole evaluated by a board-certified dermatologist.”
Moles bigger than a pea
Size matters when it comes to suspicious moles. Melanomas are usually slightly larger than a pea or a pencil eraser, about six millimeters or a quarter of an inch.
Dr. Makhzoumi told DailyMail.com, “Most moles, if benign, are smaller than an eraser. If you have a mole that is bigger than a pencil eraser, that in itself is not a warning sign and is a concern. But rather taken with the other constellation of signs, that’s something you want a dermatologist to evaluate.”
Not all melanomas endorse the “D” in ABCDEs, where D means at least six millimeters in diameter. In 2013, doctors in Queensland, Australia, treated a 38-year-old woman with an invasive melanoma on her arm measuring just 1.6mm in diameter.
The small cancerous mole didn’t appear asymmetrical either, meaning doctors still need to watch for moles that appear darker than those around it, as was the case with the Australian woman.
The doctors said, “We consider it very important that this melanoma did not have clear asymmetry, although it did have recognized evidence of malignancy… no clear asymmetry is present.”
Doctors should also monitor how a mole develops over time. This is the ‘E’ in ABCDEs. Changes in the size, shape, color, or elevation of a spot or a new symptom such as bleeding, itching, or crusting may be a warning sign of melanoma.
Dr. Makhzoumi said, “Moles tend to go through evolution, but the evolution of moles is usually that they shrink or disappear.
“If you have a mole that evolves by growing, darkening, being raised, that’s really, really important for melanoma.”
Melanoma grows in two stages, horizontal and vertical. The horizontal stage can last for years before the mole becomes dangerous and invasive, meaning it spreads to lymph nodes and organs. But in a later stage, the lesion grows vertically, then becomes a tumor that can spread elsewhere in the body and be potentially fatal.
Dr. Makhzoumi added, “Once melanoma enters that vertical growth phase, they actually speed up very quickly. So if you have a spot where a lump suddenly forms, it is very worrying about malignant melanoma.’
Bleeding or scaly patches
These often appear on areas of the skin most frequently exposed to sunlight, such as the face and top of the head.
Precancerous squamous cell carcinoma leads to actinic keratosis and leads to a skin condition that causes rough, scaly patches. The patches can sometimes bleed and ulcerate.
Dr. Lee said, “They just feel flaky, so you can feel them more than see them.” If any of those progress, they can become pavement. They can look like pink or skin-colored bumps on your skin.”
People with a history of heavy sun exposure are most likely to get this type of skin cancer. With every bad, searing sunburn comes an increased risk of squamous cell carcinoma. Fair-skinned people and people with light eyes who are more prone to sunburn are also more vulnerable to SCC.
More often than not, squamous cell carcinoma is curable if treated early. In fact, the survival rate is a whopping 98 percent.
A sore that bleeds may indicate another type of non-melanoma skin cancer called basal cell carcinoma, which, like SCC, has a high survival rate. Still, people should treat it aggressively once it’s discovered.
Dr. Lee told DailyMail.com, “Depending on location, they can grow deeper into muscle and bone, so they become problematic if they continue to grow over a long period of time.”
Basal cell carcinoma is the most common cancer in general and the most common skin cancer in particular. The number of new cases in the US exceeds 4 million cases per year.
Dr. Lee added, “Basal cell carcinomas, we don’t even stage them because the survival rates are good.”
Dark spots on genitals
Melanoma can present as dark lesions on the mucous membranes, that is, the inside of the nose, mouth, vagina or anus, or the fingers and toes.
This subtype of aggressive cancer is extremely rare and explains less than two percent of all cases of melanoma.
Unlike other types of melanoma, mucosal melanoma is not affected by sun exposure. About half of mucosal melanomas begin in the head and neck, most commonly the nose, mouth, trachea, or esophagus. Smoking, ill-fitting dentures, and ingestion or inhalation of carcinogens all significantly increase the risk of oral sarcomas.
Most of the remaining 50 percent of melanomas begin in the anus or rectal area and female genitalia.
Dr. Lee said: ‘Initially, if early, it looks like a whitish bump or ridge on the mucosal surface. So as it grows it starts to look more like a sore, it can look moldy [like a fungal infection in appearance]or other things.’