Facial skin cancer

The three most common skin cancers affecting the head and neck region are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma. Exposure to ultraviolet (UV) light on a cumulative basis is the major risk factor for BCC and SCC. Therefore, unsurprisingly, these are most commonly found on the sun exposed skin (such as face, scalp, hands and arms of the white skinned population in sunny climates).

Changing patterns of sun / UV light exposure for social reasons (holidays abroad, insufficient UV protection of exposed skin, sunbeds in tanning studios) have led to the increasing incidence of skin cancers in the United Kingdom.

Basal cell carcinoma, BCC

BCC is the most common cancer in Europe. It is usually caused by sun exposure, including occasional (minor) sunburns. It arises in the deepest layers of the outermost layer of skin; these deep layers are lined by basal cells. BCC are usually slowly growing abnormal lesions that rarely spread (metastasise) to other parts of the body. Nevertheless, if not treated promptly, there is a risk of spread and disfigurement.

Squamous cell carcinoma, SCC

SCC is the second most common form of skin cancer. The abnormal growth arises in the upper layers of the skin (the epidermis) in the squamous cells that mostly make up this layer of skin.

Similar to BCC (see above), SCC is usually caused by exposure to UV light (but there are a number of other potential causes as well). Accordingly, common locations in the head and neck region are the rim of the ear, the lower lip, a bald scalp, or regularly sun-exposed parts of the neck. SCC occurs in all parts of the body (for example, the majority of oral (mouth) cancers are SCC).

Different from BCC which very rarely spread to other parts of the body, there is a tendency of SCC to spread via local lymph nodes. This potential for metastatic spread depends on the site of the original tumour, its size and thickness, levels of invasion, rate of growth, amongst some further considerations.

Malignant melanoma

Malignant melanoma is a more serious skin cancer with a tendency to form metastases. It arises from pigment-producing cells (melanocytes) in the deep (basal) layers of the skin; it often looks like a mole or may originate from a mole. Its incidence in the United Kingdom is doubling each decade, it affects a younger age range and carries a mortality of around 40 % (currently each year about 13.500 cases are diagnosed in the UK, and about 2.000 deaths occur; malignant melanoma is not the most common skin cancer but it causes the most deaths). Malignant melanoma is more common elsewhere on the body (in men, the back; in women, the leg) but it does appear on the face.

If diagnosed (and treated) early, it is almost always curable. If left late or untreated, malignant melanoma may spread to other parts of the body and become incurable.

Next section: Facial skin cancer