Dermatologists say skin cancer can hide in unexpected places

Skin cancer does not always look like a changing mole, and some of its most dangerous forms can hide in areas people rarely examine.

Dr. Rhea Rogers, a board-certified physician, said that overlooked warning signs include sores that fail to heal and moles that bleed easily. She explained that doctors examine spots using the ABCDE method, checking for asymmetry, irregular borders, changing colors, shifts in diameter, and overall evolution in appearance. Rogers noted that these changes can happen to spots a person has had for years, making consistent tracking essential for early detection.

Gerontologist Sam Cradduck emphasized that even tiny changes in a mole can be a sign of trouble. She stated that a millimeter of growth can matter a lot. Cradduck advised that people should monitor whether a mole has increased in size, lost its symmetry, or started to bleed. This close monitoring helps distinguish between benign age spots and cells that require medical attention.

While public health messages often focus on sun-exposed areas like the face and arms, Rogers warned that skin cancer can appear in less obvious locations. She pointed out that tumors can develop behind the ears, between the toes, or underneath the nails. Because many of these areas are difficult to see, Rogers suggested that a physical exam by a doctor or assistance from a partner can help cover blind spots such as the scalp. She described these hidden growths as not always looking scary, which she said makes them particularly dangerous because they may not prompt a person to seek care.

Amy O’Rourke, an aging expert, shared her own experience with the condition. She went to a dermatologist about a brown spot on her cheek, but a full body scan revealed squamous cell cancer on top of her head. O’Rourke underwent surgery to remove the tumor. She noted that about three-quarters of her family has had skin cancer, highlighting the role of genetics in risk. Rogers said that risk factors include fair skin, age, and family history, suggesting that both genetic and environmental elements play a part.

Rogers also addressed common misconceptions about sun protection. She clarified that UVA and UVB light is invisible and can pass through glass, meaning people are exposed even indoors or while driving. Melanoma is often linked to intense, intermittent sunburns that reach deep into the skin, and it can spread very quickly. In contrast, squamous cell and basal cell cancers are more likely to appear as pinkish, itchy sores that do not heal. Rogers also corrected the myth that people with darker skin tones do not need sunscreen, stating that everyone needs protection to prevent damage to cells and DNA.

To manage risk, Rogers suggested that residents check with their insurance providers, as some plans cover an annual dermatology exam similar to a routine well woman visit. She recommended requesting a full body exam and asking about mole mapping to track changes over time. In addition to sunscreen, sun-protective clothing such as rash guards, UV clothing, and wide-brim hats can offer extra protection.