Basal cell carcinoma is the most common type of skin cancer in Australia. By the age of 70, around 70% of Australians will have had at least one BCC.
BCCs usually appear on sun-exposed areas, especially the head, neck, and upper body.
They are strongly linked to UV exposure, particularly episodes of severe sunburn during childhood and adolescence.
People on immunosuppressive medication (e.g. after organ transplant or for inflammatory arthritis) are also at higher risk.
Certain rare genetic syndromes (e.g. Gorlin syndrome) can predispose people to multiple BCCs.
BCCs can appear in several ways:
A useful rule of thumb: an “injury” on the skin that does not heal within 4 weeks should be checked by a doctor.
There are several different subtypes of BCC, each with slightly different appearances and behaviours:
The subtype helps guide the choice of treatment.
Excellent outlook – the vast majority of BCCs are cured with treatment.
Recurrence is possible, especially in morphoeic or incompletely treated BCCs.
Metastasis (spreading) is exceedingly rare, unlike with melanoma or squamous cell carcinoma.
Squamous cell carcinoma is the second most common type of skin cancer in Australia. It arises from the squamous cells in the outer layer of the skin and, unlike basal cell carcinoma, it carries a greater risk of spreading if left untreated.
Most often found on sun-exposed skin: face, ears, lips, hands, and forearms.
Particularly common in areas with chronic sun damage.
SCC is strongly linked to cumulative lifetime UV exposure.
Higher risk in people with:
SCCs are typically:
Most SCCs are cured with appropriate treatment.
SCC carries a higher risk of recurrence and spread compared to basal cell carcinoma.
Spread to lymph nodes or other organs occurs in about 2–5% of cases (higher in large, thick, or aggressive tumours, or in immunosuppressed patients).
Early detection and surgery give the best chance of cure.
Melanoma is a less common but more serious type of skin cancer. Unlike basal cell carcinoma or squamous cell carcinoma, melanoma has a greater ability to spread (metastasise) if not detected early.
It most often appears as a new or changing mole, but not all melanomas are black or brown — some are pink, red, or even skin-coloured.
Invasive melanoma means that the cancer cells have grown beyond the surface layer of the skin into the deeper layers (the dermis).
The prognosis depends on the Breslow thickness, which measures how deep the melanoma cells have grown into the skin.
In some cases (depending on thickness, ulceration, or other features), a sentinel lymph node biopsy may be recommended to check if the melanoma has started to spread.
Treatment involves surgical excision with an appropriate margin of normal skin, and further management if required depending on the stage.
When found early, melanoma is usually curable with surgery.
The deeper the melanoma, the higher the risk of spread — which is why early detection is critical.
Regular skin checks, prompt attention to new or changing moles, and awareness that not all melanomas are dark are key to early diagnosis.
Melanoma in situ means that the cancerous cells are confined to the top layer of skin (epidermis).
At this stage, the melanoma is serious but highly treatable.
The outlook is excellent: once the lesion is completely removed with surgery, the cure rate is extremely high.
Surgery usually involves removing the melanoma with a margin of normal skin to ensure no abnormal cells are left behind.
Solar keratoses (also called actinic keratoses or “sunspots”) are very common skin changes caused by long-term sun exposure.
Most solar keratoses are harmless, but each spot carries a 1 in 100 to 1 in 200 risk per year of becoming a squamous cell carcinoma (SCC) if left untreated.
Treatment depends on the size, location, and subtype:
Daily sunscreen use can reduce the number of new solar keratoses forming.
It also lowers the overall risk of developing skin cancers.
Sunscreen won’t clear existing spots, but it is vital to prevent new ones.
