BCC, SCC and melanoma: what is the difference?

Basal cell carcinoma begins in basal cells, squamous cell carcinoma begins in squamous cells, and melanoma begins in pigment-producing melanocytes. A dermatologist cannot reliably identify every lesion by appearance alone, so a suspicious area may need examination with a dermatoscope and a biopsy.

BCC often grows locally and can damage nearby skin and deeper tissue if neglected. SCC can also invade surrounding tissue and has greater potential to spread beyond the original site. Melanoma can spread through lymphatic channels or the bloodstream, which makes the lesion's depth and other biopsy findings central to staging and treatment planning.

Their appearances overlap. BCC may look pearly, shiny, ulcerated or like a sore that repeatedly crusts. SCC may appear scaly, thickened, tender or ulcerated. Melanoma may develop within a mole or as a new pigmented or non-pigmented mark that changes in shape, colour or size. These descriptions guide assessment but do not confirm a diagnosis.

Arrange a skin examination if a mark is new, changing, not healing, repeatedly bleeding or noticeably different from your other marks. Avoid picking or treating it with unprescribed acids or freezing products, because irritation can obscure its features and delay diagnosis.

Before the visit, note when you first saw the change and whether it bleeds, crusts, itches or hurts. A clear photograph with the date can document change. If biopsy confirms cancer, the pathology report guides whether surgical excision, specialised skin cancer surgery, lymph-node assessment or systemic treatment should be discussed.

Seek prompt assessment for a lesion that is changing quickly, bleeding without clear injury, forming a persistent ulcer, becoming painful, or accompanied by a new lump in a nearby lymph-node area. Contact the treating team promptly after a skin-cancer diagnosis if you develop new neurological symptoms such as a seizure, weakness on one side, confusion or a severe unfamiliar headache.

Heavy bleeding that does not stop with firm pressure, sudden collapse, or new severe neurological symptoms warrants emergency care. Urgency is based on the symptom itself; it does not identify which skin cancer, if any, is present.

Ask what the biopsy shows, whether the edges of the removed tissue are clear, and which features affect the risk of local return or spread. For melanoma, ask whether the depth warrants discussion of sentinel lymph node biopsy. Also clarify the proposed surgical approach, whether additional treatment is relevant, how the scar will be managed, and what skin and lymph-node follow-up you need.