Precancerous growths develop in the skin as a result of excessive cumulative sun exposure. Known as solar or actinic keratoses, they are biomarkers for an increased risk for developing skin cancer. Ultraviolet radiation causes damage to DNA, immune cells, and DNA repairing enzymes.
Typically, a precancerous growth appears as a red or skin colored scaly or rough plaque on areas of skin associated with excessive sun exposure; such as face, tops of ears, tops of hands, arms, neck, and chest. Actinic keratoses may bleed from inconsequential trauma such as shaving or washing your face. They are persistent. Despite multiple attempts to remove it by fingernail surgery, you will notice that it keeps recurring in the same spot. This is a clue that it may be a precancer or even an early skin cancer and should be evaluated.
Skin cancer activates defenses that prevent the body's immune system from attacking it. It also stimulates the body's blood vessels to be its blood supply.
Topical immunomodulating agents can be applied to remove precancers and certain superficial skin cancers. Cryotherapy is commonly used to target discrete pre-cancerous growths. Surgical removal is still the standard of care for most skin cancers.
Skin cancers may present as "the pimple that never goes away", a spot that is increasing in size but is painless or a spot that keeps bleeding despite no injury to the area. Pain or discomfort is not a sensitive indicator of whether a growth is cancer. In general, bleeding and/or pain may be a late symptom and indicate that the skin cancer has grown into the deeper skin layers; now involving blood vessels and/or nerves.
Prevention focuses on daily sunscreen use, photoprotective clothing that is UPF rated, and applying antioxidants.
