What are the causes and symptoms of melanoma?

Melanoma is primarily caused by UV exposure. Symptoms include changing moles, irregular borders, and new or unusual skin lesions.

What are the treatment options for melanoma?

Surgery is the main treatment, often followed by lymph node biopsy, immunotherapy, or targeted therapy if required.

What is the main cause of melanoma?

Most cases result from UV radiation exposure, especially in fair-skinned individuals.

Does melanoma cause other symptoms?

In advanced stages, melanoma can cause fatigue, swelling in lymph nodes, or weight loss if it spreads.

What kills melanoma cells naturally?

There are no proven natural remedies to cure melanoma. Evidence-based medical treatment is essential for managing the disease.

What does melanoma start like?

It often begins as a new or changing mole, typically with irregular colour, shape, or size.

Understanding Skin Cancer: Types, Causes & Treatments

Skin cancer is one of the most common cancers in Australia, affecting people of all ages and skin types. Our high UV exposure and outdoor lifestyle make early detection and treatment especially important. Understanding how skin cancer develops, the different types that occur, and the available treatment options can help you take an active role in managing your skin health.

What is Skin Cancer?

Skin cancer occurs when abnormal skin cells grow in an uncontrolled way. This can happen when ultraviolet (UV) radiation damages the DNA within skin cells, leading to changes in how they behave. If these cells continue to multiply, they can form a cancerous lesion.

Because Australia has some of the world’s highest UV levels, skin cancer is extremely common. Early diagnosis through regular skin checks is one of the most effective ways to prevent more serious disease.

Types of Skin Cancer

There are several types of skin cancer, each with its own characteristics and treatment approach.

Basal Cell Carcinoma (BCC)

BCC is the most common and least aggressive form of skin cancer. It grows slowly and rarely spreads to other parts of the body. Lesions often appear as pearly lumps, scaly patches or sores that fail to heal. Surgery is a common and effective treatment.

Squamous Cell Carcinoma (SCC)

SCC is the second most common type and can behave more aggressively. It may appear as a scaly, thickened patch that can crust or bleed. While early SCCs are generally treated with surgery, some can spread to lymph nodes or distant organs and require prompt management.

Melanoma

Melanoma begins in melanocytes, the pigment-producing cells in the skin. It is less common but more serious because it can spread quickly if not treated early. Melanoma often arises from a changing mole or a new lesion on the skin.

Rare Skin Cancers

Although uncommon, some cancers require specialised care:

Merkel cell carcinoma: A fast-growing neuroendocrine skin cancer.
Kaposi’s sarcoma: Usually affects those with compromised immune systems.

Plastic surgeons often become involved in treating these cancers when excision and reconstruction are required.

Causes of Skin Cancer

Skin cancer is influenced by a combination of environmental, genetic and lifestyle factors.

Common contributing factors include;

UV exposure: The primary cause of most skin cancers.
Fair skin: Less melanin increases vulnerability to UV damage.
Family history or genetics: Some people inherit a higher risk.
Immunosuppression: Conditions or medications that weaken the immune system.
Tanning beds: Exposure to artificial UV radiation significantly increases risk.
Outdoor work or recreational activities: Increased lifetime sun exposure.

How is Skin Cancer Diagnosed?

Most skin cancers are identified through clinical examination and confirmed with a biopsy.

Step-by-step diagnostic process

Skin Examination: A GP, dermatologist or skin cancer doctor inspects the lesion.
Dermoscopy: A magnified tool helps assess patterns beneath the skin surface.
Biopsy:
- Punch biopsy
- Shave biopsy
- Excisional biopsy
  The sample is sent to a pathologist to confirm the diagnosis.
Referral for Treatment: If skin cancer is confirmed, patients requiring surgical management are referred to a Specialist Plastic Surgeon.

When to see a doctor

If you notice any new, changing or non-healing lesions—especially those that bleed, itch, or look different from surrounding spots—you should seek medical assessment promptly.

Skin Cancer Clinics and Specialists

Skin cancer clinics play an important role in early diagnosis. Once a cancer is identified, management may involve a multidisciplinary team that includes GPs, dermatologists, oncologists and Specialist Plastic Surgeons. Plastic surgeons are often involved in cases where surgical excision and reconstruction are required, particularly for sensitive or cosmetically important areas.

Treatment Options for Skin Cancer

The choice of treatment depends on the type, location and stage of the cancer.

Surgical Treatments

Standard excision: Removal of the cancer with an appropriate margin of normal skin.
Mohs surgery: Layer-by-layer removal used in select cases, often for high-risk facial lesions (typically performed by dermatologists).
Plastic surgeons manage many skin cancers requiring precise excision and reconstruction.

Topical Treatments

Used for some superficial BCCs and SCC in situ.
(These are not performed by plastic surgeons but may be prescribed by GPs or dermatologists.)

Radiotherapy

May be used when surgery is not suitable or as an additional treatment in certain cases.

Immunotherapy

Primarily used for advanced melanoma. These medications help the immune system recognise and attack cancer cells.

Chemotherapy

Less commonly used today, but it may be recommended in specific advanced cases.

Role of Plastic Surgery in Skin Cancer Treatment

Plastic surgeons play an important part in skin cancer management when surgical excision is required. Their role includes:

Removing skin cancers with appropriate margins
Reconstructing the affected area after removal
Preserving both function and appearance
Managing complex or recurrent lesions

This approach supports effective cancer clearance while aiming for natural and functional outcomes.

Screening and Early Detection

Regular skin checks are essential. Early detection significantly improves outcomes, especially for melanoma.

What to look for

Use the ABCDE rule and monitor for:

A – Asymmetry
B – Border irregularity
C – Colour variation
D – Diameter greater than 6 mm
E – Evolving size, shape or colour

Other signs include non-healing sores or lesions that itch, bleed or change.

How often to check

Self-examination: Every 3 months
Professional skin check:
Every 1–2 years for most adults
Yearly, if you have had skin cancer previously

Preventing Skin Cancer

Most skin cancers are preventable. Practical steps include;

Apply SPF 30+ or higher and reapply every 3–4 hours
Wear protective clothing, long sleeves and broad-brimmed hats
Seek shade during peak UV times
Avoid tanning beds
Use sunglasses that block UV
Check the UV index daily
Teach children safe sun habits early

Prognosis and Living with Skin Cancer

Prognosis varies depending on the type of cancer and when it is detected. Early diagnosis often allows for straightforward treatment and an excellent outcome.

After treatment, patients may need: