Skin Cancer: Types, Detection, and Sun Safety Tips

Brandie Oros, APRN

According to the Skin Cancer Foundation, having five or more sunburns doubles your risk for melanoma. For Skin Cancer Awareness Month, we sat down with Brandie Oros, APRN, from the Skin Cancer & Dermatology Institute, to discuss skin cancer, spotting irregularities on your skin, and prevention.

What are the different types of skin cancers?

Basal cell carcinoma is the most common type of cancer in the United States, with an estimated 3.6 million cases each year. It is formed in the lower layer of the epidermis – the basal cell layer. While it is less likely to cause death, it can cause extensive damage locally, so getting it treated early is critical.

Squamous cell carcinoma is the second most common type of skin cancer. It is formed in the upper part of the epidermis, which constantly sheds as new cells are formed beneath and pushed upward. It is more likely than basal cell carcinoma to become invasive and can even metastasize. Therefore, it is also extremely important to seek treatment early.

Melanoma occurs when the melanocytes start to grow out of control. Melanocytes are the cells that form melanin, which gives our skin its color. The more melanin a person has, the darker their skin tone is. Melanoma is less common than the previous two types of skin cancer; however, it is the most dangerous as it is more likely to spread to other parts of the body and survival rates are significantly lower. 

Additionally, there are actinic keratoses, often considered a pre-cancer, and form on skin damaged by UV rays. Most squamous cell carcinomas begin as actinic keratosis, so treat them early before they transform.

How can we recognize the early signs of melanoma? 

The Skin Cancer Foundation uses the first five letters of the alphabet to help people recognize the warning signs of melanoma, known as the ABCDEs of melanoma.

A-Asymmetry. Most melanomas are asymmetrical. If a line is drawn through a lesion and the two halves are not equal, then it is asymmetrical.

B-Border. The borders of melanoma are often uneven or hazy. The borders of a healthy mole are typically smooth and even.

C-Color. Melanoma lesions are often multi-colored including brown, black, or tan. Melanoma lesions can also contain colors of red, white, or blue. Additionally, melanoma may not have any darkness at all, known as amelanotic melanoma, which is often harder to detect. 

D-Diameter or dark. If a lesion is six mm – the size of a pencil eraser – or larger, it is a warning sign of melanoma.

E-Evolving. Any change in size, shape, color, or elevation should be discussed with your dermatology provider. Additionally, any change in symptoms of a lesion such as itching, bleeding, or crusting can also warrant evaluation.

Any of the above changes in your skin should prompt you to schedule an immediate appointment with a dermatology provider for further evaluation. 

Which body areas are commonly overlooked during self-exams?

The scalp is one. This is especially important in areas with less hair (balding) or the hair part, which get more exposure to sunlight. People forget to check the soles of the feet, inside the mouth/throat, ears, and genitals for new or changing lesions, moles, or sores that will not heal. Melanoma and cancers can occur even where the sun does not shine, making it essential to monitor the entire body. I often recommend taking pictures of your skin monthly (or at least every three months) to monitor for changes. 

I used to get sunburns when I was younger – does that increase my risk?

Your risk of developing melanoma doubles with a history of only five or more sunburns. So be diligent about skin checks and yearly evaluations by a trained dermatology provider to complete a full skin exam annually. 

What are your top sun safety tips?

We live in Northeastern Nevada, where most of us enjoy the beautiful outdoors. I tell people that I do not expect them to stop living their lives outside, but there are steps they can take to help prevent skin cancer. First, wear at least a 30 SPF sunscreen EVERY SINGLE DAY on all exposed skin – rain or shine! When you are outside, seek shade, especially between 10 a.m. and 4 p.m. Cover up with clothing, wear a broad-brimmed hat, and UV-blocking sunglasses. Avoid tanning (a tan is a sign of UV damage) and AVOID tanning beds. Also, educate and protect your loved ones, as not everyone is aware of the dangers of sun exposure.

Brandie Oros has been a nurse practitioner in the Elko community for over seven years.
To schedule dermatology appointments in Elko with Brandie, visit