Introduction

Basal and squamous cell skin cancers are the most common types of skin cancer. They start in the top layer of skin (the epidermis), and are often related to sun exposure.

Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer cells.

Where do skin cancers start?

Most skin cancers start in the top layer of skin, called the epidermis. There are 3 main types of cells in this layer:

Squamous cells: These are flat cells in the upper (outer) part of the epidermis, which are constantly shed as new ones form. When these cells grow out of control, they can develop into squamous cell skin cancer (also called squamous cell carcinoma).

Basal cells: These cells are in the lower part of the epidermis, called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skin’s surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells. Skin cancers that start in the basal cell layer are called basal cell skin cancers or basal cell carcinomas.

Melanocytes: These cells make the brown pigment called melanin, which gives the skin its tan or brown color. Melanin acts as the body’s natural sunscreen, protecting the deeper layers of the skin from some of the harmful effects of the sun. Melanoma skin cancer starts in these cells.

Basal cell carcinoma

Basal cell carcinoma (also called basal cell skin cancer) is most common type of skin cancer. About 8 out of 10 skin cancers are basal cell carcinomas (also called basal cell cancers).

These cancers start in the basal cell layer, which is the lower part of the epidermis.

Squamous cell carcinoma

About 2 out of 10 skin cancers are squamous cell carcinomas (also called squamous cell cancers). These cancers start in the flat cells in the upper (outer) part of the epidermis.

These cancers commonly appear on sun-exposed areas of the body such as the face, ears, neck, lips, and backs of the hands. They can also develop in scars or chronic skin sores elsewhere. They sometimes start in actinic keratoses (described below). Less often, they form in the skin of the genital area.

Other types of skin cancer

Melanoma

These cancers develop from melanocytes, the pigment-making cells found in the epidermis. Melanomas are much less common than basal and squamous cell cancers, but they are more likely to grow and spread if left untreated. Melanoma is discussed in Melanoma Skin Cancer.

Less common types of skin cancer

Other types of skin cancer are much less common and are treated differently. These include:

5. Merkel cell carcinoma
5. Kaposi sarcoma
5. Cutaneous (skin) lymphoma
5. Skin adnexal tumors (tumors that start in hair follicles or skin glands)

Together, these types account for less than 1% of all skin cancers.

Benign skin tumors

Most skin tumors are benign (not cancerous) and rarely if ever turn into cancers. There are many kinds of benign skin tumors, including:

Most types of moles (see Melanoma Skin Cancer for more about moles)

Seborrheic keratoses: tan, brown, or black raised spots with a waxy texture or occasionally a slightly rough and crumbly surface when they are on the legs (also known as stucco keratosis)

Hemangiomas: benign blood vessel growths, often called strawberry spots

Lipomas: soft tumors made up of fat cells

Warts: rough-surfaced growths caused by some types of human papillomavirus (HPV)

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