Conditions We Treat

Skin Cancer

At Livingstone Dermatology, we understand that your skin is a reflection of your health and well-being. We are committed to the latest advancements in dermatological science, and dedicated to providing you with quality care.

What is Skin Cancer?

Skin cancer is the abnormal, uncontrolled growth of skin cells caused by mutations in their DNA. These genetic changes trigger rapid cell proliferation, forming malignant tumours. While skin cancer most commonly develops in areas frequently exposed to ultraviolet (UV) radiation from the sun or tanning beds, it can also appear on parts of the body that receive minimal sun exposure.

There are three main types of skin cancer:

Basal Cell Carcinoma (BCC) – the most common and least aggressive type of skin cancer, BCC originates in the basal cells, which are responsible for producing new skin cells. It often appears as a pearly or waxy bump, a persistent sore, or a scar-like lesion, primarily on sun-exposed areas such as the face, neck, and hands. While BCC rarely spreads to other parts of the body, untreated cases can lead to significant tissue damage.
Squamous Cell Carcinoma (SCC) – the second most common form of skin cancer, SCC arises from squamous cells in the outermost layer of the skin. It typically presents as a red, scaly patch, an open sore, or a firm, raised lump. Unlike BCC, SCC has a higher potential to invade deeper tissues and spread to lymph nodes and other organs if not treated early.
Melanoma – the most aggressive type of skin cancer, melanoma develops in melanocytes, the pigment-producing cells of the skin. It often appears as an irregularly shaped, multicoloured mole or a rapidly changing lesion. Melanoma has a high risk of metastasis, which means that it can spread to distant organs.

What causes Skin Cancer?

Skin cancer develops when genetic mutations alter the normal growth cycle of skin cells, causing them to multiply uncontrollably and form malignant tumours. The primary mechanism behind these mutations is DNA damage, which disrupts the regulatory signals that control cell division and apoptosis (programmed cell death).

One of the most significant triggers of this damage is ultraviolet (UV) radiation, which penetrates the skin and induces structural changes in DNA, particularly in the tumour suppressor genes responsible for halting abnormal cell growth. When these protective mechanisms fail, the affected cells begin to proliferate unchecked, leading to tumour formation. In some cases, additional genetic changes, such as mutations in the p53 gene or activation of oncogenes, further accelerate malignant transformation.

Over time, these cancerous cells can invade surrounding tissues and, in more aggressive forms like melanoma, gain the ability to metastasise, spreading to distant organs through the lymphatic system or bloodstream.

What are the symptoms of Skin Cancer?

Recognising the early signs of skin cancer is essential for timely diagnosis and treatment. Symptoms can vary depending on the type of skin cancer, but may include:

A new or changing mole – a mole that changes in size, shape, or colour, or develops an irregular border.
A persistent sore or ulcer – a wound that does not heal or keeps returning.
A scaly or rough patch – a red, crusty, or scaly lesion that may itch or bleed.
A pearly or waxy bump – a flesh-coloured, pink, or translucent lump that may have visible blood vessels.
A dark streak under the nail – a pigmented line or spot appearing on the nail bed.
A firm, raised growth – a fast-growing lump that feels hard to the touch.
An area of skin with an unusual texture – a patch that appears shiny, smooth, or rougher than the surrounding skin.

Who is at risk of Skin Cancer in Singapore?

While skin cancer can affect anyone, certain factors increase the likelihood of developing the condition, even in a tropical climate like Singapore. Individuals at higher risk include:

Fair-skinned individuals – those with lighter skin tones have less melanin, which makes them more vulnerable to UV-induced DNA damage.
People with frequent sun exposure – individuals who spend extended periods outdoors, such as athletes, outdoor workers, and beachgoers, face higher UV exposure.
Residents with a history of severe sunburns – repeated sunburns, particularly in childhood, elevate the risk of developing skin cancer later in life.
Those with a family history of skin cancer – a genetic predisposition can increase susceptibility to developing the disease.
People with weakened immune systems – those undergoing immunosuppressive treatments or living with conditions such as organ transplants or chronic illnesses are at greater risk.
Individuals who use tanning beds – artificial UV radiation from tanning devices significantly increases the risk of all types of skin cancer.
Older adults – the risk of skin cancer rises with age due to cumulative UV exposure over the years.
People with a history of precancerous skin lesions – those with conditions such as actinic keratosis or atypical moles are more likely to develop skin cancer.

Although Singapore’s high humidity may limit excessive sun exposure compared to drier climates, year-round UV radiation remains a significant factor, which makes it crucial to follow sun protection measures and regular skin checks.

How is Skin Cancer diagnosed?

When it comes to diagnosing skin cancer, the goal is to accurately identify skin cancer at its earliest stages. This is because timely and precise diagnosis is crucial for effective treatment. A dermatologist will employ a combination of the following methods for diagnosing skin cancer:

Comprehensive skin examination – a dermatologist carefully examines any unusual moles, lesions, or skin changes and assesses their shape, colour, size, and texture.
Dermoscopy – using a specialised dermatoscope, the skin lesions are magnified and analysed in greater detail to detect subtle abnormalities that may not be visible to the naked eye.
Digital mole mapping – patients at higher risk might be encouraged to undergo mole mapping. Mole mapping is a technology that captures high-resolution images of the skin to track changes over time.
Skin biopsy – if a suspicious lesion is identified, a skin biopsy will be performed. During this procedure, a small tissue sample is taken and analysed under a microscope to confirm whether cancerous cells are present.

What are the treatment options for Skin Cancer in Singapore?

The main goal of treating skin cancer is to remove cancerous cells while preserving as much healthy tissue as possible. Treatment options vary based on the severity of the condition, and our specialists will recommend the most suitable approach for each patient.

Surgical excision – a precise surgical removal of the tumour along with a margin of healthy tissue to ensure complete eradication. This is a common approach for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Cryotherapy – in cases of early-stage or superficial skin cancer, liquid nitrogen is used to freeze and destroy abnormal cells. Cryotherapy is often used for precancerous lesions like actinic keratosis.
Topical treatments – a dermatologist may prescribe medicated creams such as imiquimod or 5-fluorouracil for certain non-melanoma skin cancers.
Electrosurgery – for small, superficial skin cancers, a heat-based destruction (electrosurgery) to remove abnormal cells effectively may be recommended.
Photodynamic Therapy (PDT) – PDT involves applying a light-sensitive medication to the affected area, followed by exposure to a special light source to target and destroy cancerous cells.
Radiotherapy – in cases where surgery is not an option, radiation therapy may be recommended as it can help shrink or eliminate tumours.
Targeted therapy and immunotherapy – for advanced cases of melanoma, we may recommend consulting oncologists, as they can provide systemic treatments such as targeted therapy or immunotherapy to help the body fight cancer more effectively.

Book An Appointment

Despite how common it is, it is important to know that skin cancer is highly manageable and treatable, especially in its early stages. That is why it is encouraged to undergo routine check-ups to catch any changes earlier on.

If you have a family history of skin cancer or have noticed any changes to any of your moles, do contact us to schedule an appointment. Our clinical team at Livingstone Dermatology will attend to you and guide you on the journey to recovery.

Frequently Asked Questions

Can people with dark skin develop skin cancer?

Yes, individuals with dark skin can develop skin cancer, though their risk is lower compared to those with lighter skin tones. It’s important for everyone, regardless of skin colour, to practice sun protection and perform regular skin checks.

Can skin cancer develop in areas not exposed to the sun?

Yes, while skin cancer commonly occurs on sun-exposed areas, it can also develop on parts of the body that receive little or no sun exposure, such as the palms, soles, and under the nails.

Is skin cancer preventable?

While not all cases are preventable, reducing sun exposure, avoiding tanning beds, wearing protective clothing, and using broad-spectrum sunscreen can significantly lower the risk of developing skin cancer.

How often should I perform self-examinations for skin cancer?

It’s recommended to perform a thorough self-examination of your skin once a month to detect any new or changing lesions early.

Does a single sunburn increase my risk of skin cancer?

Experiencing sunburn indicates DNA damage to your skin cells, which can accumulate over time and increase the risk of skin cancer. It’s essential to protect your skin from UV radiation to minimise this risk.

Can skin cancer be cured?

When detected early, most skin cancers can be effectively treated and cured. However, if left untreated, certain types can spread to other parts of the body, which can make treatment more challenging.

Are tanning beds safer than sun exposure?

No, tanning beds emit ultraviolet radiation that can damage skin cells and increase the risk of skin cancer, similar to sun exposure. It’s advisable to avoid using tanning beds altogether.

What should I do if I notice a suspicious spot on my skin?

If you observe any new, changing, or unusual spots on your skin, it’s important to consult a dermatologist promptly for a professional evaluation.

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