Skin cancer is the most common cancer in the U.S., with an estimated 1 in 5 Americans developing the disease at some point in their lifetime. The major risk factor is excessive exposure to ultraviolet (UV) light from the sun — especially if it led to burns severe enough to blister (and even more so if the burns occurred during childhood).
Considering this, you might assume that skin cancer would appear most often on areas of your body frequently exposed to the sun, like your face, arms and hands. This is often true of basal and squamous cell skin cancers, which are commonly found on the head, neck and arms (although they may also appear in other locations).
“Basal cell skin cancers are less likely to metastasize … They tend to present as flesh-colored papules on the face. Squamous cell skin cancers can occur anywhere on the body and present in a variety of ways,” says Dr. Laura Farrington, DO, a medical oncologist at Cancer Treatment Centers of America® in Zion, Illinois (near Chicago). “They tend to be slower growing and have less metastatic potential then melanomas.”
Melanoma, which is considered the most dangerous form of skin cancer, may occur even on areas of your body that don’t get much sun exposure. It’s important to get yearly skin exams by a physician, especially if you’re at high risk of skin cancer. However, you can conduct monthly skin self-examinations as well, noting any suspicious spots. When doing so, be sure to check these commonly overlooked spots where skin cancer can hide.
“The scalp is actually a common site for melanomas,” Dr. Farrington says. It’s estimated that about six percent of melanoma patients have melanoma on their scalp or neck, and both sites are associated with worse outcomes compared to melanoma on other areas of the body — perhaps because diagnosis tends to be delayed.
Since you can’t easily check your scalp for melanoma, be sure your physician checks during your yearly skin exams. In addition, Farrington says, “It is easy to ask your hairdresser to do a quick scalp exam during a haircut.”
Your Pelvic Area
This is another area where melanoma can surprise you. “It is important to have regular gynecologic exams,” Dr. Farrington says, “because even though this area does not have much sun exposure, melanoma can still occur, and it may be difficult to check oneself.”
Under Your Nails
Melanoma under the nails is rare, but it does occur, more often in people with darker skin pigment. There is also some concern that skin cancer under the nails may be on the rise due to UV nail lights used in beauty salons. According to Dr. Farrington:
“[Skin cancer] under the nails is a very concerning area, which I am worried will worsen over the next few years, with the common use of gel manicures. The exposure to UV rays directly to the hands and nails, especially regularly, is likely to increase the risk of melanoma and other skin cancers to these areas.”
If you get gel manicures regularly, keep in mind that use of UV lamps is not necessary; you can allow your nails to air dry instead.
No matter where on your body you’re checking, Dr. Farrington recommends using the ABCDE signs when looking for melanoma. If these signs are present, you should see your doctor for further evaluation:
A is for Asymmetry: One half of a mole or birthmark does not match the other.
B is for Border: The edges are irregular, ragged, notched, or blurred.
C is for Color: The color is not the same all over and may include shades of brown or black, or sometimes with patches of pink, red, white, or blue.
D is for Diameter: The spot is larger than 6 millimeters across (about ¼ inch — the size of a pencil eraser), although melanomas can sometimes be smaller than this.
E is for Evolving: The mole is changing in size, shape, or color.