Header Couple On Beach

What is Skin Cancer?

Everyone has interesting forms of skin discoloration such as freckles and moles, most of which are completely normal. However, some of these spots do have the potential to turn into cancer. Watch for new skin growths or changes in existing moles, freckles, bumps and birthmarks.

Not all lesions will stand out or have symptoms when they turn into cancer. Cancer and precancerous spots can exist in areas of your skin that aren’t exposed to the sun. Cancer can appear on your head (in your hair), between your toes and other inconspicuous areas.

Contact our office for an appointment if you or your partner finds a suspicious lesion. Inform our front office staff why you want to see the doctor. Skin cancer has a high cure rate when detected early.

Facts, Types

Pre-Cancerous Spots

Pre-Cancerous Spots are also referred to as actinic keratoses or “AK’s” are common skin conditions caused by excessive sun exposure.   They usually appear in areas that are exposed to the sun like your face, lips, ears, neck, chest and hands.

Precancers before and after

They can range in size from a pencil led to the size of a pencil erasure. They will start out looking like a scaly patch of skin and will turn into a scaly, wart-like bump. One out of ten AK’s going untreated will likely turn into Basal or Squamous Cell Carcinoma.

Basal Cell Carcinoma (BCC)

Basal Cell Carcinoma (BCC) is the most common form of skin cancer, mostly occurring on areas of the skin that are excessively exposed to the sun.  They occur in one of five people and rarely spread to other areas of the body.  BCC’s are abnormal, uncontrolled growths or lesions that arise in the skin’s basal cells, which line the deepest layer of the epidermis (the outermost layer of the skin).

Ulcerated Basal Cell Carcinoma
Ulcerated basal cell carcinoma (left panel) and ulcerated basal cell carcinoma with characteristic pearly rim (right panel), Source

BCC’s often look like open sores, red patches, pink growths, shiny bumps, or scars.  When they are small they can look like a pimple, ingrown hair or scrape, the key warning is that they don’t resolve.  Early treatment is a quick and easy outpatient procedure or a prescription cream and leaves very little scarring.  A large BCC can require a big surgery to remove and can be cosmetically disfiguring.

Squamous Cell Carcinoma

Squamous Cell Carcinoma is the second most common form of skin cancer and can be found in inconspicuous areas such as the mucus membranes, and genital area, but is most commonly found in areas exposed to the sun.  One out of ten people develop SCC but it rarely spreads when surgically removed early.

Squamous Cell Carcinomas
Squamous cell carcinoma on the face with thick keratin top layer (left panel) and squamous cell carcinoma on the leg (right panel). Source

SCC is an uncontrolled growth of abnormal cells arising in the squamous cells, which compose most of the skin’s upper layers (the epidermis). SCCs often look like scaly red patches, open sores, cysts, or warts; they may crust or bleed.


Melanoma is the most dangerous form of skin cancer. Melanoma begins on the surface of the skin where it is easy to see and treat. If given time to grow, melanoma can grow down into the skin, ultimately reaching the blood and lymphatic vessels and spread through the body (metastasize), causing life-threatening illness.

Skin Melanomas
Melanomas with characteristic asymmetry, border irregularity, color variation, and large diameter. Source

Melanoma Examples
More examples of Melanoma moles.

Melanoma is completely curable when detected early, but can be fatal if allowed to progress and spread. Melanoma is thought to be related to lifetime sun exposure but it can form “where the sun doesn’t shine”.

Melanoma can appear anywhere on the body including the scalp, under nails, palms and soles, back of the eye and in the genital area.  Early on most Melanoma are flat, brown-black spots on the skin. Over time, they can increase in size, change in shape, have multiple colors, raise up, itch or bleed.    Early melanoma are usually asymptomatic and can only be detected by visual exam.  The American Academy of Dermatology recommends a minimum of once yearly full body exams by a Board Certified Dermatologist and monthly self skin exams.

Make an appointment if you notice a mole that is different from the others, or if it changes, itches, or bleeds even if it is smaller than 6 millimeter.  Skin cancer has a high cure rate when detected early.

Skin Cancer Prevention

Dr. Monica Scheel Dermatology is dedicated to preventing skin cancer to the best of our abilities. We take the time to educate our patients in the current medical science of skin cancer prevention.

Ways to prevent Skin Cancer:

  • Eat lots of fruits and vegetables every day.
  • Seek the shade, especially between 9 am and 5 pm
  • Do not get sunburned
  • Avoid sun tanning and tanning beds.
  • Use sun protective clothing, such as long sleeves, a broad – brimmed hat, and UV blocking sunglasses to protect from the damaging rays of the sun
  • Do not expose newborns to the sun. Sunscreens should be applied to babies over 6 months
  • Vitamin C serum applied to the skin each morning and Retinol applied at night
  • Use a zinc based sunscreen (minimum 7%) with an SPF of 30 or higher every day.
  • Apply one ounce (a shot glass) of sunscreen to your entire body 30 minutes before going into the sun. Reapply every two hours or immediately after swimming or excessive sweating
  • Check your skin regularly and report changes to your doctor.
  • See your dermatologist once a year for a full body skin check

Nurses performing a dermascope check up

For those who have had a skin cancer or pre-cancer, prevention includes all of the above and these additional measures:

  • Niacinamide 500 mg twice daily
  • Exfoliating treatments such as chemical peels and hydrafacials
  • Photodynamic Therapy (PDT)
  • Topical chemotherapy or immunotherapy medications
  • CO2 Laser skin resurfacing
  • Daily use of SPF 30 or higher
  • SPF 30 or higher lip balm for Pre-Cancers of the lip (Actinic Chelitis)
  • DNA Repair Enzymes applied to the skin
  • Exfoliative body lotion such as Amlactin or Retinol Firming Body Lotion
  • Regular checkups with your dermatologist for early detection

From Our Patients

"Dr. Monica Scheel and her staff are the best medical practitioners I’ve experienced during my 70 trips around the sun. Too often, medical offices with great doctors are poorly run - wait a long time - sometimes hours - beyond my appointment time to see the physician, only to get a perfunctory exam and a few minutes. Med schools can train the best docs, but the business management and marketing skills they need to run a practic get short shrift. Unlike too many others, Dr Scheel’s office runs like a Swiss watch - always on time - yet there is never a rush to get me in & out. The nurses, Physician’s Assistants, and Dr Scheel are unfailingly gracious, and thorough in their examinations and discussions about treatments and procedures. I highly recommend Dr. Monica Scheel Dermatology, and have referred friends and associates to her office." - Jim O.
"I always appreciate Dr. Scheel's attention when I meet with her. I never feel as though she is in a rush to get to the next patient. She always answers my questions and gives me information to improve on my health. As a melanoma survivor, I so appreciate her encouragement to get my annual labs and xrays. Her staff members are always friendly and helpful. I highly recommend Dr. Scheel Dermatology. We are so fortunate to have her in our community." - Tina C.

"Fantastic service! No waiting, everything clearly explained beautiful clean sterile offices. Doctor Scheel is extremely knowledgeable and very patient to answer any questions. Doctor Scheel offered sound advice for my skin care moving forward. I would not trust anyone but Doctor Monica Scheel for all of mine and my families skin care." - Tom A

"I have nothing but respect for Patricia PA. Patricia actually saved my husband's life by diagnosing his melanoma on his right shoulder. Patricia walked into the room and said "that's coming out now". She also identified reasons why I was having acne breakouts in my 50's. The blood test IGg identified numerous foods that contribute to the formation of acne. We have had several other procedures done by Patricia. We love and trust Patricia!" - DeLisa D.
Honestly my best experience with any dermatologist on the Big Island. From booking an appointment, checking in, procedure, and check out. Very easy, and very well adapted to COVID-19 protocols/regulations. The office atmosphere in general is beautiful. I felt very safe and comfortable. I've been to other dermatologists and waited over an hour and a half just to see the doc. With my experience at Monica Scheel, there was very little to no wait at all! I was very hesitant to book at first for removing my facial moles, because the thought of sharp objects near my face terrify me, but PA Natalie and Brooks were very friendly, and made my facial mole removal experience a pleasant one! The procedure was done so quickly, I don't know why I've waited so long to get this appointment done. I highly recommend this dermatologist office! Thank you!

I have gone to Marne (mostly in Waimea) for dermatology (checks for skin cancers and suspicious spots). She knows her stuff and cares about a patient's fears and comfort.  - Larry C.

From the minute you walk through the doors, the experience starts! I love everything about this office. From the staff, the products, and the many different procedures they offer. I have had everything from Botox , chemical peels and basal cell skin cancer removals. Regardless of the treatment or procedure the staff is extremely qualified and there to help you every step of the way.

This office is not just for the ladies. My wife got me a gift certificate at one of the office’s events for a full body skin check. While they were doing my skin check, they used MelaFind and detected a basal cell carcinoma on my cheek. Dr Scheel’s team did a great Mohs surgery on it. Was very impressed and glad I went in for a routine checkup.

If is was not for Dr Monica Scheel Dermatology Office, I would still not know that I had Melanoma on my leg. The spot was so small that I had not noticed it, and was discovered when I had my full body cancer screen check at Monica’s Office, with their professional and caring dedication to the customers.

Patient who attended our Free Skin Cancer Screening – 13 years in Hawaii…. Lots of fun and sun, but I want to take a few minutes and tell you the importance of getting your skin checked regularly. Hopefully we caught this and another spot on my back soon enough. A week later, I got the phone call that I’ve been praying about all week … Melanoma. A nasty skin cancer that if not detected early can grow downward and once in your bloodstream can ultimately kill you. The good news is, with such an early detection, the doc is confident they removed all of the cancer.

Read full story for this patient here