Concerned with marks, blemishes and sunspots on the skin?

I feel ya.

Most of my hobbies and recreational activities are spent outdoors, largely in the sun, so I've had my share of mysterious skin blemishes that have shown up over the years.

I can certainly commiserate with the anxiety of not knowing what you're looking at when a suspicious spot shows up.

So what are we looking at when one of these mysterious marks appears on our skin?

Are these sunspots, unnoticed birthmarks, or an early skin cancer?!

Now:

I always say it's never a bad idea to err on the side of caution when it comes to this topic and learn all you can. Skin cancer can spread quickly, so early detection is critical.

The Skin Cancer Foundation reports that:

  • 1 in 5 Americans will develop skin cancer by the age of 70.
  • More than 2 people die of skin cancer in the U.S. every hour.
  • Having 5 or more sunburns doubles your risk for melanoma.

I'm here to help clear up a little of the confusion and provide a thorough guide for determining the differences between birthmarks, skin cancer, and sunspots.

(And hopefully, put your mind at ease in the process...)

Let's dive right in.

A sunspot is a blemish on the skin that is the result of the overproduction of skin pigment. The medical name for a sunspot is "actinic lentigines," but you've also probably heard them called liver or age spots.

They're usually pretty small and brownish-grey in color, and they're not raised or textured.

Sunspots usually appear on the body in areas where you get the most sun exposure (hence the name, sunspots) such as your face, back, arms, shoulders, and the back of your hands.

On average, most people develop sunspots around 40, but the age when sunspots form can vary, depending on how much sun exposure they've had.

Sunspots can look similar to cancerous spots when in their early stages, so keep an eye on them. They're not a type of skin cancer, and they don't progress into any kind of skin cancer, so they don't need treatment (unless you want to get rid of them for cosmetic purposes).

If you do notice changes to any of these spots, particularly rapid changes, get it checked right away, either by your doctor or a dermatologist.

If you want to keep your skin even-toned and free from sunspots, protect it from UVA and UVB rays. Follow the same preventative guidelines that are in place to protect from skin cancer. This means:

  • Apply sunscreen liberally and reapply regularly per the products' instructions, particularly when swimming or sweating. Choose SPF 30 or higher. No DIY sunscreens, I'm begging you.

  • Cover up with clothing. Keep sunspots off of your face, shoulders, and all those other places they tend to congregate by covering your skin and shielding your face. 

  • Avoid the sun between 10 a.m. and 3 p.m.

  • Choose cosmetics with an SPF.

  • Stay out of the tanning bed. Completely.

A birthmark is an irregularity that can occur anywhere on the skin. Usually, it's present at birth or develops within a month after birth. There are two kinds of birthmarks: vascular and pigmented.

(Image source: https://factdr.com/)

  • Vascular birthmarks are caused by an overgrowth of blood vessels.
  • pigmented birthmarks are caused by an overgrowth of skin-pigment cells.

Some birthmarks can also be caused by an overgrowth of smooth muscle, fat, keratinocytes, or fibroblasts.

A birthmark's appearance is as diverse as the people who have them. They can be different colors, such as brown, purple, red, tan, and even pale blue. They can vary in size and texture, some being raised, and some flat.

Most birthmarks are harmless and may end up fading on their own. Like sunspots, birthmarks should be regularly monitored both by yourself and your doctor/dermatologist. You should be looking for changes in pigmentation, size growth, and elevation if your birthmark is raised, like a mole.

Although rare, moles can sometimes turn into skin cancer. This becomes more of a concern with aging, so it's important to have any moles you may have checked at your yearly checkup, or as needed if they change in size or appearance.

Skin cancer is a condition where a change occurs in otherwise normal skin cells, making them multiply and grow in abnormal ways. As they multiply and spread (a process called metastasis), a tumor forms.

Like other cancers, what makes skin cancer so dangerous is that if untreated, the developed tumors can invade the space of the tissues surrounding them, robbing them of the oxygen and nutrients they need.

  • If you've already had skin cancer before. If you've had skin cancer once, you're at a higher risk of developing it again.

  • A family history of skin cancer. If anyone in your family, particularly a closer relative such a sibling, parent, aunt or uncle, grandmother or grandfather has had skin cancer, you may be at higher risk of developing it.

  • A weakened immune system. People living with HIV/AIDS, those who are taking immunosuppressant drugs, and people with other conditions that cause weakened immune systems have a higher risk of developing skin cancer.

  • Precancerous skin lesions. Lesions known as actinic keratoses are precancerous skin growths that can increase your risk of developing skin cancer. They're mostly found in fair-skinned people who have had sun damage, most commonly on the face, hands, and head. They range in color and appear as rough, scaly patches.

  • Moles. Abnormal moles, which are generally larger and more irregular looking than normal moles, are called dysplastic nevi. These moles should be watched regularly, as they are more likely to become cancerous than regular moles.

  • Fair skin. Having fair skin means you have less pigment in your skin. This lack of pigment (melanin) means your skin has less natural protection from potentially damaging UV rays. Fair-skinned people who freckle or sunburn easily are also more likely to develop skin cancer. That said, keep in mind that anyone can get skin cancer, regardless of skin tone and color, so don't get complacent on getting those checkups if you're not a fair complected person!

  • A history of sunburns. While sunburns at any age put you at risk for skin cancer, if you've had blistering sunburns (even just one) as a kid or teenager, you're at an increased risk of developing skin cancer later on.

  • Excessive sun exposure. Let's be clear: spending time in the sun is fun, hence the term "fun in the sun." But, spending a lot of time exposed to UV rays without the protection of sunscreen or clothing increases your risk of developing skin cancer. I don't mean to rain on the tanning parade, but a tan is just your skin's reaction as an injury response to exposure to too much UV radiation.

  • Sunny or high-altitude climates. People living in higher elevations are exposed to stronger UV rays, as are people who live in sunny, warm climates. Greater exposure means higher risk.

  • Exposure to certain substances. Certain substances can increase the risk of skin cancer. Arsenic, asbestos, and beryllium are a few examples.

  • Exposure to radiation. Radiation treatments, such as those for skin conditions like acne and eczema, may cause an increased risk of skin cancer.

There are three types of skin cancer, and they are named for the specific skin cells where it develops:

• Basal Cell Carcinoma: The most common type of skin cancer, basal cell carcinoma damages the tissue around it like other cancers, but it grows slowly, and isn't very likely to spread too far and damage organs or cause death. Usually, basal cell carcinomas can be removed with little to no invasive methods of surgery, laser surgery being the most common method of carcinoma removal.
• Squamous cell carcinoma: Squamous cell carcinomas, along with basal cell carcinomas, are referred to as "common" skin cancers. Squamous cell carcinoma grows slowly as well, usually over months, but if untreated can spread farther than basal cell carcinomas. It shows up on areas of skin most prone to sun exposure and looks like a scaly red spot that can crust and bleed when scraped.

      • Melanoma

Melanomas are very dangerous because they can grow fast and spread to other parts of the body. A melanoma can become life-threatening within as little as six weeks, so early detection is crucial. Melanomas, including a particularly dangerous form called nodular melanoma, can appear on areas of the skin not ordinarily prone to sun exposure.

Look for flat, blotchy spots, with a blurry or uneven outline. They can be more than one color, including red, brown, black, blue, or grey. Nodular melanomas look different from the more common melanomas. They're raised, and instead of blotchy, they have a more even coloring. Again, a nodular melanoma is very dangerous and grows faster than the more common melanomas, so get to your doctor immediately if you suspect you may have one.  

The ABCDE rule is a rule of thumb when looking for melanoma:

  • Asymmetry. Be suspicious of spots that are asymmetrical, not round.
  • Border. If it's got an uneven border, get it checked out.
  • Color. Look for spots that have uneven or odd coloring.
  • Diameter. Look for spots bigger than 7 mm.
  • Evolving. If you notice new moles or a change in a mole you've already got, or you have strange patches on the skin you hadn't seen before- go get it checked out.

There are many ways we can help prevent and deter skin cancer.

      • Apply sunscreen liberally.

Reapply regularly per the products' instructions, particularly when swimming or sweating. Choose SPF 30 or higher, but remember there is no SPF that can block the sun's rays completely. Which is why you should also...

      • Cover up with clothing.

I know the sun feels good on your skin on a breezy beach day, but if you want to be safe, you gotta cover those places which are the most exposed to the sun, like the shoulders, back, arms, face, etc. Wear a sunhat and sunglasses, a swim cover-up, a t-shirt, or whatever you like that's comfortable and protective. Lots of surf companies make great swim shirts that provide excellent protection against harmful UV rays.

      • Avoid the sun between 10 a.m. and 3 p.m.

This is the time of day when the sun's rays are at their strongest. Getting out earlier in the morning or later in the evening for outdoor activities is a good practice.

      • Choose cosmetics with an SPF.

Many cosmetic companies offer choices with varying degrees of SPF protection. If you're going to be wearing makeup anyway, this is a great, low maintenance way to keep your skin protected.

      • Stay out of the tanning bed. Completely. That is all.

      • Know the side-effects of your medications.

Be sure to ask your doctor or pharmacist about any side effects of your medications, both prescription and over-the-counter. Some common drugs, like certain antibiotics, can make your skin more sensitive to light, and you'll need to take extra care to stay out of the sun.

In addition to what we've looked at so far, there are a couple of other skin conditions worth mentioning in this article:

Melasma is another of those common skin problems that affect areas with more sun exposure, appearing as patchy, brownish-gray spots, mainly on the face. Melasma is more common in women, particularly during pregnancy, and is thought to be triggered by hormones. Melasma is not considered a dangerous skin condition.

A genetic trait usually seen in fair-skinned people, freckles are flat, brownish spots that darken in the summer with more sun exposure. They tend to fade in the winter, in some people disappearing altogether. Generally, freckles become less noticeable with age.

I hope this guide to determining the differences between birthmarks, skin cancers, and sunspots has taught you a little about what to look for when looking at skin blemishes!