Skin cancer can look like a pearly bump, a scaly red patch, a dark streak under your nail, or a mole that’s changed shape or color over a few weeks. There’s no single appearance, because the three main types of skin cancer each show up differently on the skin. Knowing what to look for across all three types gives you the best chance of catching something early.
Basal Cell Carcinoma
Basal cell carcinoma is the most common skin cancer, and it often looks surprisingly subtle. The classic sign is a slightly transparent, dome-shaped bump with a pearly or waxy surface. On lighter skin, this bump tends to look pearly white or pink. On brown and Black skin, it often appears brown or glossy black with a rolled, raised border. You may notice tiny blood vessels running across the surface, though these are harder to see on darker skin tones.
Not all basal cell carcinomas look like bumps. Some show up as flat, scaly patches with or without a raised edge. Others look like white, waxy, scar-like areas without a clear border, which makes them easy to dismiss. A brown, black, or blue lesion with dark spots and a slightly raised, translucent border is another presentation. These bumps and patches tend to bleed easily, scab over, and then reopen. A sore that won’t fully heal is one of the most reliable warning signs.
Squamous Cell Carcinoma
Squamous cell carcinoma typically looks rougher and more textured than basal cell. The most common form is a firm bump (or nodule) that can be pink, red, brown, or black depending on your skin tone, sometimes even the same color as the surrounding skin. It can also appear as a flat sore topped with a scaly, crusty surface.
Pay attention to any new sore or raised area that develops on an old scar or a spot that was previously injured. On the lips, squamous cell carcinoma often starts as a rough, scaly patch that eventually breaks open into a persistent sore. It can also develop as a raised, wart-like growth on the genitals or anus, or as a rough patch inside the mouth. These lesions tend to feel gritty or sandpaper-like to the touch.
Precancerous Patches: Actinic Keratosis
Before squamous cell carcinoma develops, you may notice actinic keratoses, which are precancerous spots caused by years of sun exposure. These are rough, dry, scaly patches usually less than an inch across. They can be flat or slightly raised, and their color ranges from pink to red to brown. Many people feel them before they see them: running your fingers over the skin, you’ll notice a sandpaper-like texture. Some patches itch, burn, bleed, or develop a hard, wart-like surface. Not all of them progress to cancer, but treating them early eliminates the risk.
Melanoma and the ABCDE Rule
Melanoma is less common than basal or squamous cell carcinoma but far more dangerous. The ABCDE rule is the standard framework for spotting it early:
- Asymmetry: One half of the mole doesn’t match the other.
- Border: The edges are ragged, notched, or blurred, and pigment may spread into the surrounding skin.
- Color: Multiple shades of brown, black, and tan are present. You may also see areas of white, gray, red, pink, or blue within the same spot.
- Diameter: Most melanomas are larger than 6 millimeters (about the size of a pencil eraser), though they can start smaller.
- Evolving: The mole has changed in size, shape, or color over weeks to months.
That last point is especially important. Normal moles do change over a lifetime, but those changes happen very slowly, over years. Changes that happen in weeks to months are the ones that need evaluation.
Nodular Melanoma
Not every melanoma follows the ABCDE pattern. Nodular melanoma grows vertically into the skin rather than spreading outward, so it may look symmetrical and have even borders. Instead, watch for the EFG features: the spot is elevated above the skin surface, firm to the touch (more solid than soft), and growing noticeably over weeks or months. These lesions often look like a raised dome or a dark, firm bump and can be aggressive, so rapid growth alone is a reason to get checked.
Amelanotic Melanoma
Some melanomas contain little or no pigment at all. These “amelanotic” melanomas often show up as a pink to red bump, flat spot, or fleshy nodule rather than a dark mole. Because they don’t look like what most people picture when they think of skin cancer, they’re frequently misidentified as a pimple, bug bite, or irritation. Any new pink or red spot that persists for several weeks and doesn’t respond to basic care deserves a closer look.
Skin Cancer Under the Nails
Melanoma can develop under a fingernail or toenail, where it typically appears as a dark brown or black vertical streak running from the base of the nail to the tip. The streak usually starts narrow, less than 3 millimeters wide, but gradually widens over time, often starting at the bottom of the nail first. In more advanced cases, the discoloration can spread beyond the nail onto the surrounding skin, a sign known as the Hutchinson sign. Some subungual melanomas produce no color change at all and instead cause a small, irregularly shaped growth that lifts or damages the nail.
This type of melanoma is the most common form of melanoma in people with dark skin, and it also occurs on the palms of the hands, the soles of the feet, and on fingers and toes. A dark patch on your palm or the bottom of your foot, or a dark band under your nail, warrants professional evaluation.
How Skin Cancer Looks on Darker Skin
Most skin cancer images online show examples on lighter skin, which can make it harder for people with brown or Black skin to recognize warning signs on their own bodies. Basal cell carcinoma on darker skin often appears as a brown or glossy black bump rather than the classic pearly pink. Squamous cell carcinoma may present as a dark brown or black nodule rather than a red, scaly patch.
Melanoma in people with dark skin is more likely to occur in areas that get less sun exposure: palms, soles, nail beds, and the skin between fingers and toes. This form, called acral lentiginous melanoma, can look like a dark patch on a palm or sole, or a dark streak under a nail. Because skin cancer in darker skin often appears in less obvious locations and in less recognizable colors, it’s frequently diagnosed at a later stage. Checking your palms, soles, nails, and the spaces between your toes is just as important as scanning sun-exposed areas.
Merkel Cell Carcinoma
Merkel cell carcinoma is rare but aggressive. It typically appears as a firm, painless, reddish or purplish bump on sun-exposed skin, most often on the head, neck, or arms. The characteristics that distinguish it can be remembered with the acronym AEIOU: the bump is asymptomatic (not tender), expanding rapidly, found in someone who is immunosuppressed, older than 50, and located on a UV-exposed area with fair skin. Because it doesn’t hurt and can look like a cyst or other harmless bump, rapid growth is the most useful early clue.
What Actually Warrants a Skin Check
The common thread across all types of skin cancer is change. A spot that grows, bleeds, crusts, changes color, or refuses to heal over several weeks is doing something that normal skin doesn’t do. The specific appearance varies widely, from pearly bumps to pink patches to dark nail streaks, which is why no single checklist catches everything.
A practical habit is to do a full skin check once a month, covering sun-exposed areas, scalp, nails, palms, soles, and the skin between your toes. You’re not looking for a specific shape or color. You’re looking for anything new, anything different from your other spots, and anything that’s changed recently. Dermatologists sometimes call this the “ugly duckling” sign: the mole or spot that doesn’t look like any of your others is the one worth investigating.