Brown skin spots - when to take action

Dr Helena Torpinski|Skin cancer
21 November 2019


There are many types of brown skin spots, and while many are harmless, you should take action when it comes to others.

We discussed brown spots you don’t need to worry about in our last blog (read it here).

In this blog, we look at the three types of brown spots that do require action – Squamous Cell Carcinomas (SCC), Basal Cell Carcinomas (BCC) and Melanomas.

These cancers are named after the type of skin cell they form within. Skin cancers are uncontrolled growths of abnormal cells.

The sooner they are identified and treated, the better your chance of avoiding surgery, potential disfigurement or even death – we don’t want to alarm you, but Melanoma kills over 1700 Australians each year, and rates have almost doubled in the last 35 years.

Skin cancers rarely hurt, meaning they’re usually seen, not felt, first. Regular skin checks of your entire body are the best way to catch skin cancers early. Talk to your GP or dermatologist about how often you should be getting your skin checked.

Squamous Cell Carcinoma

SCC is a form of skin cancer which develops in the squamous cells – they’re the cells that make up the middle and outer layers of the skin.

These cancers are not as dangerous as melanomas, though they can be aggressive and if left untreated, can invade and destroy surrounding structures or other parts of the body, causing serious complications.

However, for the most part, SCCs are not life threatening and can be successfully treated.

They can occur anywhere on the body where skin has squamous cells, but will tend to be found on sun-damaged skin – head, neck, face, ears, lips, hands and arms.

And remember – sun damage can be the result of sun tanning beds as well as direct sun exposure.

SCCs can also be an early form of Bowen’s disease.

Symptoms of SCCs

  • a quick growing lump on the skin
  • a patch of sore, rough skin
  • a firm read lump
  • a thickened or warty bump, crusty, itchy or bleeding
  • a scaly patch of skin, may look like an ulcer

If you notice a scab or scaly patch of skin which isn’t healing after a month or two, see your doctor.

Most SCCs are completely curable when caught early.

Basal Cell Carcinoma

BCCs begin in the basal cells. These are cells in the skin that produce new skin cells when old ones die off.

BCC is the most common type of skin cancer, accounting for around 75% of all skin cancer cases.

They’re slow growing and therefore the least dangerous. They are easily curable, however, if left untreated, they can erode into surrounding structures, destroying skin and connective tissue. This can cause ulceration.

Luckily, BCCs don’t spread to other parts of the body.

BCCs most commonly occur on sun exposed areas, such as the head and neck, and are a direct result of sun damage. Consequently, you’re more likely to experience them if you have fair skin, Celtic background, if you work outdoors or play regular outdoor sport.

Worryingly, BCCs were previously only seen in those over 40 year, but are now being diagnosed in patients in their 20’s and 30’s.

Symptoms of BCCs

  • slow growing bump or red patch
  • bleeding or non-healing wound
  • may have a puffy “bubble” appearance
  • may be flat, or have pinkish blotches
  • may seem like a bite or pimple that doesn’t heal

The best way to protect yourself from BCCs is to avoid the sun and use sun protection.


Melanomas are cancers that originate in melanocytes, or pigment cells.

They have the potential to be very dangerous because they can invade nearby tissues and spread to other parts of the body, commonly lungs, liver, bone or brain.

The earlier a melanoma is detected and removed, the more likely that the treatment will be successful. For this reason, regular skin checks for all Australians, particularly those with fair skin, is very highly recommended.

Risk factors for melanomas include having fair skin, skin that burns instead of tanning, freckles and blonde or red hair.

Family history of melanoma can also indicate higher risk, specially in a first degree relative. The gene CDKN2A is key, and if you have deletion or mutation of this gene, you are at higher risk.

Further, if you have lots of moles this increases your risk, as ultraviolet radiation from the sun can damage them and increase their risk of becoming malignant. If you have a childhood history of tanning, sunburn or sunbed use, you’re also at increased risk.

A depressed immune system can also pay a part.

1 in 13 men, and 1 in 22 women, will be diagnosed with melanoma by age 85 in Australia. We have the highest rate of melanoma in the world (together with New Zealand) and it is our third most common cancer.

Symptoms of melanomas

  • an existing mole begins to grow
  • an existing mole changes shape – a previous smooth border becomes irregular or develops an outline that looks notched
  • an existing mole or freckle changes its shade of brown, or develops several different shades or colours
  • an existing mole or freckle gets thicker
  • any spot or bump, mole or freckle that is itchy, bleeding, sore, weeping, looks inflamed, is crusting or flaking
  • any new spot or mark that appears and grows quickly, with an outline that is not smooth or is multi-shaded.

Our advice is to be familiar the moles, freckles and spots on your skin, your partner’s skin or your children’s skin. If you see any change, get it looked at by your GP or dermatologist quickly. Most melanomas will appear on skin that has been exposed to the sun, so they are likely to be in places where you can see them more easily.

Don’t worry – simply take action

Worrying can be a needless waste of energy and time, and will change nothing in the outcome of any experience you may have with skin cancers. Early detection can remove need for concern, so regular skin checks are advised.

Modern technology is developing amazing tools to help doctors note your current moles, freckles and spots, and then compare them from one visit to the next. So be sure to give your skin the best chance of health by attending your regular skin checks on time.

However, if you’ve got spots on your skin that are worrying you, or that have noticeably changed colour, shape or size, that have recently appeared, or that are showing signs of trauma (bleeding, weeping, swelling etc) we strongly suggest you make an appointment with your GP, dermatologist or skin specialist as soon as possible.

To make an appointment with our dermatologist, call our receptionists.