It usually occurs after the age of forty and is more prevalent in blond, fair-skinned men. Unlike many other malignant growths, it does not spread until it has been present for a long period of time. The cell damage results in an ulcerlike growth that spreads slowly as it destroys tissue. A large pearly-looking lump, most often on the face by the nose or ears, is usually the first sign. About six weeks after it appears, the lump becomes ulcerated, with a raw, moist center and a hard border that may bleed.
Scabs continually form over the ulcer and then come off, but the ulcer never really heals.
Sometimes basal cell carcinomas show up on the back or chest as flat sores that grow slowly. In squamous cell carcinoma, the underlying skin cells are damaged and this leads to the development of a tumor or lump under the skin, most often on the ears, hands, face, or lower lip. The lump may resemble a wart or a small ulcerated spot that never heals. This type of skin cancer occurs most frequently in fair-skinned men over sixty years old. The risk is higher for those who have had long-term outdoor employment and for those who reside in sunny climates.