Almirall
Dermatology

Keratinocyte cancer

Keratinocyte cancer refers to a group of skin cancers that develop from keratinocytes, the cells that make up most of the epidermis (the outer layer of the skin). These cancers are commonly grouped under the term non-melanoma skin cancer because, unlike melanoma, they do not originate from melanocytes.

In the majority of people, keratinocyte cancers grow slowly and remain confined to the area where they start, particularly when they are identified early. This local behaviour is important because it means treatment is usually straightforward and highly effective, with excellent outcomes.

What are the main types of keratinocyte cancer?

Non-melanoma skin cancer mainly includes two forms: 

  • Basal cell carcinoma (BCC): This is the most common type of skin cancer. BCCs usually grow slowly and almost never spread to other parts of the body. However, if left untreated, they can gradually invade nearby tissues and cause local damage.
  • Cutaneous squamous cell carcinoma (cSCC): cSCC tends to grow faster than most BCCs and has a higher, although still generally low, risk of spreading to lymph nodes or other organs. 

Doctors often discuss certain precancerous or very early conditions, such as actinic keratosis and Bowen’s disease, alongside keratinocyte cancer because they share similar causes and management approaches.

What triggers keratinocyte cancer?

The main cause of KC is long-term exposure to ultraviolet (UV) radiation, either from natural sunlight or artificial sources such as sunbeds. UV radiation damages the DNA of skin cells, and over time these changes can lead keratinocytes to become cancerous. 

Risk increases as UV damage accumulates over many years. Several factors, such as fair skin, increasing age and a weakened immune system, can further raise the likelihood of developing keratinocyte cancer.

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What are the typical symptoms of keratinocyte cancer?

Non-melanoma skin cancer often appears as a new or changing skin lesion that does not heal. It is most commonly found on areas that receive a lot of sun exposure, including the face, scalp, ears, neck, forearms and hands.

Common warning signs include:

  • A sore or spot that does not heal after several weeks
  • A persistent scaly, crusted or rough patch
  • Bleeding, oozing or repeated scabbing
  • A raised or shiny lump, sometimes with small visible blood vessels
  • A firm, tender or rapidly enlarging nodule, which can be more typical of SCC

Any lesion that changes quickly, becomes painful, bleeds easily or repeatedly reappears should be checked by a healthcare professional.

Explore all keratinocyte cancer signs & symptoms

How is it diagnosed?

Diagnosis of keratinocyte cancer usually begins in primary care. A GP will assess the lesion and, if it appears suspicious, refer the patient to a specialist skin clinic. Specialists often examine the skin using a dermatoscope, a handheld device that allows a closer look at surface structures.

Confirmation is made by taking a biopsy or by removing the lesion entirely and sending it for laboratory analysis. Pathologists then determine the exact type of cancer, how deeply it has grown and other features that help guide treatment decisions.

What treatment options are available?

There are several effective treatments for keratinocyte cancer at all stages, and management is tailored to the type of cancer, its size and location, and individual risk factors.

Surgery is the most common treatment. The lesion is removed along with a small margin of healthy skin. For selected low-risk or superficial lesions, non-surgical options, such as prescription creams, photodynamic therapy or cryotherapy, may be appropriate.

Radiotherapy can be recommended when surgery is not suitable or would cause significant cosmetic or functional problems.

In rare cases where squamous cell carcinoma becomes locally advanced or spreads, specialist teams may use systemic treatments such as immunotherapy.

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Frequently asked questions

References