Skin Cancer Signs Patients Miss: Sores That Won't Heal and Hidden Spots

A brown spot on the cheek brought aging expert Amy O'Rourke to a dermatologist — but the full body scan found squamous cell carcinoma on top of her head. She had surgery, and the cheek spot wasn't the story at all.

That case, highlighted in a recent Gray Media consumer health segment, is the pattern dermatologists say they see constantly: patients check the visible, sun-exposed areas and miss the lesions hiding where mirrors and eyes don't reach.

"You have to look everywhere because they can hide," said Dr. Rhea Rogers, a board-certified physician. "They can be behind your ears, between your toes, underneath the nails."

What are the warning signs people overlook?

Beyond the classic changing mole, Rogers flagged two signs patients routinely dismiss:

• Sores that don't heal
• Moles that bleed easily

Rogers walked through the standard clinical criteria physicians use when evaluating a lesion — the familiar asymmetry, border, color, diameter and evolution checklist.

"We look at the asymmetry, how symmetric is it? Is it the border of it? Does it change? The color, the color can change. The diameter, and then evolving. Is it changing in its appearance to you?" Rogers said.

Gerontologist "Sam" Cradduck stressed that change matters even in spots a patient has had for decades. "A millimeter can matter a lot," Cradduck said. She advised tracking whether a mole has grown, shifted in symmetry, or started to bleed.

Rogers added a caution that cuts against patient intuition: "They don't always look scary. But that's what makes them so dangerous."

Why can't patients do this alone?

Self-exams have a blind-spot problem. The scalp, the backs of the ears, between the toes — these are places a patient can't inspect alone. Rogers said a physician's exam, or a partner's help, covers the territory a solo check misses.

O'Rourke's case is the concrete proof: her presenting complaint was on her cheek, and the cancer was on her scalp. Aging well coach Katherie Ambrose said she recently established care with a dermatologist, had a full body scan, and brought her husband in for one as well.

The practical ask, per the segment: at the annual dermatology visit, request a full body exam, and ask about mole mapping to track changes over time.

Does insurance cover it?

Rogers raised an access point many patients don't know: some insurance plans cover an annual dermatology exam the same way they cover a well woman exam. She suggested patients check with their insurance before assuming the visit is out of pocket — a call that could remove a real barrier to screening.

How much of the risk is genetics?

O'Rourke's own family history is stark: around three-quarters of her relatives have had skin cancer. Asked whether that risk is genetic or environmental, Rogers said it's probably both — fair skin, age and family history all raise baseline risk.

On the environmental side, Rogers flagged a detail most patients miss: UVA and UVB light are invisible and pass through glass, meaning window exposure still counts.

The cancer types present differently, and Rogers drew the distinction plainly. Melanoma is usually linked to intense, intermittent but deep sunburn and tends to look like a mole. "It spreads very quickly," Rogers said. "So you definitely want to pay attention." Squamous cell and basal cell carcinomas are more likely to appear as pinkish, itchy lesions or sores that won't heal.

Who needs sunscreen?

Rogers directly addressed a persistent myth — that African Americans don't need sunscreen. "Yes, you need sunscreen," she said. Sunscreen protects against damage to cells and DNA, regardless of skin tone.

Beyond sunscreen, the segment pointed to physical barriers: rash guards, sun guards, UV-protective clothing and wide-brimmed hats.

What does this change for patients over 50?

The segment's through-line is that older patients carry decades of accumulated sun exposure, and the highest-yield intervention is the one O'Rourke stumbled into: a full body exam, not a spot check. With some insurers covering an annual dermatology visit and mole mapping available to document change over time, the tools exist — the shift is asking for them before a hidden lesion announces itself.