LIFESTYLE NEWS - A sore that will not heal, a patch of skin that repeatedly bleeds or crusts, or a mole that begins to change may seem insignificant. But these can be warning signs of skin cancer and should not simply be ignored.
As South Africa marks Albinism Awareness Month in September, attention is being drawn to the heightened risk of sun damage and skin cancer faced by people living with albinism.
Albinism is a genetic condition that affects the production of melanin, the pigment that gives colour to the skin, hair and eyes. Because people with albinism produce very little or no melanin, they have less natural protection against ultraviolet (UV) radiation.
Professor Chrysis Sofianos, a triple board-certified plastic surgeon and Academic Head of the Division of Plastic and Reconstructive Surgery at the University of the Witwatersrand, says ongoing sun protection and awareness of changes to the skin are particularly important.
“Protect your skin and know what is normal for you so that you can have any concerning changes assessed early,” he says.
Skin cancer is not always obvious
One challenge in detecting skin cancer in people with albinism is that some lesions may not have the pigmentation commonly associated with suspicious skin changes.
This means colour should not be the only factor considered when deciding whether a lesion requires medical attention.
Sofianos also points out that skin cancer is not exclusively a disease affecting fairer skin. While higher levels of melanin provide greater natural protection, people with darker skin can also develop skin cancer.
Some skin cancers may occur in areas that receive little sun exposure, including the soles of the feet, palms and underneath the nails.
“Everyone should be familiar with their skin and pay attention when something changes, including in less obvious areas,” he says.
Nearly 27 000 skin cancer cases recorded
The scale of skin cancer in South Africa is reflected in figures from the National Cancer Registry (NCR).
The NCR recorded 26 967 cases across three major skin cancer categories in 2024: basal cell carcinoma (BCC), squamous cell carcinoma (SCC) of the skin and melanoma.
BCC was also ranked as the second most common cancer among men and third among women, while SCC of the skin ranked third among men and fourth among women.
Sofianos says these figures highlight why people should not assume that a small or painless skin lesion is harmless.
“Many lesions begin as something very small and seemingly insignificant,” he says.
Warning signs can include:
- a new growth;
- a sore that repeatedly fails to heal;
- a lesion that bleeds or crusts; and
- changes in the size, shape or colour of an existing mole.
Anyone concerned about a skin change should have it assessed by an appropriate healthcare professional rather than attempting to diagnose it themselves.
Early treatment can mean less extensive reconstruction
The consequences of delaying treatment can extend beyond the cancer itself.
Skin cancers affecting areas such as the nose, eyelids, ears, scalp and other parts of the face may require the removal of affected tissue. Depending on the size and location of the resulting wound, reconstructive surgery may then be necessary.
“People often think of plastic surgery purely in aesthetic terms, but reconstruction after cancer treatment is a significant part of the speciality,” says Sofianos.
Albinism Awareness Month provides an opportunity to highlight the particular health challenges faced by people with albinism. Photo: Supplied
Reconstructive surgery can involve restoring both the appearance and function of an affected area.
For people with albinism, the ongoing risk of UV-related damage can also mean that treatment is not necessarily a once-off experience. Some patients may develop multiple cancerous or precancerous lesions over time, making continued skin protection and follow-up important.
Don't let fear of scarring delay treatment
Sofianos says the effects of delayed diagnosis can be seen when larger lesions require more extensive removal and reconstruction.
This can potentially result in more visible scarring and longer wound-healing periods.
“The earlier we can identify and appropriately treat a cancer, the better our chance of limiting how much tissue needs to be removed and how extensive the reconstruction may need to be,” he says.
For this reason, concern about scarring should not prevent someone from having a suspicious lesion assessed.
Protect your skin and act on changes
Albinism Awareness Month provides an opportunity to highlight the particular health challenges faced by people with albinism, while also reminding the wider public that skin cancer can affect anyone.
For people with albinism, careful protection from UV exposure and regular attention to their skin are especially important.
For everyone, the message is straightforward: if a skin lesion is changing, bleeding, repeatedly crusting or failing to heal, don't ignore it. Have it checked.
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