Many people are surprised to learn that skin cancer often doesn’t hurt in its early stages. This is especially true for nonmelanoma skin cancers, such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Pain is more likely to develop as skin cancer grows.

As skin cancer grows, it may become painful if lesions (spots or growths on the skin) get larger, form open sores, grow into deeper tissue, or affect nearby nerves.

Learn more about when skin cancer can become painful, what that pain can feel like, and other sensations you may experience when you have skin cancer.

Pain Can Be a Symptom of Skin Cancer

Early nonmelanoma skin cancers often don’t hurt because they stay in the outer layers of the skin. As the cancer grows deeper, however, it can damage surrounding tissue and trigger inflammation.

Some lesions may break down and form open sores, called ulcers, which can become tender or painful. In rare cases, skin cancer can grow into nearby nerves, causing more significant discomfort.

A skin lesion that doesn’t hurt can still be cancerous, which is why it’s important to pay attention to changes in your skin rather than relying on pain as a warning sign.

Pain May Indicate a More Advanced Tumor

Pain doesn’t always mean skin cancer is serious, but it can sometimes be a sign that a tumor (cancerous growth) has grown beyond the earliest stages.

Nonmelanoma skin cancers often begin in the top layers of the skin. As they grow, they may extend into deeper layers of skin and nearby tissues. Larger tumors are more likely to become inflamed or affect nearby nerves, all of which can contribute to discomfort.

Nonmelanoma skin cancer is usually slow-growing, so it can often be detected and treated early, before it spreads. Delaying care for a suspicious mole or skin spot could allow it to keep growing, increasing the risk of symptoms such as pain or bleeding.

That’s why dermatologists recommend paying attention to changes in your skin, even if a spot doesn’t hurt. Early treatment can often prevent lesions from growing larger and causing symptoms such as pain or bleeding.

Squamous Cell Carcinoma May Cause More Pain Than Basal Cell Carcinoma

A 2012 study found that about 40 percent of people with SCC reported pain compared to about 18 percent of people with BCC.

Researchers aren’t completely sure why SCC tends to cause more pain than BCC. One possible explanation is that SCC is more likely to grow into deeper layers of skin and surrounding tissue. Because of this tendency, SCC may irritate nerves or trigger inflammation more often than BCC.

Itchiness May Be More Common Than Pain

One study found that itchiness was the most commonly reported symptom of both BCC and SCC.

Although some people may confuse itching and pain, it’s also possible to have both. Because itching is so common, skin cancer may be mistaken for dry skin, eczema, or an insect bite. If an itchy spot doesn’t heal, keeps growing, or repeatedly bleeds or crusts over, it’s important to have it checked by a dermatologist.

Some People May Have More Pain Than Others

Some people with skin cancer are more likely to have pain than others.

For example, people who’ve had an organ transplant may be more likely to develop aggressive forms of nonmelanoma skin cancers, which can be painful.

Tumor location can also affect how much discomfort a person experiences. Skin cancers that develop in areas with many nerve endings or that grow into nearby nerves are more likely to cause pain.

Other Symptoms To Watch For

Because early signs of nonmelanoma skin cancer often aren’t painful, you’re more likely to notice skin changes before you feel discomfort.

You should watch for visible changes in your skin, including:

• A new growth, spot, or bump on the skin
• Open sores that don’t heal or that heal, scab, and come back
• Rough or scaly patches that might crust or bleed
• Existing moles, freckles, or other spots that change in size, shape, color, or texture
• Moles or freckles with an odd shape or irregular borders
• Shiny, waxy, or translucent bumps
• Wartlike growths
• Skin growths with raised edges and a lower center
• Flat, firm areas that may look pale, yellow, white, or scarlike
• Raised patches that may itch, crust, or bleed

BCC growths may feel smooth and waxy, while SCC lesions may feel rough and scaly.

When Should You See a Dermatologist?

Nonmelanoma skin cancer doesn’t usually hurt in its earliest stages, which is why pain isn’t considered a reliable warning sign. Many people first notice a new growth, a sore that won’t heal, or an itchy patch of skin before they feel any discomfort.

As BCC and SCC grow, however, pain may develop — especially if the lesion becomes ulcerated or inflamed or it affects nearby nerves. Paying attention to changes in your skin and seeking medical care early can help lead to earlier diagnosis and treatment.

While some melanomas might become sore, itchy, or painful as they grow, they may also be painless in their early stages.

You don’t need to wait until a skin lesion becomes painful to have it checked. Consider making an appointment with a dermatologist if you notice any of the symptoms above or any skin changes you’re concerned about.

Early detection is one of the most important factors in successfully treating skin cancer. When found early, many skin cancers can be treated before they grow deeper into the skin or spread to other parts of the body.

Join the Conversation

On MySkinCancerTeam, people share their experiences with skin cancer, get advice, and find support from others who understand.

Have you had pain related to skin cancer? Let others know in the comments below.