I Was Diagnosed With Skin Cancer at 41. It Looked Like Dry Skin.

11 minutes ago
6 min read

I wear sunscreen on my face every single day. I’ve never been the girl all oiled up baking in a lounge chair for hours. I've done the things you're "supposed" to do.

None of that stopped me from getting diagnosed with skin cancer at 41.

Picture on the left was the morning of my MOHS procedure to remove the infiltrative basal cell carcinoma on my nose. Picture on the right was about an hour later where he marked where the skin cancer was. Can you see it?

It started as a spot I kept picking at

I had a small patch of dry skin my left nostril that I thought absolutely nothing of. Randomly, it would flake. I’d exfoliate my face and it would come off and look totally normal. But I started noticing it would eventually come back weeks later. One time I picked at it and a tiny (and I mean TINY!) amount of blood came with it. I knew I was going for my skin check in the next fews months so I made a mental note to remember to tell my dermatologist about it.

When I went for my annual skin check, I brought it up to my dermatologist. She didn’t find it (not blaming anyone here just worth mentioning because it would have been nearly impossible to see unless you were specifically looking for it.) It was also in the corner of my nose right in the nostril crease so very easy to miss or brush off. She wanted to biopsy it.

About 10 days later I got the biopsy results back: infiltrative basal cell carcinoma.

I'd heard of basal cell carcinoma before but until it hits you, it doesn’t really mean much. I didn't know "infiltrative" was a word attached to it, or what that word meant for my treatment. So I went down a research rabbit hole, and I want to walk you through what I learned, because a lot of it surprised me and I think it helps to know what it is and what to look for.

What basal cell carcinoma actually is

Basal cell carcinoma (BCC) is the most common form of skin cancer, and one of three main types you'll hear about:

Basal cell carcinoma (BCC): The most common. Slow-growing, rarely spreads to other parts of the body, but can cause real damage locally if ignored, especially on the face.
Squamous cell carcinoma (SCC): The second most common. Can grow faster than BCC and has a higher chance of spreading if untreated.
Melanoma: Less common than BCC and SCC, but the most dangerous, because it's the type most likely to spread and become life-threatening.

BCC's reputation is "the skin cancer that won't kill you," and statistically, that's true. But "won't kill you" and "no big deal" are not the same thing, especially when it shows up on your face. Removing it can mean real reconstruction, and the earlier it's caught, the smaller that reconstruction has to be.

Why "infiltrative" changes the story

Not all basal cell carcinoma behaves the same way. Mine was the infiltrative subtype, which is one of the more aggressive forms BCC can take.

Here's what that means in plain terms: instead of growing as one contained lump you can see and measure, infiltrative BCC grows in thin, irregular strands that push down into the skin, often extending much further and deeper than what's visible on the surface. That's part of why it can look so unassuming, like a scar, a rough patch, or in my case, "just dry skin," while actually reaching deeper than expected underneath. It doesn’t necessarily have a classic look.

It's also why the standard treatment for infiltrative BCC is Mohs micrographic surgery, a procedure where the surgeon removes a thin layer of tissue, examines it under a microscope on the spot, and keeps going layer by layer until the margins come back completely clear. It's precise by design, because with a cancer that spreads in unpredictable strands, "we think we got it all" isn't good enough. You need to actually confirm it.

The upside: caught and treated this way, basal cell carcinoma has a five-year cure rate around 99%. That's about as good as outcomes get in oncology.

The tradeoff: because Mohs keeps removing tissue until margins are clear, you don't know how big the resulting hole will be until it's over. Mine left a defect in my nostril about a centimeter wide, which then required a second procedure, a flap repair with a plastic surgeon, to reconstruct the area. I'm in the healing process now.

Biopsy request form with syringe, scalpel, and sterile blade wrapper; label reads basal cell carcinoma on a clinical desk.

What basal cell carcinoma can actually look like

This is the part I most want people to walk away with, because "picture a mole" is the wrong mental model entirely. BCC doesn't need to look dramatic to be serious. Watch for:

A shiny, pearly, or waxy bump, sometimes with small visible blood vessels
A flat, scaly, or scar-like patch, especially one that looks slightly sunken or indented
A sore that won't heal, or one that seems to heal and then reopens
A spot that bleeds, oozes, or crusts with no clear reason why
A reddish or pink patch that persists for weeks without resolving
Any "dry skin" that you find yourself picking at over and over, instead of it just running its course

Notice what's not on that list: an irregular mole with uneven color. That's the classic melanoma warning sign, and it's genuinely useful for melanoma. But it's not built for basal cell carcinoma, which is a big part of why BCC gets missed. It doesn't play by the mole rules.

Here’s the scary part, even though the list above is worth knowing, there isn’t really a “distinct” look for BCC. It can be extremely unassuming just like it was in my case. I scoured the research for pictures to share with you all and the thing is, there are just too many different images to make it make sense. If there is something that looks different, won’t go away, comes back, bleeds, or is at all discolored or raised, please get it checked out.

This isn't just an "older person" disease

BCC is often talked about as something you get in your 60s and 70s after decades of sun damage. The data tells a more complicated story. Basal cell carcinoma incidence has been rising in adults under 40, with a disproportionate increase specifically in young women. I was 41. I was not the exception the statistics would have you expect. I will say that I was the youngest by more than 20 years when I was in the surgeons office. Both the plastic surgeon and the Mohs surgeon commented on my young age.

What to actually do about this

Get an annual skin check with a dermatologist. Not a "someday" item. A yearly appointment, on the calendar, the same way you'd book a dentist cleaning. I’m actually going to be upping my frequency to every 6 months now that I have been diagnosed. I don’t ever want to go through anything like this again if I can help it.

Get anything questionable looked at between visits, too. You don't need to wait for your annual appointment if something changes. If you notice any of the following, call your dermatologist:

A spot or patch that hasn't healed in more than a few weeks
Anything that bleeds, crusts, or oozes without an obvious cause
A "dry patch" you find yourself picking at repeatedly
Any new bump, sore, or discoloration that just doesn't look like the skin around it
A scar-like area that showed up out of nowhere

Trust "this looks a little off" over "this is probably nothing." I could have easily talked myself out of mentioning mine. It genuinely looked like nothing to me. Now I know better.

I’m not done here. In part 2 I'll go deeper on sun exposure, what the evidence actually shows about prevention, and what else is in our control.

This post is for educational purposes and shares my personal experience. It is not medical advice and isn't a substitute for an evaluation by a licensed dermatologist. If you notice anything on your skin that concerns you, please make an appointment to have it checked.

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