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5 Early Signs of Skin Cancer Miami Residents Should Never Ignore

Florida has one of the highest skin cancer rates in the country — and Miami's year-round UV exposure is a big reason why. Here are five early warning signs dermatologists want you to know.

Dr. Carolina Puyana, MDMay 13, 20267 min read

Florida consistently ranks among the top states for skin cancer diagnoses. Living in Miami means 12 months of intense UV exposure — not just at the beach, but walking to your car, eating lunch outdoors, and sitting near windows. The good news: skin cancer is one of the most treatable cancers when caught early. The bad news: most people don't know what to look for.

Here are five early signs that warrant a same-week dermatology appointment.

1. A mole that follows the ABCDE rule

The ABCDE rule is the gold standard for recognizing melanoma — the most dangerous form of skin cancer:

  • A — Asymmetry: One half doesn't match the other
  • B — Border: Edges are ragged, notched, or blurred
  • C — Color: Multiple shades — tan, brown, black, red, white, or blue within a single lesion
  • D — Diameter: Larger than 6 mm (the size of a pencil eraser) — though melanomas can be smaller
  • E — Evolution: Any mole that changes in size, shape, color, or starts to bleed or itch

Any single one of these is enough to schedule a skin check immediately.

2. A pearly, shiny bump that bleeds easily

This is the classic presentation of basal cell carcinoma (BCC) — the most common skin cancer in the US, with over 3.6 million cases diagnosed annually. BCCs often appear on sun-exposed areas: nose, cheeks, ears, scalp, and shoulders.

They may look like:

  • A flesh-colored or pink pearly bump
  • A pinkish patch of skin
  • A sore that heals and then comes back

BCCs rarely spread to other parts of the body, but they grow locally and can cause significant tissue damage if ignored, especially on the face. Mohs surgery achieves up to 99% cure rates for BCC on the face.

3. A flat, scar-like lesion that appears out of nowhere

A morpheaform or scleroderma-like basal cell carcinoma can look like a pale, flat scar that you don't remember getting. It's one of the more deceptive presentations because it doesn't look like a "cancer." These tend to have deeper roots and are often larger than they appear at the surface.

If you notice a scar-like spot on your face or scalp that wasn't there before, have it evaluated.

4. A rough, scaly red patch that won't heal

This describes actinic keratoses (AKs) and squamous cell carcinoma (SCC). AKs are precancerous — they're your skin's warning sign that UV damage has accumulated past a safe threshold. Left untreated, roughly 5–10% progress to squamous cell carcinoma.

SCC is the second most common skin cancer. When caught early, it's highly treatable. When ignored — especially in immunosuppressed patients — it can spread.

In Miami, we see AKs frequently on the forearms, scalp (especially in men who've spent years in the sun), backs of the hands, and lower legs of women who've spent decades in sundresses.

5. Any sore that keeps coming back

A wound that heals, disappears, and then returns in the same location is a red flag. Both BCC and SCC can mimic non-healing wounds. Don't assume it's a bug bite that's slow to heal — especially if it's been weeks.

Why Miami specifically changes your risk

Florida's UV index regularly hits 10–11 (extreme) for 8+ months of the year. For comparison, New York peaks around 7–8 in summer. This means:

  • Cumulative exposure is higher even if you're not a "beach person"
  • Year-round exposure means no low-UV "rest period" that northern states get in winter
  • Outdoor culture — dining al fresco, sports, pools — adds hours of unprotected exposure that people don't count

According to the Florida Department of Health, Florida has one of the highest melanoma rates per capita in the U.S., and the rate is rising.

What to do next

Annual full-body skin exams with a board-certified dermatologist are the most effective tool you have. We're trained to identify lesions that look normal to untrained eyes. If you haven't had a skin check in the last 12 months — or ever — this is the year to start.

Book your annual screening at Miami Skin Center. Early detection saves lives, and in Miami, it saves a lot of them.

This page is educational. Specific treatment decisions are made during your visit with Dr. Puyana.

Written by

Dr. Carolina Puyana, MD

Double Board-Certified Dermatologist & Mohs Surgeon · Skin Cancer · Lasers · Cosmetic

Dr. Carolina Puyana is a double board-certified dermatologist and Mohs surgeon, recognized for both clinical excellence and academic distinction. She graduated with the Highest Honors at the top of her class from the University of Illinois Chicago College of Medicine, after earning her undergraduate degree from the University of Miami and her Master of Public Health from UM's Miller School of Medicine — also with the Highest Honors. A distinguished physician-scholar, Dr. Puyana has authored over 45 peer-reviewed publications with more than 300 citations, contributed to four major dermatology textbooks, and was awarded a National Institutes of Health research grant for her work on skin cancer disparities. Bilingual in English and Spanish, she founded Miami Skin Center to bring elite, evidence-based dermatology to South Florida — combining academic rigor with the personal attention every patient deserves.

View all articles by Dr. Puyana

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