What Hugh Jackman's Story Can Help Us Understand About Skin Cancer

The sentence that matters

NBC News reported in April 2023 that Hugh Jackman, then 54, had posted an Instagram video saying he had two biopsies on spots on his nose. His doctor had told him they might be basal cell carcinoma. "I'll find out in two or three days, and as soon as I know, I'll let you know," he said.

He used the moment for one message. "If I can just take this opportunity to remind you summer is coming, for those of us in the Northern Hemisphere, please wear sunscreen," he said. "No matter how much you want a tan, trust me, trust me, trust me. This is all stuff that happened 25 years ago; it's coming out now. Put some sunscreen on."

NBC noted he had posted similar videos after biopsies in August 2021, February 2017, May 2014 and November 2013.

That last line in his video is the medicine. The damage that produces a skin cancer on a nose in your fifties was done decades earlier, and it cannot be undone. What you can change is the next twenty-five years.

Three cancers in one word

NCI describes the skin's outer layer, the epidermis, as containing three kinds of cell, and each one gives rise to a different cancer.

Squamous cells are thin and flat and form the top layer. Basal cells are round and sit underneath them. Melanocytes sit lower still and make melanin, the pigment that colors skin and darkens it in the sun.

So basal cell carcinoma starts in basal cells, squamous cell carcinoma in squamous cells, and melanoma in melanocytes. Melanoma is much less common than the other two, but far more likely to invade nearby tissue and spread.

Jackman's own phrase for basal cell carcinoma, "the least dangerous of them all," is a fair summary of the ranking. It is not a reason to leave one alone. Our page on melanoma covers the type that behaves differently.

What these cancers look like

NCI lists the signs of basal cell and squamous cell carcinoma:

• A sore that does not heal
• An area that is raised, smooth, shiny and looks pearly
• An area that is firm and looks like a scar, and may be white, yellow or waxy
• An area that is raised and red or reddish-brown
• An area that is scaly, bleeding or crusty

NCI adds where they turn up: most often on skin exposed to the sun, such as the nose, the ears, the lower lip or the backs of the hands. Jackman's spots were on his nose, one of the sites NCI names first.

There is also a precancerous change worth knowing. Actinic keratosis appears as a rough, red, pink or brown scaly patch, flat or raised, usually on the face or the backs of the hands. It can also show as cracking or peeling of the lower lip that lip balm does not fix.

How they are treated

Diagnosis is a skin exam followed by a biopsy: all or part of the abnormal growth is cut out and examined under a microscope. That is what Jackman described.

NCI lists several surgical options for basal cell carcinoma, squamous cell carcinoma and actinic keratosis:

• Simple excision. The growth is cut out with a margin of normal skin.
• Mohs micrographic surgery. The tumor is removed in thin layers, and each layer is checked under a microscope during the procedure. Layers keep coming off until no cancer cells are seen. NCI notes it removes as little normal tissue as possible and is often used on the face, fingers and genitals, or where the border of the growth is unclear.
• Shave excision. The area is shaved off with a small blade.
• Curettage and electrodesiccation. The tumor is scraped out with a sharp spoon-shaped tool. An electric current then stops the bleeding and destroys remaining cells.

Mohs is the reason a growth on a nose can be removed without losing much of the nose. Our page on skin cancer screening covers who benefits from checks.

The risk factor everyone already knows

NCI names it plainly: having a fair complexion and being exposed to sunlight are risk factors for both basal cell and squamous cell carcinoma. The mechanism is ultraviolet radiation, from the sun and from tanning devices, damaging the DNA in skin cells.

Repeated biopsies over a decade, as Jackman described, are not unusual in someone with heavy cumulative sun exposure. Our page on skin cancer prevention covers what actually reduces exposure.

Skin cancer occurs in people of every skin tone. In darker skin it is less common, and NCI notes that melanoma in particular is often found in places the sun does not reach, such as under a nail or on a palm or sole.

When to get checked

Book an appointment for:

• A sore anywhere on the skin that is not healing
• A pearly, shiny bump, particularly on the nose, ear or lip
• A scaly or crusty patch that bleeds and scabs and comes back
• A firm, waxy area that looks like a scar you do not remember getting
• A rough scaly patch on the face or hands that keeps returning
• Any mole that has changed shape, color or size

A spot on the nose that bleeds when you dry your face and heals and bleeds again is the classic presentation. It is easy to explain away for years.

What this does not mean

• Jackman described biopsies and his doctor's suspicion. Nothing here states his results or his treatment.
• Basal cell carcinoma is not melanoma, and the two are not interchangeable in risk or in treatment.
• "Least dangerous" does not mean harmless. Left alone, a basal cell carcinoma keeps growing locally and destroys tissue.
• Sunscreen lowers ultraviolet exposure from here on. It does not reverse damage already done.
• Having had one skin cancer does not mean another is coming. It does mean regular checks are worth keeping.

Sources

• NBC News, Hugh Jackman posts video on new skin cancer scare and urges fans to 'please wear sunscreen' — https://www.nbcnews.com/pop-culture/celebrity/hugh-jackman-posts-video-new-skin-cancer-scare-urging-sun-safety-rcna78081
• NCI PDQ, Skin Cancer Treatment (Patient Version) — https://www.cancer.gov/types/skin/patient/skin-treatment-pdq
• NCI PDQ, Skin Cancer Screening (Patient Version) — https://www.cancer.gov/types/skin/patient/skin-screening-pdq
• NCI, Common Moles, Dysplastic Nevi, and Risk of Melanoma — https://www.cancer.gov/types/skin/moles-fact-sheet
• SEER Cancer Stat Facts, Melanoma of the Skin — https://seer.cancer.gov/statfacts/html/melan.html

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

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