Skin cancer is the most frequent type of cancer in the United States, and the one that is seen more in young people than other forms of cancer. This is largely due to sun exposure during play in childhood without adequate sun protection, but it’s mostly related to tanning during the teenage years, either at the beach or in a tanning bed.
In this article, we’ll be discussing how to conduct skin self-exams, what to look for if you spot a suspicious lesion, the different types of skin cancer and what they mean, and diagnosis and treatment by a board-certified dermatologist.
Skin Self-Checks & Skin Cancer Diagnosis
The most important step in early diagnosis is to check your own skin. Skin self-exam can alert you to changes in the skin and aid in early detection. Follow these easy instructions for self-examination and use this body map chart from SkinCancer.org.
Look for these changes or warning signs:
- A skin growth that is pearly, red, brown-black or multicolored
- Any growth that changes in size, texture, color or thickness
- Any spot that bleeds, scabs, crusts or an open sore that doesn’t heal.
If you have any suspicious lesions, don’t delay. Make an appointment for a complete skin exam.
Types of Skin Cancer
There are cancerous lesions and pre-cancerous lesions one must look for. If you’re ever unsure about a spot on your skin, schedule an appointment with a board-certified dermatologist for a skin check. You should be getting skin checks at least once per year to ensure early detection of skin cancer.
Here are the 5 skin lesions to look for:
- Actinic keratosis: These scaly or crusty growths most often occur on the face and back of the hand. They can be seen on any sun exposed area. They are pre-cancers and are considered a precursor to squamous cell carcinoma.
They can be treated with cryosurgery, topical medications or photodynamic therapy (PDT), a treatment that combines a light activated medication with blue light. More than 90% of pre-cancers resolve with treatment. Regular follow up and re-treatment is needed.
- Basal Cell Carcinoma: This is the most common form of skin cancer. The usual appearance is a pearly or red bump, a red patch or an open sore that bleeds and doesn’t heal. Basal cell carcinoma is caused by long term sun exposure as well as recurrent sun burns. When treated promptly, basal cell carcinoma is curable.
Superficial small basal cell cancers can be treated with topical creams: Imiquimod or 5 Fluorouracil as well as a minimal surgery called curettage and desiccation. Invasive basal cell cancers can be treated by cutting and stitching (ie excisional surgery). Mohs’s Surgery is used for larger basal cells and those in problem areas such as the nose, ears, lips and eyelids.
- Dysplastic Nevi: These are benign moles that may resemble melanoma due to irregular color or shape. People who have them are at increased risk of developing single or multiple melanomas. If a mole shows several warning signs of melanoma, it is recommended to have a biopsy. Should the biopsy result confirm a large number of atypical cells, complete excision is recommended.
- Melanoma: The most dangerous form of skin cancer, these growths most often are caused by ultraviolet radiation from sunshine or tanning beds. Melanoma is usually black or brown but they can also be skin-colored, red or have several different colors. If melanoma is recognized and treated early, it is almost always curable, but if it is not, the cancer can spread to other parts of the body.
Melanoma is treated by surgical excision with wide margins. Lymph node studies and biopsy may be recommended for more deeply invasive melanoma. If melanoma has spread beyond the skin, there are new targeted chemotherapy agents to control the spread.
- Squamous Cell Carcinoma: This skin cancer appears as a scaly or warty growth on sun damaged skin. Fair skinned individuals who have had chronic sun exposure are at the highest risk. Patients over 50 and those on immune-suppressive medications are also at risk. Treatment of squamous cell carcinoma is similar to treatment of basal cell carcinoma.
Surgical Skin Cancer Treatments – Mohs Surgery
Dr. Goodlerner often uses a version of Mohs surgery. This is especially useful in treating cancers of the nose, ears, and other hard-to-treat areas, because it allows the removal of cancerous tissue with a much smaller border of surrounding healthy tissue. Dr. Goodlerner uses micro-surgical techniques to remove suspect tissue one skin layer at a time. Each layer is sent to a hospital pathologist for frozen section evaluation. As soon as an examination shows no more cancerous tissue, the procedure is ended. The treated area can then be reconstructed with good cosmetic results.
Other Skin Cancer Treatments
Myths and Truths about Skin Cancer
Here’s everything you need to know to protect your skin from aging and from skin cancer:
Myth: Tanning at a salon is safer than outdoor tanning
Fact: Indoor tanners have a higher risk of skin cancer that those who have never tanned indoors. There is growing evidence that tanning beds can increase the risk of developing melanoma.
Myth: The sun is the best way to get Vitamin D
Fact: Our bodies produce Vitamin D with a limited amount of sun exposure (5 minutes daily for a Caucasian at noon in the summer). Sun exposure beyond that can break down vitamin D and increase the risk of skin cancer and skin aging. The safest way to get vitamin D is through diet and supplements.
Myth: People of color do not get skin cancer
Fact: People of color have a lower risk of skin cancer than their fair skinned friends, but they have a higher risk of dying from it. The rates of melanoma, the most dangerous skin cancer, are on the rise. In the US, Hispanics and African-Americans present to physicians with more advanced cases of melanoma. Whatever your skin color, protect yourself, perform regular skin self-exams and see a dermatologist if you have a new or changing skin growth.
Myth: Windows protect us from UV rays
Fact: Window glass can block most UVB rays, but not UVA rays. Even in a car you can still tan or burn. In fact, in sunny climates, individuals that drive a long distance to work have more sun damage and skin cancer on the left side of the face.
Myth: Teens and young adults don’t have to worry about skin cancer. It only affects older adults.
Fact: Melanoma is the most common form of cancer in those aged 25-29. And, the rate is increasing faster in women ages 15-29 than in men. The melanoma rate increase in younger women is likely due to use of tanning beds. Those at risk should perform regular skin self-exams and see a dermatologist right away if there is a changing mole.
Myth: You don’t need to wear sunscreen on a cloudy day
Fact: Even under cloud cover, it is possible to get sunburned and harm your skin and eyes. Sun protection is important on a cloudy day.
Myth: Suncreen with SPF 30 is all the protection you need; anything higher will not make a difference
Fact: While SPF 30 is adequate if enough sunscreen is applied, it may only provide SPF 15 if you under-apply by half. It takes a shot glass full to cover your body and 1 tablespoon for your face. Higher SPF sunscreens, 50 or more, may increase sun protection by 5%. That can make a difference if you are doing sports in midday sun. If you are engaged in water sports, it is equally important to use a product that is water-resistant and to reapply at least every hour and a half.
Concerned about sun safety or a suspicious skin lesion? Or perhaps you just know you’ve abused your skin too long with excessive sun exposure and want to make sure you get a skin check. Either way, contact us for a consultation with Dr. Goodlerner, board-certified dermatologist in Torrance, South Bay in South LA. In addition to skin cancer diagnostic tools, Dr. Goodlerner can also locate sun damaged skin that isn’t cancerous and provide recommendations for eliminating it to reveal healthier skin.