Skin cancer occurs when normal skin cells turn into abnormal skin cells that rapidly grow. There are two divisions of skin cancer: non-melanoma skin cancer (NMSC) and melanoma. NMSC are most common on sun-exposed areas of the body. Skin cancer is caused by sun exposure and severe sunburns. People with lighter skin are more likely to experience sunburn and more likely to develop skin cancers. Significant exposure to sun and/or tanning beds accumulates throughout life and increases the risk for skin cancers. The two most common NMSCs are called basal cell carcinoma and squamous cell carcinoma. Symptoms of NMSCs are pink, red, swollen, bleeding, non-healing, or crusty lesions. Some people develop scaly lesions called actinic keratoses, which are precancerous lesions that can turn into squamous cell carcinoma if left untreated. If your dermatologist suspects a skin cancer, they will do a skin biopsy and sent the specimen for evaluation by a dermatopathologist. You dermatologist will then use the diagnosis details from the pathology report to determine the best treatment plan.
What is the treatment?
Electrodessication & Curettage (ED&C): ED&C is known as the “scrape and burn” technique. In this method, the skin cancer is scraped with a curette and burned with an electrical needle called hyfrecator. This wound heals on its own in a few weeks and no sutures are needed.
Surgical Excision: The skin cancer is surgically excised with appropriate margins to remove the entire skin cancer, and the resulting skin defect is sutured in layers. The internal stiches dissolve on their own in a few weeks to a few months, and the top stiches are left in skin for 5-14 days, depending on the type of repair, location of surgery on the body, and types of sutures used. The lesion removed is sent to a dermatopathologist to confirm negative margins.
Mohs Micrographic Surgery: This is a tissue-sparing procedure in which the cancer is excised in layers to confirm negative margins. A Mohs surgeon has the necessary equipment to process the tissue and confirm negative margins prior to closing the wound. The patient will have confirmation the entire skin cancer has been removed before the surgeon begins to close the wound with sutures, repairs it with a skin graft or flap, or allows the wound to heal on its own through second intention. This is the preferred method of treatment for large cancers or tumors on cosmetically sensitive areas like face, ears, scalp, fingers, toes and sometimes neck.
Topical Chemotherapy: This is a non-surgical treatment option that can be used for superficial skin cancers that are limited to the top layer of the skin. This treatment requires precise application of a prescription chemotherapy cream or solution on the skin cancer for several days to several weeks as directed by your dermatologist.
Radiation Therapy: This is an option for difficult to treat tumors, very large tumors spanning over multiple cosmetic units on face and ears, or for patients, usually elderly, who are not candidates for surgical excision.
If you have a skin cancer, your dermatologist will follow up with you and conduct frequent full body skin checks to monitor existing lesions and catch new concerning lesions early.
What prevention measures can I take?
Sunscreen
Increase skin coverage when exposed to the sun (i.e. clothing, hats, sunglasses)
Patients who develop any suspicious lesions that are changing, growing, bleeding, or not healing, should consult a dermatologist for evaluation. Patients with a history of sun damage, precancerous lesions, or skin cancers need routine skin examinations. Our dermatologists can help determine the right course of treatment for you.
