Skin checks, treatments, mohs surgery
Did you know that skin cancer is the most common cancer in the United States?
Major skin cancer causes involve skin cells becoming damaged, such as when the skin suffers from overexposure to the sun’s ultraviolet (UV) rays. While the sun itself is unavoidable, it is important to remember that there are ways to prevent and detect skin issues before they progress into dangerous forms of skin cancer.
An annual skin check with one of our board-certified dermatologists at Millburn Laser Center in Millburn, New Jersey is also an important practice to add to your calendar. Whether it is summer or not, you should be aware of your moles, sunspots, and freckles.
Skin Cancer and Its Symptoms
The most common types of skin cancer are:
- Basal cell carcinoma (BCC) – The most common type of skin cancer. It forms in the basal cells of the skin (cells responsible for making new cells to replace the cells that die) and often look like red patches or open sores.
- Squamous cell carcinoma (SCC) – The second most common type of skin cancer. It starts in the cells of the outer layer of the skin, the epidermis. They are typically found on the parts of skin that are most often exposed to the sun and look like scaly red patches, warts, or elevated growths that may bleed or crust.
- Melanoma – The most dangerous form of skin cancer. Cancerous growths develop when unrepaired damage to skin cells triggers mutations, causing the skin cells to form malignant tumors.
See your doctor when you experience these symptoms:
- Sores, scratches, and cuts that do not heal
- A new mole, spot, or lump that appears on the skin
- An existing mole that changes size, shape, or color (it may also bleed or itch)
- A lump or spot that bleeds when rubbed
- Any abnormalities on the skin
- To learn more about skin cancer, visit cancer.gov
Actinic keratosis (AK), also known as a solar keratosis, is a crusty, scaly growth caused by damage from exposure to ultraviolet (UV) radiation. AK is considered a pre-cancer because if left alone, it could develop into a skin cancer, most often the second most common form of the disease, squamous cell carcinoma (SCC).
The Importance of an Annual Skin Check
Early detection is always key and a skin cancer screening can serve as your best line of defense in detecting cancer before it spreads and becomes difficult to treat. An annual skin cancer test is recommended for those who are at higher risk of skin cancer. People who have a family history of skin cancer, those who are frequently exposed to the sun, and those with specific skin types (e.g., pale or freckled skin) are more prone to skin cancer.
The Skin Cancer Foundation has developed a tool (ABCDE) you can use to examine your skin at home:
- Asymmetry – If you draw a line through your mole and the two halves don’t match, it could be a sign of melanoma.
- Border – melanomas have uneven borders. Edges may appear notched or scalloped.
- Color – benign moles usually have one color (e.g., brown). A melanoma will have a variety of colors and may appear red, white, or blue.
- Diameter – melanomas are larger in diameter compared to a pencil eraser (6 mm).
- Evolving – when a mole is evolving, it changes in shape, size, color, and elevation, and may bleed or itch.
What Does an Actual Skin Check Entail
Before the examination, you will be asked if you have any concerns. This is the time you mention any skin changes you’ve observed. Your doctor will then perform a head-to-toe skin exam, taking note of any spots that require closer examination. The skin check will typically include your scalp, eyes, eyelids, mouth, ears, hands, fingers, feet, toes, and toenails. If there are skin irregularities, your doctor may use a dermatoscope (a tool that looks like a magnifying glass with a flashlight), which allows for a more thorough examination.
When a skin abnormality is discovered, your doctor may send a sample of your skin tissue for a biopsy in order to determine if it is benign or to rule out whether cancerous cells are present.
Skin Cancer Treatment Options
Once the skin cancer is confirmed by a biopsy and a proper skin cancer diagnosis has been made, your dermatologist will recommend a treatment option suitable to your skin cancer type, taking into consideration its size, location, and features.
Skin cancer treatment is done on an outpatient basis, typically by any of these surgical methods:
Excisional Surgery – A scalpel is used to excise or remove the entire skin cancer along with a surrounding border of normal skin as a safety margin.
Curettage and Electrodesiccation (Electrosurgery) – The doctor scrapes off a portion or all of the lesion using a curette (a spoon-shaped instrument with a sharp, ring-shaped tip), and then burns the site with an electrocautery needle to stop the bleeding and destroy any remaining cancer cells. The process may be repeated one to three times during the surgery to remove all of the cancer cells.
Cryosurgery – Liquid nitrogen is used to freeze and destroy the lesion and the surrounding skin.
Laser Therapy – A laser beam with a specific wavelength is used to make bloodless cuts on the skin in order to remove the skin’s outer layers or some amount of deeper skin. This procedure is used to treat actinic keratosis and low-risk skin cancers.
Mohs Surgery – A precise surgical technique where layers of skin cells are progressively removed and examined until the patient is cancer-free.
While simple excision, electrosurgery, and cryosurgery may be considered to treat BCC and SCC, the preferred skin cancer treatment option for non-melanoma cancers is Mohs Surgery.
According to the American Academy of Dermatology, Mohs offers a unique benefit because this surgical technique allows the doctor to see where the cancer stops. Other treatment options do not offer this advantage. Since the procedure provides the ability to see where the cancer stops, Mohs has a high success rate and allows patients to keep as much healthy skin as possible.
What Happens During Mohs Surgery?
Mohs surgery is performed by dermatologists who have completed extensive training.
During the procedure, most patients are awake and alert. An anesthetic will be injected to numb the area that will be operated on. The surgeon will then cut out the visible skin cancer and also remove a thin layer of surrounding skin. The treated area will be bandaged so the patient can comfortably wait for lab results. During the lab work, the surgeon will examine the removed skin under a microscope. If cancer cells are found, more skin will be removed from the patient. This process continues until the surgeon no longer sees any cancer cells. Wounds may or may not require stitches, depending on their size and location. Some patients may need a skin graft or other types of surgery to help minimize scarring and further promote healing.
Frequently Asked Questions
Q: How Long Does A Skin Check Take?
A: A skin exam is quick and painless, and usually only takes 20 minutes. If it’s your first visit, it may take longer since your medical history will be brought up and your doctor will also discuss skin cancer risk factors with you.
Q: Do I Have To Wait A Year To Get Checked Again?
A: No. You can always make an appointment for a skin check, especially if you’ve observed something that looks suspicious on your skin. To help you know what to look for, you can use the Skin Cancer Foundation’s memory tool, which summarizes the warning signs of skin cancer using the letters ABCDE:
- Asymmetry – when one half of a mole doesn’t match the other
- Borders – when a spot looks uneven and patchy, with a poorly defined border
- Colors – when a mole or spot does not have a uniform color (it can have shades of brown or black, and sometimes white, red, or blue)
- Diameter – melanomas are usually greater than 6mm (the size of a pencil eraser)
- Evolving – when you have a mole or skin lesion that changes in size, shape, or elevation, or you have symptoms such as itching, crusting, or bleeding, see your doctor immediately.
Q: When Is Mohs Surgery Recommended?
A: Mohs is usually recommended for those with BCC or SCC, especially when the condition is large or aggressive, appears on an area with little tissue underneath it (e.g., scalp, eyelid, ear, nose, hand, foot, or genitals), or when the cancer was treated and then returned.
Q: Can Mohs Also Treat Melanoma?
A: Yes. Mohs can treat melanoma, the most serious type of skin cancer. However, Mohs can only be used to treat an early melanoma, specifically a lentigo malignant melanoma, which stays close to the surface of the skin.
Q: What Is The Outlook For Mohs Patients?
A: Mohs patients can expect good results. If your doctor recommends Mohs, you can take comfort in knowing that the surgical procedure has a high success rate. Your doctor will only remove the least amount of skin necessary to spare healthy tissue and minimize scarring.
Q: Can You Die From Skin Cancer?
A: Yes. When it spreads, melanoma becomes a deadly cancer. According to the American Academy of Dermatology, Nearly 20 Americans die from melanoma every day. In 2019, it is estimated that 7,230 deaths will be attributed to melanoma — 4,740 men and 2,490 women.
Q: What Is The Survival Rate Of Skin Cancer?
A: BCC and SCC are highly curable if detected early and treated properly.
As for Melanoma, the Melanoma Research Alliance states that:
The five-year survival rate of stage 3 melanoma is 63.6%. It’s 22.5% for stage 4 melanoma, and the five-year survival rate for melanoma stages 0, 1, and 2 is 98.4%.
Schedule a Skin Cancer Consultation Millburn, New Jersey
According to the American Academy of Dermatology, approximately one in five Americans will develop skin cancer in their lifetime, and about 9,500 people in the U.S. are diagnosed with skin cancer every day. Being proactive about preventing and detecting skin cancer can be life-saving. Here at the Millburn Laser Center in New Jersey, our highly-trained board-certified dermatologists specialize in the detection and treatment of skin cancer and have our own on-site Mohs Surgery Center. To learn more about skin cancer causes and how to protect your skin, schedule a skin screening with us today or call us at 973-315-8590.
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