Skin cancer is now the most common cancer in the U.S.
You have a one in five chance of developing skin cancer in your lifetime.
How Often Should You Have a Skin Exam?
If you don’t have a history of skin cancer, a yearly full-body skin check by a board certified dermatologist is recommended. However, if you’ve had cancerous spots removed in the past, your dermatologist will determine your schedule for rechecks, which might be more frequent.
In addition to regular checkups, performing routine head-to-toe self-exams can help alert you to new or changing moles or spots, which may be a sign of skin cancer. Remember to examine your body front and back in the mirror, then your right and left sides with arms raised. Bend your elbows and look carefully at the forearms, back of upper arms, and palms. Check the back of your legs and feet, including the soles and spaces between your toes. Examine the back of the neck and scalp with a hand mirror (part hair and lift). Also check the back and buttocks with a hand mirror. Make notes of your spots so you can track changes. Any worrisome skin lesions should be evaluated by a board certified dermatologist.
Dermatologists’ tips and more information on checking your skin can be found on the American Academy of Dermatology’s website: www.aad.org.
What Are the Three Most Common Types of Skin Cancer?
The three most common types of skin cancer are basal cell carcinoma, melanoma and squamous cell carcinoma. Basal cell is found on skin that receives lots of sun exposure, like your face, ears, neck and hands, but you can get it anywhere on your body. It is a slow growing cancer, but can go deep even to the bone, destroying tissue as it goes.
Malignant melanoma can spread quickly and generally begins with a mole or a pigmented spot. There are several signs to look for: half of the spot is different than the other, it has an irregular shape or border, it has many colors, and the spot or mole is greater than the size of a pencil eraser.
Squamous cell carcinoma sometimes begin as an actinic keratosis—a pre-cancerous rough patch that is irritated, and may be rough and scaly. These spots are also found on skin that sees a lot of sun. When the spot turns into a lump or bump, begins to bleed or won’t heal it may have become cancerous.
Do you know the ABCs of Melanoma?
Actually it’s the ABCDEs! It’s a helpful acronym to assist you in keeping an eye on suspicious moles and spots. Any changes since your last skin exam? Changes like:
A for Asymmetry The two sides of the mole are not the same.
B for Border The edges of the mole are scalloped or irregular.
C for Color The color of the mole is varied and could include tan, brown, black and even white, red or blue.
D for Diameter A melanoma is usually larger than 6mm. This is the size of a pencil eraser.
E for Evolving The mole has changed in any way: color, size or shape.
Any of the above ABCDEs warrant a mention to your dermatologist. If you’ve never had a skin check before and you have a match with one of the above, schedule your appointment now.
A family history of melanoma greatly increases your likelihood of developing this type of skin cancer. If your parent, sibling, child, grandparent, grandchild, aunt or uncle had melanoma you are at risk. If you have more than 100 moles on your body and some are atypical, you should have a full-body screening by a board certified dermatologist every three to six months. An atypical mole is one that does not look normal, but is not necessarily cancerous.
In addition to screenings by your dermatologist, you should do a self-exam once a month. The ABCDEs tell you exactly what to look for.
How fast does basal cell carcinoma grow?
While generally slow growing, the spreading rate of basal cell carcinoma can vary depending on the health of your immune system. It is not the most deadly of skin cancers, but if left untreated it can be disfiguring. This is because the lesion can grow deep into the skin.
If the basal cell carcinoma is on your face, Mohs surgery is often recommended due to the precision of removal and very high cure rate. With Mohs, the tumor is removed and then thin tissue samples are removed and examined under a microscope until no more cancerous cells are found. This way healthy skin is preserved.
Closing the surgical site will depend on how much tissue was removed. This can range from letting it heal naturally to stitches to a skin graft or a skin flap. Most basal cell carcinoma is cured with minor surgery. Mohs surgery is named after the doctor who invented the method.
Basal cell carcinomas can also be treated non-surgically with cryosurgery (freezing with liquid nitrogen) but with this method, the recurrence of cancer is high.
Should you worry about AKs (actinic keratosis)?
AKs are very common among people with fair skin and blue or green eyes. They are also more common on people who live closer to the equator, no matter what skin type, as sun exposure is a big factor in the development of AKs.
You’ll find actinic keratoses on the face, back of hands, bald scalp, neck, shoulders and any other skin subjected to frequent sun exposure. They are scaly little spots that can sometimes itch or be sensitive to the touch. In some cases they can also bleed. Generally they are red, but can appear pink or tan.
About 10% of AKs progress to squamous cell carcinoma. This type of cancer is very dangerous if left untreated as it can spread to internal organs.
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