Here Comes the Sun

Summer has arrived and for some people, that means being outside in the sunshine. As you are heading for the beach, make sure to bring the sunscreen as well as sunglasses and a sunhat. Otherwise, you are increasing your risk of skin cancer. That is because skin cancer is caused by ultraviolet (UV) rays from the sun or tanning beds which damage the DNA in the cells of our skin.

Basal cell carcinoma (BCC) is the most common type of skin cancer. BCC can have different appearances. It may be a domed-shaped skin growth with blood vessels that is often pink or skin-colored but can have flecks of brown or black. It may also appear as a shiny pink or red scaly patch of skin and can be confused with eczema.

Squamous cell carcinoma (SCC) is the second most common type of skin cancer. SCC may appear as a rough, scaly patch or skin thickening that may bleed. It may also look like a wart or an open sore.

Melanoma is the most dangerous form of skin cancer. Melanomas usually originate from pigment-producing melanocytes in the skin and may look like a mole or develop from a mole. Melanomas are often black or brown but can be skin-colored, pink, red, purple, blue or white.

Skin cancer is diagnosed by taking a sample, or biopsy, of the suspected skin cancer and sending it for pathology analysis.  Dermatologists commonly perform skin checks and they biopsy suspicious areas to send to pathology.

Because our face is often exposed to the sun, it is a common location to get skin cancer and this includes on or near our eyelids. Sometimes, a dermatologist may refer a patient to an ophthalmologist or oculoplastic surgeon to biopsy a suspicious lesion if it is close to the eyes. An ophthalmologist may also see a suspicious lesion when they are performing a patient’s eye exam.

When there is skin cancer on the face, it is often removed by Moh’s surgery, which is considered a tissue sparing procedure. With Moh’s surgery, the suspected area of skin cancer is removed and then the margins are checked for cancer cells while the patient waits. If there are still cancer cells found, the Moh’s surgeon will take out more skin in the corresponding area. Once the margins are all found to be cancer free, the wound can be closed or reconstructed. If the wound is at or near the eyelids, the Moh’s surgeon may send the patient to an oculoplastic surgeon for reconstruction so that the function of the eyelids can be maintained. Other specialty areas, like the nose, may go to other specialists, like an Ear Nose and Throat (ENT) surgeon or a Plastic surgeon.

Even if you take multiple precautions against skin cancer, it is still important to regularly check yourself for any unusual skin changes.  If you have a sore that bleeds easily, won’t heal or does heal and returns, constantly crusts or oozes over, has a sunken center like a crater, or has visible blood vessels around it, you should have it examined by a dermatologist.

Author:  Dr. Elizabeth Chiang


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