According to the American Academy of Dermatology, 1 in 5 people will develop skin cancer in their lifetime. Skin cancer refers to an uncontrolled growth of abnormal cells in the epidermis, the outermost layer of the skin. It is most commonly found on sun-exposed areas of the body but can occur anywhere on the skin. When skin cancer is caught early, it can usually be completely treated. If left untreated, skin cancer can grow and potentially spread inside the body. For this reason, we recommend regular full body skin examinations with a board-certified dermatologist to monitor for concerning lesions.
Skin cancer is most often caused by the cumulative damaging effects of ultraviolet light exposure from the sun and/or tanning bed use. Some skin cancers can occur as a result of certain medications or due to a genetic tendency as well.
Yes, there are precancerous skin lesions, but it can be difficult to know which lesions are truly concerning. Also, having a history of precancerous skin lesions means that you have a higher risk of developing a skin cancer over your lifetime.
The following lesions may have the potential to turn into skin cancer:
DYSPLASTIC NEVI: Moles (nevi) are very common benign skin growths that can appear from birth to early adulthood. However, if a mole appears abnormal on exam, a sample (biopsy) of it is sent to a pathology lab to look for the presence of abnormal cells. If abnormal cells are present, the nevus is described as dysplastic. Dysplastic nevi fall on a spectrum of mild to severe based on how abnormal the cells appear. Mildly dysplastic nevi are considered benign, and further removal is typically not indicated. Severely dysplastic nevi have abnormal cells which have unpredictable behavior, and complete removal is warranted. Moderately dysplastic nevi may or may not be further removed depending on your dermatologist’s recommendation and guidelines by the American Academy of Dermatology. Certain patients with many dysplastic nevi and/or history of melanoma may be advised to have mole mapping.
ACTINIC KERATOSES: AKs are persistent, rough, scaly spots that appear on sun-exposed areas after years of ultraviolet light exposure from sunlight or tanning bed use. These spots can bleed, itch, hurt, or not cause any symptoms at all. Left untreated, up to 20% of actinic keratoses can turn into a type of skin cancer called squamous cell carcinoma. AKs can be effectively treated with liquid nitrogen, topical prescriptions, or photodynamic therapy (PDT). PDT is a two-stage treatment that combines light energy with a topical medication (photosensitizer). This photosensitizer is designed to destroy cancerous and precancerous cells after light activation. PDT is offered in our office, and these treatments are usually covered by insurance.
There are three common types of skin cancer:
BASAL CELL CARCINOMA: BCC is the most common form of skin cancer. This type of cancer arises from the basal layer, the deepest part of the top layer of the skin. BCCs tend to grow slowly and often appear as pink, pearly bumps or red, scaly patches that bleed easily and/or do not heal. While this type of skin cancer has low potential for spreading inside the body, BCCs can be locally destructive and require treatment to protect surrounding tissue.
SQUAMOUS CELL CARCINOMA: SCC is the second most common form of skin cancer. This type of cancer arises from more superficial cells in the upper layers of the skin. SCCs tend to be growths that may be painful, increasing in size, bleeding easily, or healing poorly. SCCs that occur in the skin can usually be treated once diagnosed, but they do have some risk of metastasizing (spreading to other areas of the body).
MALIGNANT MELANOMA: Melanoma is one of the most dangerous and deadly types of skin cancer due to its ability to spread. Melanoma arises from the pigment-producing cells of the skin called melanocytes. Melanoma can occur anywhere on the skin. If detected early, melanoma can usually be completely cured. If left untreated, melanoma can spread inside the body to other organs including the lymph nodes, lungs, liver, and brain.
Fortunately, skin cancer that is detected early is almost always curable with minimally invasive treatments. For this reason, we recommend regular full body exams with a dermatologist to monitor for concerning lesions. Mole mapping is also offered in our clinic. If skin cancer is identified, your dermatologist will discuss your treatment options with you.
TOPICAL TREATMENTS: Prescribed topical chemotherapy can be an option for early, superficial non-melanoma skin cancers. Creams such as 5-fluorouracil or imiquimod can effectively treat skin cancer cells – allowing normal, healthy skin cells to grow.
ELECTRODESICCATION AND CURETTAGE (ED&C): This in-office procedure is a treatment option for superficial non-melanoma skin cancers. A local anesthetic is injected in the skin, and then the cancer is eliminated through a series of scrapings with a special tool (curette) followed by electrocautery.
SURGICAL REMOVAL: Many of our skin cancer excisions are performed in-office. During this procedure, a local anesthetic is injected in the skin, the visible lesion is removed completely, and the sample is sent to a laboratory to confirm that the cancer has been entirely removed. This procedure usually requires stitches, with limitations in activity until the stitches dissolve or are removed.
MOHS MICROGRAPHIC SURGERY (MMS): This specialized surgery technique is recommended for removal of localized skin cancers involving areas of the body like the face or scalp. During this procedure, the surgeon takes the smallest amount of skin and then evaluates the skin sample for cancer under a microscope while the patient waits in the office. This results in the smallest scar possible, confirms precise removal of the cancer, and minimizes the risk of skin cancer recurrence in that area. Typically, non-melanoma (BCC and SCC) skin cancers are treated with MMS. This procedure may require stitches, with limitations in activity until the stitches are removed. MMS is offered in our clinic with Dr. Bart Endrizzi.