Skin Cancer

Skin cancer, the most common form of cancer in the U.S., is primarily caused by ultraviolet radiation exposure from the sun.  Solar radiation skin changes are cumulative and comes from years of solar exposure.  It can come in many forms and can affect all regions of the body.  Approximately  80% of skin cancers appear on the face, head or neck where they may result in unsightly disfigurements if not treated properly. 

There are several different types of skin cancer.  Basal cell carcinoma is the most common type of skin cancer as well as the least invasive.  Though it is usually slow growing and rarely spreads, serious disfigurement can result if left untreated.  Squamous cell carcinoma, the second most common form of skin cancer, often appears on the face, lips or ears.  This form of skin cancer sometimes spreads to distant sites (metastasis) like the internal organs or lymph nodes and, if left untreated, can be life threatening. 

The clinical presentation  of both basal cell and squamous cell carcinomas vary widely in appearance.  Some appear as small white or pink nodules or bumps with surfaces that are smooth or shiny, waxy or pitted.  Others may appear as a rough, dry or scaly red spot; a firm, red lump with a crusty surface; a cluster of crusted nodules; a sore which fails to heal or continues to bleed; or a white patch resembling scar tissue. 

Malignant melanoma is the third most common form of skin cancer and may appear anywheres on the body.   Like squamous cell carcinoma, it may spread to distant sites, becoming life threatening if left untreated.  Malignant melanoma may be discovered after a change in the size, shape or color of a mole or it may be seen as a new skin growth.  Warning signs include the ABC’s - Asymmetrical growth, a ragged or Blurred border the Color of which may be  mottled appearance (tan, brown or black shades, sometimes with red, white or blue mixed in)  as well as  any unusual increase in size of a growth to more than 6mm in diameter. 

Plastic surgeons can be helpful in treating skin cancer as they may surgically remove growths while maintaining both form and function  as well as  providing the most pleasing post-operative appearance.  This may be of particular concern for cancers occurring in highly visible areas such as  the face. 

A number of methods may be used to treat skin cancer, though most are removed surgically.  Most small skin cancers can typically be treated easily and quickly during an outpatient procedure using local anesthesia.  A simple excision typically results in a thin, barely visible scar.  Larger skin cancers or those which have spread may require more extensive surgery.  Other options for treatment include cryosurgery, radiation therapy, topical chemotherapy, and Moh’s surgery.  During your consultation, your surgeon will go over all treatment options as well as their risks and benefits. 

Some treatments may result in an unsightly scar or permanent change to the facial structures, in which case a plastic surgeon can be indispensable.  Reconstructive techniques like scar revision and tissue flaps can help to repair damaged tissue, rebuild body parts, and restore acceptable appearance and function.