People frequently ask what exactly I do as a plastic surgeon, and they are surprised to discover that I spend about 20% of my time treating skin cancer. Since most skin cancers are treated by surgically removing them, it makes perfect sense that a plastic surgeon would be involved in these cases.
Most patients who come in for a skin check actually have benign or pre-cancerous lesions rather than actual skin cancers. They have fancy medical names like actinic keratosis or seborrheic keratosis and are usually treated with freezing or topical creams. True skin cancers fall into three main categories:
Basal Cell Carcinoma is the most common skin cancer we see, and has a red, shiny appearance, often with a small central ulceration or depression. It has very clear borders typically. This cancer grows slowly and is seen on sun-exposed areas of the body. It essentially never spreads to other parts of the body but can come back in the same area if not completely removed.
- Squamous Cell Carcinoma looks more like a “sore” or “scrape” with irregular borders and often some scabbing. It usually appears relatively flat and is also on the sun-exposed areas of the body in most patients. Squamous Cell Carcinoma of the skin can spread to other organs although this is relatively rare. Again, the treatment involves complete surgical removal. To see photos, click here.
- Melanoma is the third major type of skin cancer and can show up anywhere on the body, not just the sun-exposed areas. It often looks like a flat or slightly raised mole with irregular borders and a mix of colors including brown, black or pink. We are very aggressive in removing melanoma because it most certainly can spread to other parts of the body, and proves rather resistant to treatment once it does. People with a family history of melanoma or a bad sunburn in childhood are at increased risk for developing a melanoma as compared to the general population. To see sample photos, go here or here.
If you have any questions about a particular mole or skin lesion, please do come in for a skin check. Insurance covers skin cancer screening and treatment, and sooner is definitely better than later in this case!