Although the number of skin cancer diagnoses will rise again this year, New York dermatologist and president of The Skin Cancer Foundation, Deborah S. Sarnoff, MD says it’s not all negative news. “Some of the increase can be attributed
to the people who didn’t protect their skin when they were younger, and now they’re paying the price. But, we can also credit the fact that more people are getting screened for skin cancers than ever before, which is a positive indicator that our awareness efforts are working.”
These are the three most common types of skin cancer:
Basal Cell Carcinoma (BCC): The most common skin cancer, BCC is almost always found on areas of excessive sun exposure, such as the face, ears, neck, scalp, shoulders and back. To protect these areas, Saddle Brook, NJ dermatologist Dr. Fredric Haberman suggests wearing sunglasses and a hat with a brim of at least 4 inches—hats with a UPF (Ultraviolet Protection Factor) of 50+ can block 98 percent of the sun’s harmful rays.
Squamous Cell Carcinoma (SCC): The second most widespread type, SCC is typically found on the face, neck, hands, arms, legs and a balding scalp, as well as the rim of the ear and the lower lip.
Melanoma: While not nearly as prevalent as the former two, it is the most dangerous. Almost all melanomas can be
attributed to sun damage, and in women, they are most often on the arms and legs. In men, the back, head and neck
are common sites. Cases of melanoma in the U.S. are estimated to increase by 2 percent in 2020, but as Dr. Sarnoff points out, “the good thing is that mortality rates have gone down due to more skin cancers being caught early. Melanoma deaths will actually decrease by 5.3 percent this year.”
Some warning signs to be on the lookout for at home: sores that don’t heal within three weeks, or that continue to itch, crust, scab or bleed; and lesions that increase in size and appear pearly, translucent, brown, black or multicolored.
Color Blind
Skin cancer can affect anyone, regardless of race, ethnicity or skin tone. According to New York dermatologist Michelle Henry, MD, the logic that darker skin tones don’t burn is “absolutely incorrect. My Fitzpatrick type 5–6 skin has sustained sunburns numerous times in my life. Melanin is protective, but not perfect. Patients with dark skin also develop skin cancer and often have worse outcomes that are likely due to less surveillance and suspicion for skin cancers.” Dr. Haberman adds that even though melanomas, specifically, are rare in those with dark skin, “the palms of the hands, soles of the feet and nail beds account for half of all melanomas that occur in African Americans.” These areas may be more difficult to examine at home, which is why an annual screening with a board-certified dermatologist is critical.
Modern Mohs
In skilled hands, skin cancers can be excised with a surgical technique called Mohs. The next frontier of treatment,
however, involves removing the cancers with nonablative lasers, and no cutting. New York dermatologist Orit Markowitz, MD is on the leading edge of this method: “I spearheaded the use of an advanced imaging device called Optical Coherence Tomography for skin cancers, which allows me to look across skin and below skin at the depth to determine the cancer’s spread, and obtains more precise margins than Mohs surgery,” she says. “Once I’ve defined the margins, I treat the spot with several nonablative lasers to remove the skin cancer without surgery or scarring.” For most of Dr. Markowitz’s patients, one treatment does the trick, but for those with larger or deeper skin cancers, she
may treat them two or three times over the course of a couple months.
