Lathering on sunscreen before heading to the beach is second nature (or should be). But if that’s all you are doing to shield yourself from the harmful UV rays, you are still at an increased risk of getting skin cancer.
One in five Americans will develop skin cancer in their lifetime. Statistics like this remind us that we need to do everything we can to protect ourselves. In an effort to learn more about preventative measures and treatments for skin cancer, we called on Dr. Elizabeth Callahan, fellowship-trained Mohs skin cancer surgeon and founder of SkinSmart Dermatology, for an exclusive FEMME ROUGE interview.
WHAT IS SKIN CANCER AND HOW DOES IT AFFECT THE BODY?
Skin cancer primarily affects the skin, but if it’s not detected early enough the cancer can spread to underlying skin structures. There are three major types of skin cancer. The two most common forms are squamous cell carcinoma and basal cell carcinoma – I see these every day at my practice. The more rare but most deadly type of skin cancer is malignant melanoma.
WHO IS AT RISK OF GETTING SKIN CANCER? DO ALL AGES AND ETHNICITIES HAVE THE SAME RISK?
While people with lighter skin color are at the greatest risk for skin cancer, everybody is at risk and I think the best form of defense is to wear sunscreen each day and to see a dermatologist for a complete skin check.
HOW OFTEN SHOULD WE GET CHECKED?
That depends on how old you are and how much sun exposure you had in your life. When you are younger, you should see your dermatologist every couple of years. As you get older and your risk increases, especially if you have had skin cancer, it’s very important to get checked at least once a year.
WHAT ARE SOME OF THE THINGS YOU LOOK FOR IN A STANDARD CHECK UP?
When we examine your skin, we look at the entire outside of your body. We start at the top of your head and then work our way down to the toes. We are checking for things that look irregular: borders, color, or shape. Most importantly, we look at areas that the patient says have changed. So, what a patient tells a doctor is equally as important as the skin exam.
WE HEARD YOU HAVE A NEW SKIN CANCER WING. CAN YOU TELL US ABOUT IT?
I started the practice in 2005, and from the start it was really important to cover all of the aspects of dermatology in everything that we do at SkinSmart. So, we cover medical dermatology, cosmetic dermatology, and surgical dermatology. For several years I was the sole physician in the practice, and in 2013 Dr. Adams joined the team. So now we have two fellowship trained Mohs surgeons and we have expanded the facility to 10,000 square feet, creating a safe and relaxing environment for patients. The wing is state of the art to make patients feel comfortable, which is important because often times they spend an entire day with us.
WHAT IS MOHS SURGERY AND WHAT MAKES IT A UNIQUE PROCEDURE FOR TREATING SKIN CANCER?
Mohs surgery is a very specialized form of skin cancer surgery where all of the margins are examined. The tissue is removed in our office under local anesthesia. We then take the tissue in our lab, located in our surgical wing, and we look at 100% of the margins under a microscope. Only Mohs surgery is this thorough, which leads to a 95% cure rate for skin cancers found on the face. Mohs surgery is usually used on the face and places where you want to conserve as much of the normal tissue as possible.
UNFORTUNATELY, A LOT OF US ALREADY HAVE SKIN DAMAGE. WHAT CAN WE DO ABOUT IT?
Many of the patients who come to me, particularly in Florida, have already experienced skin damage in their lifetime. They come with various brown spots, red spots, precancers – things that require treatment. One of the most important things that I treat on a daily basis is precancerous lesions. We know that precancers have a 5% chance of evolving and becoming a squamous cell carcinoma. So with at least half of my patients, I am going to be identifying and remedying the precancerous lesions right there in the office with a freezing treatment called liquid nitrogen or we may offer some other therapy for them – either a prescription treatment that they can use at home, or coming into my office for special light treatments.
For red spots and brown spots there are various topical treatments that we can recommend to the patient. We also have different light and laser devices that can help to lighten the skin’s tone and texture. All of this begins with prevention. It’s never too late to start using sunscreen and develop smart habits.
WHAT ARE SOME OF THE THINGS OUR YOUNGER READERS CAN DO TO PREVENT SKIN DAMAGE AND SKIN CANCER IN THE FUTURE?
The single most important way you can avoid damage to your skin is to make sure you are protecting it at all times. It means avoiding sun exposure when the sun is most intense between the hours of 12pm and 3pm, using a sunscreen with a protection of SPF 30, and wearing protective clothing. A tan is a very temporary thing, but your skin is forever. Make sure you aren’t spending extra money on SPF 50 or 100, when SPF 30 is going to do the job. When I go shopping for my own sunscreen, I look for products that are 100% organic with the minerals zinc and titanium. I prefer to protect my skin with these minerals because it provides a strong and broad protection, and avoids chemicals that can sometimes irritate the skin. It’s really not the number of the SPF – it’s how often you are reapplying and how much you are putting on.