Moles & Melanoma

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For years, everyone told us that the sun was great, getting a golden tan was all the rage; achieving this ultimate result with baby oil, tanning reflectors, and as much time as possible at the beach or pool. Here in Newark and Wilmington Delaware, and close by southern New Jersey and Cecil County, Maryland, there is a vast population of sun worshippers as we are surrounded by beaches, bays, rivers, and canals.

Even though the warm sunshine boosts our spirits, there is a dangerous tradeoff. The longer days and more intense sunlight during the warmer month expose you to the sun’s dangerous ultraviolet radiation (UVR). This ‘dark’ side of the sun leads to more than 3.5 million cases of skin cancer in the US each year. Also, most of the skin damage associated with aging, such as wrinkling, sagging, leathering, is UVR related.

Many people consider skin cancer to be a minor health concern; however, someone dies from skin cancer every hour. This is unfortunate, since most skin cancers are preventable or at least curable when detected at an early stage. The skillful treatment provided by your board certified plastic surgeon at Advanced Plastic Surgery & Nouveau Cosmetic Center will ensure you get the appropriate medical/surgical treatment; removing the skin cancer while minimizing scarring.

What’s the harm in sunburn?

Sunburn, the skin reddening caused by overexposure to the sun’s harmful UVR, may seem like a temporary irritation, however, it causes long-lasting damage to the skin. One blistering sunburn in childhood or adolescence more than doubles a person’s chance of developing melanoma later in life; and even five ‘mild’ sunburns at any age will do the same.

Ultraviolet radiation from the sun is the #1 cause of skin cancer, but UV light from tanning beds is similarly harmful. People who use tanning beds, nearly 30 million people every year, are 1.5-2.5 times more likely to develop skin cancer.

Mole

A common mole, or nevus, is a growth on the skin that develops when pigment cells (melanocytes) grow in clusters. Most adults have between 10 and 40 common moles. These growths are usually found above the waist on areas exposed to the sun. They are seldom found on the scalp, breast, or buttocks.

Although common moles may be present at birth, they usually appear later in childhood. Most people continue to develop new moles until about age 40. In older people, common moles tend to fade away.

A common mole is usually smaller than about 5 millimeters wide (about 1/4 inch, the width of a pencil eraser). It is round or oval, has a smooth surface with a distinct edge, and is often dome-shaped. A common mole usually has an even color of pink, tan, or brown. People who have dark skin or hair tend to have darker moles than people with fair skin or blonde hair.

Dysplastic Nevi

Dysplastic nevi (atypical moles) are unusual benign moles that may resemble melanoma. A dysplastic nevus may be bigger than a common mole, and its color, surface, and border may be different. It is usually more than 5 millimeters wide. A dysplastic nevus can have a mixture of several colors, from pink to dark brown. Usually, it is flat with a smooth, slightly scaly, or pebbly surface, and it has an irregular edge that may fade into the surrounding skin.

Can a dyplastic nevus turn into melanoma? Yes, but most do not. Therefore, surgical excision may be recommended. People who have dysplastic nevi are at increased risk of developing single or multiple melanomas. The higher the number of these moles someone has, the higher the risk; those who have 10 or more have 12 times the risk of developing melanoma compared to the general population. Dysplastic nevi are found significantly more often in melanoma patients than in the general population.

Melanoma

  • Appear as a dark flat or raised area on the skin
  • The ABCD rule can help you remember the symptoms of melanoma
    • A-Asymmetry: the shape of one half does not match the other
      B-Border: edges are ragged or blurred
      C-Color: uneven shades of brown, black, tan, red, white, or blue
      D-Diameter: significant change in size (> 6mm)

Malignant Melanoma thankfully is the least common skin cancer because it is the most problematic and frankly deadly variant [114,000 new cases with 68,000 being aggressive] leading to 8,600 deaths per year. These lesions generally begin life as a mole. However, the melanocytes , pigmented cells, grow out of control and can often metastasize, spread to other parts of the body. Treatment is much more extensive with much larger areas of skin needed to be removed, often requiring more extensive treatments such as skin grafts or flaps to close the wound, lymph node biopsies, and follow up evaluation with an oncologist.

The ABCDs are instructed regarding moles and melanoma evaluation:
A – Asymmetry – a mole should have a very similar and smooth look to itself with each half matching
B – Border – a mole should have a smooth border or edge to it, and not be irregular
C – Color – a mole should generally be pink or light tan to brown with one color throughout
D – Diameter – should be less than 1 cm

Think of a pencil eraser. Its round, with a smooth edge, one color throughout and reasonably small. Moles that lose these outward appearances may have issues internally that need to be evaluated.

Skin Cancer Surgery

The diagnosis of “skin cancer” is scary, but the good news is that most skin cancers are curable if detected at an early stage. Plastic surgeons can surgically remove skin cancers using specialized techniques to preserve one’s health and appearance.

Skin cancer is diagnosed by performing a biopsy. This involves taking a sample of tissue, which is placed under a microscope and examined by a pathologist. Sometimes a biopsy can remove all the cancer tissue, and no further treatment is needed. However, further surgical intervention may be needed to remove additional cancer tissue or to reconstruct the area. Although no surgery is without scars, a plastic surgeon will make every effort to treat the skin cancer without dramatically changing your appearance.

Prevention

Sunscreen

Sunscreens are chemical agents that help prevent the sun’s ultraviolet radiation (UVR) from reaching the skin. Two types of UVR, UVA and UVB, damage the skin and increase the risk of skin cancer. UVB is the chief culprit behind sunburns; however UVA rays, which penetrate the skin more deep, are the cause of photoaging. Therefore, a broad-spectrum sunscreen which offers protection against both UVA and UVB rays is recommended.

Most sunscreens with an SPF of 15 or higher do an excellent job of protection. SPF, Sun Protection Factor, is a measure of the sunscreen’s ability to prevent UVB from damaging the skin. But what does this mean? If it takes 20 minutes for unprotected skin to start to turn red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer—about 5 hours. In addition, SPF 15 blocks approximately 93% of all incoming UVB rays, 30 blocks 97%, and 50 blocks 98%.

To ensure that you get the full SPF of the sunscreen, 1 ounce, the size of a shot glass, should be applied to your entire body 30 minutes before going outside and reapplied every 2 hours.

Self Examination

Most people have freckles, birthmarks, or moles, but any irregularities or a change in the shape, edge, color, or size can be a warning sign of skin cancer. Since most skin cancers are treatable, early detection is key. A self examination every 6 months is recommended. This could take no longer than 10 minutes, a short amount of time to save your life. Concerning areas should be brought to the attention of your primary care physician for further evaluation.

Do you have a concerning lesion or spot…

Advanced Plastic Surgery & Nouveau Cosmetic Center located in Newark, Delaware, is convenient to Wilmington, Elkton Maryland, Chester County Pennsylvania, and Southern New Jersey. Our well trained staff and highly qualified surgeons are available to assist you with your concerns. Our surgeons use the latest in surgical technology to provide patients with the finest medical care.

Please contact us today to schedule a consultation. Our plastic surgeons will discuss the best options for your needs and discuss all aspects of the procedure at your initial consultation.