As a Manhattan dermatologist, I spend a lot of my time making beautiful people look even more gorgeous. I am constantly researching the latest tools and creams to make skin texture smoother, brown spots lighter and skin more radiant. I have lasers to treat every type of wrinkle or blemish, at least a half dozen injectable fillers to plump up the deepest wrinkle and enough Botox to paralyze an elephant. In the upcoming posts, I will talk a lot about ways to make your skin look even more beautiful, but given that May is Melanoma Awareness month, this post will focus on skin cancer. Because no matter how beautiful you look, don't think that you are immune from skin cancer.
Not a day goes by when I don't diagnose or treat a skin cancer. Skin cancer is by far the most common type of cancer in this country and its incidence is growing at an alarming rate. This year, 108,203 people will be diagnosed with melanoma, the most serious form of skin cancer, and over 1 million Americans will develop non-melanoma skin cancers, such as basal cell carcinoma and squamous cell carcinoma, which even though they are less deadly than melanoma, they can be quite disfiguring. If these trends continue, it is estimated that one in five give Americans will develop a skin cancer in their life time.
The good news is that both melanoma and non-melanoma cancers can be cured if detected and treated early. The bad news is that most people rarely examine their skin and when they do they don't know how to tell the difference between a normal mole and one that could be malignant. Most people have moles which can develop from any time in early childhood through middle age. The ones to worry about are what we call "atypical", i.e. unusual moles that most of the time are larger than normal moles, vary in color, and often have irregular borders. Both normal and atypical moles can develop into melanoma, which usually begins as a mottled, light brown to black flat blemish with irregular borders. It is usually at least ¼ inch in size and may turn shades of red, blue or white, crust on the surface and bleed. Melanomas most frequently appear on areas which are most frequently exposed to the sun, such as the upper back, torso, lower legs, head and neck, but can occur anywhere on the body.
To help patients remember these warning signs of melanoma, I instruct them to look at their moles for the ABCD features:
Asymmetry - One half does not match the other half.
Border irregularity - The edges are ragged, notched or blurred.
Color - The pigmentation is not uniform. Shades of tan, brown or black are present. Dashes of red, white, and blue add to the mottled appearance.
Diameter/Different - While melanomas are usually greater than 6mm in diameter when diagnosed, they can be smaller. If you notice a mole different from others, or which changes, itches or bleeds even if it is smaller than 6mm, it should be evaluated.
Moles that show any or all of these features need to be examined by a dermatologist.
In my upcoming posts, I will show you how to get to know your own skin better. Not only will it keep you looking beautiful, it just might save your life!