Pink Prescriptions - May 2024
Help Your Skin Win Against Skin Cancer
May2024 Issue — Pink Prescriptions
Help Your Skin Win
Against Skin Cancer
The beach, golf, tennis, bike rides, long walks, pickle ball, fishing, kayaking, boating, and summer picnics all have two things in common: 1. They are all a ton of fun, and 2. They all expose us to the sweltering summer sun. Like most everything in life, there is both a good and bad side of sunshine. The essential Vitamin D we soak in from the sun’s rays is important for good health and feeling well. However, if we take in too much, especially without protection, those rays of sunshine can decide to play dirty.
The key to enjoying the sunshine, again, like most everything, is moderation. Be smart and proactive when spending the day outdoors. Use a tent or umbrella to relax under when at the beach. Be sure to lather on the sunscreen if you’re going to be on the courts or golf course for hours on end. Wear a hat; there are a lot of cute ones out there! Pay extra attention to your face, nose, the tops of your feet, the tips of your ears, and your shoulders. Buy a quality sunscreen. (See our suggestions.) And get checkups every year.
So, welcome to the South, where the beautiful sunshine can turn to painful sunburn in a hot minute.
By Christopher Culpepper, MD | General Surgeon,
Hilton Head General and Laparoscopic Surgery
Can basal and squamous cells
turn into melanoma?
Skin cancer, in general, can be classified into two main groups, melanoma and non-melanoma skin carcinoma. In the general population, the group of non-melanoma skin cancers, which include basal cell and squamous cell carcinomas, are much more common than melanoma. Unfortunately, melanoma as a skin cancer is one of the most feared and difficult cancer diagnoses in all of medicine due to its potential for late diagnosis and aggressive metastatic spread. There is good news and bad news, however. The good news is basal cells and squamous cells, and their corresponding skin cancers, have no potential to become melanoma due to the fact they represent entirely different cell lines in the skin. The bad news is that patients with non-melanoma skin cancer carry a significantly higher risk of developing melanoma within their lifetime. This fact underscores the importance of good dermatologic screening and biopsy with a primary care physician or dermatologist.
What is MOHS surgery and is it the
only treatment option?
Mohs (Micrographically Oriented Histographic Surgery) is a highly specialized procedure for treating skin cancer lesions. The Mohs surgeon can remove the skin lesion layer-by-layer and examine each layer under a microscope until the area of the skin is cancer-free. Performed under local anesthesia, Mohs is an outpatient procedure that can last up to an hour. It can be used to treat all types of skin cancers, including melanoma and basal and squamous cell skin cancer. Mohs can be used to treat skin cancers located in sensitive areas, where it is important to minimize the removal of healthy tissue, such as the head, face, fingers, toes, and genitals. However, Mohs is not the only option for the surgical treatment of skin cancer. More traditional surgical options include wide local skin excision to ensure negative margins both wide and deep, including potential need for lymph node dissection. This is typically performed in an office setting or operating room (depending on size, depth, and local or distant spread) by a general surgeon.
Dr. Culpepper is a board-certified general surgeon. He completed his medical degree at the University of Tennessee – Memphis and his residency at the University of Kentucky. Dr. Culpepper joined Hilton Head General & Laparoscopic Surgery in 2023. www.hhisurgeons.com
By Nikki Newman, PA-C
Beaufort Memorial Lowcountry Medical Group Primary Care
The older I get, the more brown spots I have on my skin. How do I know if these are cancerous?
As you age, you may notice spots appearing on your skin, particularly in areas that are often exposed to the sun, like your face, hands, and neck. These small gray or brown spots are “actinic lentigines,” more commonly referred to as sunspots, age spots, or liver spots. These are not a form of skin cancer, nor do they progress to become skin cancer. But if you notice any rapid changes to one of these spots, you should get it checked out by your provider right away.
That said, some people are more likely to get skin cancer than others. If you have fair skin, had multiple sunburns during childhood, or have a family history of skin cancer, you should be extra cautious and make annual skin exams a priority.
Even if you have no known risk factors, it’s still a good idea to perform regular skin self-exams, looking out for suspicious spots or moles that meet “ABCDE” criteria, which indicate it could be melanoma:
• Asymmetry—when one part of a mole or mark looks
very different in shape than the rest of it.
• Borders that are uneven or irregular
• Color—different colors or shades throughout a mole
• Diameter larger than ¼ inch (about the size of a pencil eraser)
• Evolving shapes, sizes, or colors
We hear a lot about melanoma, but what are the other types of skin cancers, and are they dangerous?
Skin cancer is by far the most common type of cancer in the U.S., diagnosed in more men and women each year than breast, prostate, lung, and colon cancers combined. While the disease is often slow-growing, it can become serious or life-threatening if it spreads to other parts of the body.
Melanomas, which form in skin that produces pigments (moles, freckles and age spots), are more rare than some of the other forms of skin cancer, accounting for only about 1% of skin cancers, but can be far more dangerous. Melanoma can be fatal if left untreated.
The more common forms of skin cancer are basal and squamous cell cancers. These usually appear in areas that get sun exposure, such as the face, head, and neck. They are less likely to spread to other parts of the body and become life-threatening. Basal and squamous cell cancers are usually curable if detected early.
Nikki Newman is a board-certified physician assistant (PA) at Beaufort Memorial Lowcountry Medical Group Primary Care in Beaufort. She was recognized as Beaufort Memorial’s 2023 “Provider of the Year.”
By Rafael Sanchez, MD | Prestige Primary Care
How often and at what age should
I start getting checked for skin cancer?
According to the U.S. Preventive Services Task Force, a group who provides guidance for primary care physicians, there is not enough scientific evidence to make a recommendation about adults receiving skin cancer screenings from their primary care doctor. However, the American Academy of Dermatologist encourages everyone to serve as their own health advocate by regularly conducting self-exams of their skin. Individuals who notice any new spots on their skin, any spots that look different from the others, or anything changing, itching, or bleeding, should see a board-certified dermatologist. While everyone is at risk of developing skin cancer, some individuals have a higher risk and should be particularly vigilant.
Adults 35–75 with one or more of the following risk factors should be screened at least annually with a total body skin examination:
• Personal history: History of skin cancer; CDKN2A (or other high-penetrance gene) mutation carrier; and immunocompromised patients
• Family history: Melanoma in one or more family members; Family history suggestive of a hereditary predisposition to melanoma
• Physical features: Light skin, blonde or red hair; >40 total nevi (moles); 2 or more atypical nevi; many freckles; severely sun-damaged skin.
• UVR overexposure: History of blistering or peeling sunburns; history of indoor tanning
Board-certified adult internal medicine and aesthetics specialist Rafael Sanchez, MD is an exceptional provider for all aspects of routine health and wellness care. A graduate of Duke University School of Medicine in Durham, NC, Dr. Sanchez completed two residencies in internal medicine and pediatrics. Prestuuge Primary Care offers the full scope of family medicine/primary care, with a strong focus on preventive health services. 843-227-4595; 25 Hospital Center Blvd, Ste 309, HHI.
Find Your SPF
Essential Defense Mineral Shield by SkinMedica
When choosing sun protection, ingredients matter. Mineral-based sunscreens are the most gentle for ALL skin types. Essential Defense Mineral Shield by SkinMedica provides the highest level of UVA protection and UVB coverage. This lightweight, slightly tinted formulation also evens the complexion, making Essential Defense Mineral Shield a must-have for any skincare regime. — Dustin, Hilton Head Medical Spa
Alastin SilkSHIELD® All Mineral Sunscreen
SPF 30 with TriHex Technology®
Powerful Protection with Added Benefits: With powerful yet gentle protection, this transparent sunscreen has an exclusive peptide blend that provides anti-aging benefits long after sunset. Because it is lightweight and oil free, it also makes a great sunscreen for men. — Teresa, Serendipity Medical Spa
Aslastin HydraTint Pro Mineral Broad Spectrum Sunscreen SPF 36
“This is hands-down our favorite sunscreen that works with all skin tones. Perfectly balanced, this sunscreen is a patient-favorite to use as an all-in-one sunscreen and coverup.”
– Jason Pampucha, Aspire Medical Spa
& Advanced Womens Care of the Lowcountry
SkinCeuticals #1 Physician Recommended Physical Fusion UV Defense SPF 50
This sunscreen is a weightless, 100% mineral sunscreen that provides UVA/UVB protection and is safe for all skin types. It is paraben free, fragrance free, and non-comedogenic. It starts working right away, as opposed to chemical sunscreen, which can take about half an hour for effective sun protection. This form of SPF is also photostable, so it doesn’t need to be reapplied as often as a chemical sunscreen.
— Carla, One Care Spa