What you need to know...

Skin cells normally reproduce themselves.  That is how the skin regenerates itself and performs its very important protective function.  But sometimes a particular skin cell type reproduces itself in an uncontrolled fashion and a skin cancer develops.  This can happen with any cell type, but the most frequent types of skin cancer, and therefore the ones we shall discuss here, are Basal Cell Cancer, Squamous Cell Cancer and Malignant Melanoma. 

The most common cause of Skin Cancer is sun exposure over a long period of time.  So here in the South we are at high risk and Skin Cancers are common and are often found on parts of the body with more sun exposure. 

Basal Cell Cancer

Basal Cell Cancer is a malignancy of the lower cell layer in the epidermis.  Basal Cell Cancers (BCCs) often appear as a pearly translucent papule or plaque.  This can initially look like a pimple but with time it will tend to grow.  In later stages it can become ulcerated, crusted or can bleed.  There are also other variants of BCCs that can look like eczema or even like scars (Sclerosing Basal Cell Cancer). Basal Cell Cancers rarely metastasize or cause death and instead they become larger over time in a more gradual fashion. For that reason people sometimes overlook them until they become larger and deeper, even though it’s best to catch them at an earlier smaller stage.

Squamous Cell Cancers

Squamous Cell Cancers (SCCs) form from the upper cell layers of the epidermis.  They often appear initially as a scaling patch or papule.  Later these become larger, more raised and nodular and crusted.  They can be caused by ultraviolet radiation, but also can be caused by chronic ulcers, some viruses and even chronic trauma.  They are more malignant than BCCs and can metastasize in some cases, especially when located on the ear or the lip.

Melanoma

Melanoma is the most dangerous form of skin cancer.  It forms from the melanocytes, the cells that manufacture pigment in the skin.  It can form by malignant transformation of a pre-existing mole or can form de novo, on previously normal skin.  Because melanoma forms from pigment cells, the melanoma cancer will usually be pigmented.  Melanoma will often appear as a darker spot in the skin.  Because Melanoma is so important we want to explain this particular type of cancer in more detail and therefore have set up a separate page devoted to information about Melanoma.

Photos - Melanomas and other Skin Cancers can vary widely in their appearance. For some examples of this please go to the Skin Cancers section of our photo gallery. That’s why any suspicious lesion should be evaluated by a dermatologist.

Prevention – As mentioned above there is a high risk of skin cancer in the South in both men and women and in all skin types. There is an additional risk with light colored skin, eyes or hair, or a family history of melanoma. The best prevention is to use sunscreens regularly and take precautions against excess sun exposure. It’s important to pay attention to your body, & to do skin self-exams. In addition you should see your dermatologist regularly for routine preventative skin exams. This allows for the most efficient treatment, leaving the least scar.

If there are suspicious lesions, see the proper specialist right from the start. A non-dermatologic physician may not know what they are looking at or treat correctly, may leave more of a scar, have a higher recurrence rate and treatment may be more expensive.

Treatment - The initial treatment for skin cancers is surgical and it’s very important to completely eliminate the tumor while being very careful to avoid damage to the surrounding tissues. If the cancer is not completely removed, any recurrent tumor is harder to treat than the initial cancer was. Recurrence of Basal Cell Cancer or Squamous Cell Cancer can often be larger than the initial tumor, deeper, can be enmeshed in scar tissue, and can be separated from the initial tumor. Even the histologic type of tumor can change to a more aggressive one. Therefore since recurrent BCCs and SCCs can be harder to recognize and harder to treat, that makes the initial treatment even more important.

A Dermatologist specializes in treating the skin and is the doctor best able to diagnose and select the most appropriate method of treatment for skin cancer. We use many types of treatment including excision and suturing, freezing, curetting and desiccation, lasers, etc. That way we can choose the best method for each person and each cancer
based on the histologic type of cancer, size, depth, location, etc. After treatment you should follow-up on a routine basis with your dermatologist to ensure that in case there is any recurrence it is treated early.

Dr. Steinberg specializes in the care and treatment of skin cancer and related disorders. He has treated more than 10,000 skin cancers with a cure rate better than 99%. He is trained in and uses a number of kinds of treatment for skin cancer, not just one method. Radiation therapy and Mohs surgery are indicated in rare cases and we offer them in those cases, but we don’t use complex, aggressive therapies unless they provide a benefit for the patient. We work with other specialists and provide the broadest range of options for skin cancer. In addition, with the special focus that our office has on cosmetic treatments and cosmetic outcomes, we pay very close attention to the aesthetic outcome and to minimizing scarring.