Check That Spot - Part 2
HTBLO Skin Cancer Edition
Today I’m popping a pin in our ongoing youth-y education to focus on grown-n-sexy problems. I wanted to walk through my skin journey the past few years just to share some information and send up a flare!
Let’s take a walk down dermatology lane!
Back in September, I wrote about an actinic keratosis gone wild. It was a growth the size of a round, fabric-covered, blouse button that had perched on the bridge of my nose. The removal happened back in 2017 (the road to that removal was bumpy as hail) and since then, things had been fairly quiet on the epidermis front.
Mostly just keeping on top of my yearly full-body skin checkups and freezing off a brown spot here and there for beautification.
Pro Tip: remove nail-polish off your fingers and toes before your annual appointment. Skin cancer can show up under the nail and usually presents as a dark streak.
Then in 2022 - just months after my annual appointment - I decided to go back in and get a small grouping of zits above my eyebrow checked out. I’d been dabbing a generic zit cream on that lil’ gang of intruders for a few weeks but alas they were not standing down.
My dermatologist, at the time, was young and professional and easy to talk to. She quizzically looked at the eyebrow gang through a loop. Unsure of what they were, she called in a more senior derm. He took one look and said, “I’m not exactly sure what those are but let’s burn them to the ground.” What I thought were just a few tiny pimples ended up being horseshoe shaped cluster of eleven little baddies that needed to be smoked out.
My Derm asked if there was anything else I was concerned about and I remembered that there was a teeny tiny raised speck above my lip - I thought it was blackhead. She grabbed two small white sticks and popped out what looked like a sesame seed. It was a milia, trapped skin that forms a cyst. She looked around my face and removed a total of three milia. One in my eyebrow — that was nestled amongst the fab eleven —one above the lip and one by my temple. So many weirdo little things going on!
My full body check was just a few months earlier? Had she missed these things? I left the office with questions, but ultimately proud of myself for staying on top of my health.
Pro Tip: If a pimple, a little burn, an abrasion, a growth, a bump anything shows up on your skin and doesn’t go away in a few weeks - make an appointment to get it checked out.
Brace yourself for the next round of discoveries on my skin journey…
A few months went by and the little pimple thing above my lip came back. Same exact spot. I wondered if another milia had formed. There was also a small abrasion by my temple. I made another appointment. The doctor took a look. She ran her finger over the abrasion and dismissed it as nothing to worry about. As far as the lip spot was concerned there was no milia was present but she wasn’t quite sure what it was. She said “Let’s keep on eye on it, come back in a few weeks and if it’s still there we can freeze it off.”
Walking to my car I realized that answer didn’t work for me. It felt too casual. I made an apt with the head Derm to get a second opinion.
Things I felt when asking for a second opinion:
Self conscious that I was being dramatic.
Worried that by asking for a second opinion I was throwing this young, female doctor under the bus.
The head Derm burst through the examination room with cartoon like energy. He looked at the spot above my lip and said “I don’t know what that is, let’s take a biopsy.” Dammit. I really was hoping we wouldn’t have to do that. I also mentioned the abrasion looking thing above my right temple. He also dismissed it as nothing to worry about. The biopsy stung but was over quickly. I got very specific instructions on how to handle the healing process to minimize the biopsy scarring.
Apply Aquaphor daily with a q-tip
Keep covered with band aid for two weeks
Red light is proven to accelerate the healing process. My beloved Omnilux face mask was called into action. I’d hold it over the cut for a few minutes a day before covering it with Aquaphor and a band aid.
The office called - it was basal cell carcinoma. Fuck.
Basal cell is the most common type of skin cancer. If caught early and treated it is unlikely to spread. You will not die from basal cell but it absolutely needs to be dealt with.
Hanging up with the office I was pissed. Had I continued with the original treatment plan, who knows when I would have discovered that the spot on my lip was actually basal cell cancer.
The recommended treatment plan for basal cell is MOHS surgery.
MOHS surgery is a method for treating skin cancer lesions. During this procedure, the surgeon removes thin layers of skin one layer at a time and examines each layer under a microscope to determine if any cancer remains.
Not wanting to cut into my face — I chased my tail trying to seek out other treatment options like topical chemotherapy, radiation therapy, laser surgery and cryosurgery. Ultimately, I met with a doctor who set me straight. MOHS is the gold standard for anything on the face. They make the smallest incision possible, check that margins on site and continue cutting until all of the cancer is removed. My husband and I both felt very good about this doctor, he was very knowledgeable and straight forward. I made my appointment for the surgery.
If you have to go down the road of MOHS please connect with other people who have gone through it. Every person I spoke with had the same experience. You go in feeling like it’s not that big of a deal and then you leave a little traumatized. After the initial cut you have to wait for an hour or so to find out if they need to go back in. I was very, very lucky. My margins came back clear and they were able to sew me up after the first cut. The nurse let me know that the lady they were working on the day before was not so fortunate, she went through five rounds of cutting and testing. Nightmare. In some cases, patients need a plastic surgeon involved to patch up their face post MOHS.
Even with my small incision I left with five stitches and a very swollen lip. Once you’ve had basal cell present the possibility of it happening again is very high. I wanted to know if there was anything I could do, other than applying sunblock religiously, that could help prevent another occurrence. The doctor mentioned a procedure called PDT - photo dynamic therapy. It’s usually covered by insurance and can kill off pre-cancers that are emerging from damage done decade ago.
This was me a week or so after the procedure - not bad! I was diligent about the aftercare and had two laser treatments to reduce the redness in the scar.
More on photodynamic therapy next week!
Ps, that abrasion on my temple that the other two doctors dismissed? It was precancerous and needed to be frozen off. ✌🏻
Love to hear your thoughts or experiences!
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Yo, what a JOURNEY! Your poor lip!
Thank goodness you were diligent! I have been putting off my skin check and I need to make an appointment.