I have the fair skin curse.

Well, not exactly. But having fair skin is difficult sometimes.

---

My first pre-cancerous mole was removed from my back before I graduated from high school. I’ve experienced multiple sunburns, and at least two of them have blistered. The song lyric “sunshine on my shoulders” was so true for me, and also very painful.

Since that first mole removal, I’ve become more vigilant about caring for my skin, being mindful of my sun exposure, and seeing a dermatologist for an annual skin check.

---

However, I’m also human.

Many of you who know me, know that I grew up around water. I don’t enjoy the beach as much as I used to, but I didn’t always use sunscreen or reapply like I should have, especially in my college years.

The combination of multiple sunburns over many years, and having fair skin caused multiple moles to pop up. I’ve had four significant moles (maybe more, I lost track for a while) removed and biopsied from my back. I’ve had more stitches in my back than anywhere else on my body.

---

The good news? My annual skin checks are working. Plus, I’m much more aware of my sun exposure now, and I’m using sunscreen, hats, and protective clothing more frequently.

I went to the dermatologist today, after my original appointment was changed twice due to COVID. The Suffolk office is really close to my house. The doctor was great, although I miss my old nurse practitioner (NP) terribly. She left the practice in mid-2019 to go out on her own.

Everything looked good for this year, with the exception of a two-toned brown/black mole on my upper left arm. The doctor was great and pointed out why he was concerned about it. A team of two ladies came in after the doctor, numbed my skin around it, and removed the mole for biopsy. I’ll be notified of the results in 1-2 weeks, depending upon how long it takes for it to be reviewed by pathology.

If need be, the office will call and schedule me for a follow-up visit. In the past, my NP needed to obtain clear margins, meaning that they needed to go a bit farther out from where the mole was removed to make sure all the pre-cancerous cells are gone. Otherwise, it could develop into actual skin cancer.

---

Skin Cancer

There are three types of skin cancer: Basal cell carcinoma, squamous cell carcinoma, and melanoma.

Basal cell carcinoma is typically slow-growing, and the most common type of skin cancer. It can develop from actinic keratoses, which are scaly, damaged areas of skin. These can occur in places with lots of sun exposure – Your face, scalp, and the back of your hands.

Squamous cell carcinoma is less common. UV exposure is a contributor, but you’re at higher risk if you have had chronic skin wounds, radiation therapy treatment, or were an organ transplant recipient.

Melanoma begins in the melanocytes, where the skin pigment cells change into cancerous cells. This is the lowest diagnosed type of skin cancer, but it has the highest death rate. Melanoma has been found on the torso / trunk, lower legs, palms, soles of the feet, and the skin under the nails. UV exposure is the biggest factor, but family history is also significant.

---

Educating Yourself

You can do self-check skin exams on yourself!

Here are the “ABCDEs” to look for:

• A – Asymmetry (Not the same shape on all sides)
• B – Border irregularity (Ragged / blurred edges)
• C – Color (Different shades of tan, brown, or black)
• D – Diameter (Larger than 1/4 inch)
• E – Evolving (Changes over time)

Now – Don’t panic if you see something suspicious. It’s important to call your dermatologist to make an appointment, or ask family / friends for recommendations. You can also check your health insurance (U.S.) for in-network providers that are close to you. Some providers also perform virtual visits, or you can text photos to a secure phone number for review.

Also, make an appointment as soon as possible if you experience itching or swelling of a skin lesion, if the lesion changes size or color, or there’s pain in the area.

---

Not Just Fair Skin

There are many factors with skin cancer. Here are a few things to be aware of regarding higher risks.

• Hair color – Blond/blonde or red
• Skin that freckles or sunburns easily
• Family history of melanoma or non-melanoma skin cancer
• History of unusual moles
• History of sunburns, particularly blistering ones
• History of tanning bed use
• More than 50 moles, or any that look irregular
• Organ transplant recipient

It’s a good idea to visit a dermatologist annually if you tick off more than one of these. Most skin exams take 10-20 minutes. For today’s visit, I was out the door in 35 minutes, and that included the biopsy. I have to let the area heal with twice-daily bandage changes and petroleum jelly after the first 24 hours (Tip: Don’t use Neosporin or triple antibiotic ointment!) It’s really simple and virtually painless.

---

Resources

For more information, check out the links below.

Annual Exams | Skin Cancer Foundation

What to expect during a skin exam | MD Anderson

Skin Cancer | MD Anderson

---

Until the next headline, Laura Beth 🙂