This article first appeared in the Summer 2019 issue of NewBeauty. Click here to subscribe.
From 3-D printing to matrix magic, the treatment for skin cancer keeps improving. And, while New York plastic surgeon Stafford Broumand, MD is wary of calling attention to anything “new” regarding skin cancer treatment, he has seen a recent shift in the field, in one particularly crucial area. “The ‘new’ isn’t so important—what’s important is that more people are getting checked and then getting the skin cancer removed.”
New York dermatologist Dendy Engelman, MD, and many other doctors, are particularly sensitive to fears that skin cancer treatments will cause permanent defects. “Doctors who perform reconstruction on those who have had skin cancer are now utilizing multiple modalities to ensure the best aesthetic and skin health outcome—it doesn’t have to be scary. This means coupling laser therapies with topical treatments for the scar and surrounding skin in order to eliminate perceptible scarring and minimize the risk of other skin cancers erupting in these regions. Pulsed-dye laser, IPL, PDT, and fractionated CO2 are all used to assist in the aesthetic result.” “Patients are always amazed at how great they look one week post-surgery,” adds Dr. Engelman. “They will often like the side of their face that was treated better than the untreated side!” Boston facial plastic surgeon Jaimie DeRosa, MD agrees. “Most patients are surprised to find out that, in the right hands, skin cancer reconstruction can result in a nearly imperceptible scar or deformity.”
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The Right Treatment
Because there are several types of cancers, Dr. Broumand says patients need to know what kind of skin cancer they are dealing with and ensure they are going to the right doctor to get the correct procedure to remove it. “People are always surprised that plastic surgeons do skin cancer reconstruction, even though we have a clear understanding of how to make the wounds heal better over time.”
Likewise, Dr. DeRosa isn’t a dermatologist, but she does do her fair share of skin cancer reconstruction and she’s particularly excited about two innovations: “3-D printing and tissue engineering technologies. Three-dimensional printing has been shown to aid in improving symmetry and results when repairing defects in difficult areas, such as on the face. Then there is tissue engineering, which has produced several dermal matrix materials to enhance the outcomes in the repair of large cutaneous defects,” she says. “I am excited to see the continued collaboration between science and biomedical engineering and technology. Colleagues are working hard to create viable organs, such entire ears via tissue engineering, which will open more options for repairing defects after skin cancer removal.”
The bottom line, Studio City, CA dermatologist Gene Rubinstein, MD, says, is that there is much more flexibility now in the treatment of skin cancers. “Mohs surgery is still the gold standard for areas such as the face, or large non-melanoma skin cancers, but there are topical agents, or creams, that can be used for the treatment of pre-cancers or thin non-melanoma skin cancers,” he says. “We also perform a procedure called photodynamic therapy (PDT), which can quickly eliminate pre-cancerous growths by using a topical solution on an area of skin, and then exposing the area to blue LED light.”
Sun Safety Tips
Of course, before there is skin cancer and the treatment of it, there is prevention. The American Academy of Dermatology (AAD)’s official stance on sun-safety is protection, protection, protection: “Because exposure to UV light is the most preventable risk factor for all skin cancers, the AAD encourages everyone to stay out of indoor tanning beds and protect their skin from the sun’s harmful UV rays by seeking shade, wearing protective clothing and using a broad-spectrum, water-resistant sunscreen with SPF 30 or higher.”
In 1981, Australia launched the “Slip, Slop, Slap” campaign with Sid the Seagull (a sun-safety version of Smokey the Bear). Sid recently added “Seek” and “Slide” to his rules: slip on sun-protective clothing; slap on a hat; slop on sunscreen; seek shade and slide on sunglasses.
Richland, WA dermatologist Sidney B. Smith, MD loves the newer FDA sunscreen proposals, but holds patients to “an even higher standard” that Sid the Seagull would approve. “One, avoid peak hours of sun exposure whenever possible. Two, wear sun-protective clothing. Three, apply and reapply sunscreen,” says Dr. Smith. “Sunscreen needs to be SPF 30 or higher and contain zinc and/or titanium dioxide for happy, healthy skin.”