Under the Surface of Skin Cancer
Skin cancer is the most common cancer worldwide. By age 70, 20 percent of Americans will have developed the disease somewhere on their body. When caught early, even the deadliest skin cancer—melanoma—is treatable. In fact, 99 percent of those who catch melanoma in its early stages survive at least five years after diagnosis.
The names of skin cancer come from where the cancer is found, from the top to the bottom layer of skin. Three common types of skin cancer that affect the face are:
- Squamous cell carcinomas: The top layer of skin on your body is the epidermis. This layer consists of thin, flat cells called squamous cells. Because they’re most likely to be exposed to the sun, squamous cells frequently become cancerous.
- Basal cell carcinomas: These round cells are directly under squamous cells. Though not the topmost layer of cells, basal cells are the most common cell type to give rise to skin cancer.
- Melanomas: At the bottom of the epidermis are cells called melanocytes. Responsible for determining the color of your skin, these can become cancerous cells. When this happens, the diagnosis is melanoma. Melanoma is particularly dangerous because it often spreads to other body parts and organs.
Diagnosing Skin Cancer: Know Your ABCDs
Skin cancer on the face has certain traits. Knowing these allows you to recognize a potential skin cancer early.
Signs and symptoms of skin cancer include:
- Asymmetry—Healthy moles look the same on both sides. Moles that are not symmetrical may indicate cancer.
- Border—Moles should have clear, smooth borders. The borders of cancerous moles are fuzzy or irregular.
- Color—Do your moles contain more than one color? They may be cancerous.
- Diameter—Normal moles are small. When a mole is larger than a pencil eraser, it may be skin cancer.
In addition to the ABCDs of skin cancer, look out for moles that look different than the rest, or if an existing mole changes, itches or bleeds. To find out, visit your primary care provider or a dermatologist.
When you seek medical attention, a medical provider will evaluate your suspicious mole. If they suspect cancer, your provider will remove the mole and send it to the laboratory for microscopic examination. Soon after, you’ll learn if your mole was cancerous and whether further treatment is necessary.
With many moles, this is all the treatment that is necessary. For others, you may need something more, such as Mohs micrographic surgery.
Surgery for Skin Cancer on the Face
Mohs micrographic surgery is the most precise treatment modality for basal or squamous cell carcinoma. This treatment is performed with local anesthesia in an outpatient office setting, which means you’re awake during the procedure and don’t require an overnight hospital stay.
Surgeons who perform Mohs surgery are specially trained and board-certified to remove cancer and evaluate removed cells for signs of cancer. Additionally, they’re skilled in reconstructing the area where skin cancer on the face was present.
Named after its inventor, Dr. Frederic Mohs, the surgery is a three-step process:
- Visible skin cancer on your face gets removed surgically.
- The Mohs surgeon immediately evaluates the removed tissue under a microscope to determine if the cancer has spread beyond the removed area. If the cancer has spread, the surgeon identifies its direction and repeats steps one and two until there is no trace of cancer. By removing the cancer one layer at a time, the surgeon removes very little healthy tissue. This leads to improved aesthetic results, which is especially important when the skin cancer is on your face.
- The final step is reconstructive surgery. This can be a simple stitching procedure, a skin graft or a more advanced procedure. Regardless, Mohs surgeons will begin reconstruction as soon the cancer is removed, sometimes in coordination with another specialist. As with the previous steps, there is no need for an operating room or hospital stay.
Life After Skin Cancer Treatment
Following Mohs surgery, you may want to take the day off work. You’ll also want to avoid exercise and other strenuous activities for a day or two. A week later, you’ll return for follow-up care. At that appointment, the surgeon removes your stitches and ensures you’re healing properly.
This is not, however, the end of your skin cancer journey. That journey will last a lifetime. Because once you have skin cancer, you’re at higher risk to experience it in the future.
After treating skin cancer on the face, you may need to visit a dermatologist for yearly check-ups, or a few times a year. These regular appointments help you catch skin cancer recurrence in its earliest, most treatable stages.
More to Read
- Everything You Need to Know About Skin Cancer Prevention
- Protect Your Skin From The Sun With These 8 Easy Tips
- Keep Yourself and Your Family Safe This Summer
- Here’s How to Stay Safe in the Summer Heat
Medically reviewed by Zaineb Hassan Makhzoumi, MD, MPH, FAAD.
