Most skin cancers are either basal or squamous cell carcinomas. Basal cell carcinomas develop from the lowest levels of the skin and tend to be very slow growing. Untreated basal cell carcinomas can invade the bone and muscles under the skin.
Unless they are completely removed, basal cell carcinomas will grow back. Squamous cell carcinomas develop from the upper layers of the skin, and can invade nearby tissues if not removed. Both types of skin cancer tend to develop on chronically sun-exposed parts of the body, such as the face, head, neck, and the backs of the hands.
After identification and diagnosis of skin cancer, the next step is treatment. Possible treatments include skin cancer surgery, radiation, targeted local therapies, and even chemotherapy. The type of treatment that is appropriate depends on the type of cancer, its size, and its location. However, practically all simple skin cancers are treated with surgical removal. Methods of performing surgical removal include:
- Excision – using a scalpel to cut out the lesion
- Curettage and electrodesiccation – using special instruments to remove superficial lesions
- Mohs surgery – microscopic surgery that removes one layer of skin at a time to conserve as much healthy skin as possible
Of course, most people are concerned about the possibility of scarring, particularly because skin cancers tend to occur in very visible locations. Both surgical excision and curettage techniques tend to leave a scar that is about an inch long. Mohs surgery is less likely to leave a visible scar and is often used to remove cancers from the face for this very reason.
In Mohs surgery, each layer of skin is removed and examined under a microscope for cancer cells. As soon as all of the cancer has been removed, the surgeon stops removing tissue. If scarring is a significant concern due to the location of the cancer, a plastic surgeon can step in after the dermatologist has removed the cancer and close the wound in such a way that visible scarring is minimized.
What to Expect
Unfortunately, until the surgeon begins work on removing the lesion, it is often unclear how much tissue will have to be removed. Lesions that appear to be superficial are occasionally found to have spread deeply or widely, requiring the removal of a much larger piece of tissue than was anticipated. Sometimes, skin grafts are necessary to close large excisions. However, modern cosmetic surgery techniques can reduce scarring to a minimum even when skin grafts are necessary, and plastic surgeons are skilled at hiding any resulting scars in the natural folds and creases of the face.
If a cosmetically displeasing scar does develop, treatments such as dermabrasion, lasers, and vitamin E creams can help improve the appearance of the scar. A scar revision surgery can also be performed by a cosmetic surgeon to remove or hide the scar. Today, patients should not be overly concerned about disfiguring scars from skin cancer treatment.
Schedule Your Consultation
At The John Bull Center for Cosmetic Surgery and Laser Medispa, Dr. John Bull works with each patient closely to determine the most effective treatment for his or her needs. Our medical team will be with you every step of the process to ensure you get the best possible results. Contact The John Bull Center today to schedule your consultation.