Concerned Wife's Cancer Fears Justified

Question:

My husband is 54 years old and has scaly spots on his forehead and the sides of his face. He says it is just dry skin, but he will not apply moisturizer. Recently one began to bleed slightly and now has a scab. He claims it is because he picked at the spot. I think he should see a dermatologist, because I think he has skin cancer. Am I being an over-reactive wife?

Answer:

Repeated sun exposure can cause skin damage, pre-skin cancer growths, and skin cancer, especially in fair-skinned individuals. The typical aging signs of sun damage include rough skin texture, poor skin tone, large pores, blotchy skin color, brown spots, and wrinkles. Sun damage can produce rough, small (3-6 mm) scaly spots of abnormal cells on the surface of the skin, which represent pre-skin cancers called “actinic keratosis.” These spots remain on the skin, even if the scaly portion is picked off by the individual. The spots feel rough to the touch and may be painful if large or irritated by picking or rubbing or even pressure from hats. Actinic keratosis is very common among golfers and others who participate in outdoor sports without adequate sun protection. Susceptible persons usually have more than one keratosis on areas of their bodies that have the most sun exposure. It is important to see a dermatologist right away to address these pre-skin cancers, as some may turn cancerous over time.

There are many ways to remove pre-skin cancers. The goal is removal with as little residual skin discoloration or scarring as possible. In many cases, with small actinic keratosis, they can be treated with liquid nitrogen or creams that kill the abnormal or pre-skin cancer cells. Both treatments cause a scab-like phase of healing with resolution of the actinic keratosis when healed. The healing process takes 2-4 weeks, depending on the size and location of the actinic keratosis. For instance, the hands heal slower than the face. The skin’s final appearance is usually excellent. There are times when the size of the growth and/or the fact that it is bleeding requires a skin biopsy to make sure the growth is not a skin cancer. This is an easy, in-office procedure.

Sun damage is cumulative over one’s lifetime and sun exposure history. Safe sun exposure should be your goal, using a sunscreen with an SPF of at least 30, containing micronized zinc oxide or titanium dioxide, in addition to other sunscreen ingredients in the product.